Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or South Dakota for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to South Dakota only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. South Dakota (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Vision Care Associates, LLP (NPI 1265502264)

Field	Value
Entity Type	Organization
Organization	Vision Care Associates, LLP
Address	310 8th Ave Nw
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Optometrist
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

Key Findings

VISION CARE ASSOCIATES, LLP is effectively a single-payer Medicaid provider: lifetime Medicaid revenue is $6M and there is none below for Medicare (no Medicare billing on file). The practice has an established NPI enumerated 2006-11-08 (~20 years ago), indicating long-tenured operations in ABERDEEN, SD focused on payer-reimbursed clinical and optical services.

Revenue is highly concentrated in a narrow set of ophthalmic/optical codes: the top three Medicaid codes 92014, V2020, and V2199 together account for 71.5% of this provider's total Medicaid revenue (92014: $1.7M, 28.0%; V2020: $1.4M, 23.9%; V2199: $1.2M, 19.5%). This concentration shows that the bulk of dollars come from comprehensive eye exams and frame/lens purchases rather than a broad mix of medical or surgical ophthalmology services.

The code mix supports a retail optometry/optical dispensing business model: 92014 and 92004 are high-revenue exam codes (92004: $964.7K, 16.1%) while V2020 (Frames, purchases) and V2199 (single vision lens) together drive substantial frame/lens revenue. High claim volumes for dispensing and refraction-related codes (e.g., V2020 25.1K claims; V2199 19.8K claims; 92015 28.7K claims) suggest significant on-site eyewear sales and routine vision service throughput in addition to clinical exams.

On statewide competitive standing, this provider is a dominant outlier for its top services: 92014 ranks #1 of 131 providers in-state (100th percentile; extreme outlier), V2020 ranks #1 of 110 providers (100th percentile; extreme outlier), and V2199 ranks #1 of 98 providers (100th percentile; extreme outlier). These rank/percentile positions indicate an unusually large share of in-state volume for comprehensive exams and optical dispensing compared with peers.

While optical and comprehensive exam codes dominate revenue, clinical evaluation-and-management and diagnostic codes show modest, typical volumes: 99213 accounts for $69.6K (1.2%) and ranks #109 of 344 providers in-state (69th percentile), and retinal/imaging codes such as 92134 and 92133 produce comparatively small revenues ($8.9K and $7.7K respectively). This suggests the practice operates primarily as an optometry/optical provider rather than as a specialty retinal or medical ophthalmology referral center.

Some codes appear as high-volume administrative or quality-reporting claims with no direct payment: G8427 has 4.2K claims with $0 paid and ranks #1 of 16 providers in-state (100th percentile; extreme outlier), and other measure codes such as G9368, 2022F, and G8731 also show claims with $0 paid. These entries point to extensive documentation or quality-measure reporting activity that does not contribute to gross Medicaid revenue but may reflect program participation or reporting practices.

Several secondary lens and specialty-lens codes (V2299 $260.9K, 4.4% and V2781 $23.8K, 0.4%) also rank at or near the top in-state (V2299 #1 of 10 providers; V2781 #1 of 5 providers), indicating the practice captures a wide array of optical product types beyond basic frames and single-vision lenses. For payers, this mix signals the provider is a key source of both routine eyewear and higher-priced specialty lens services within the state.

For payer strategy and network considerations, VISION CARE ASSOCIATES represents a major in-state supplier for Medicaid beneficiaries needing comprehensive eye exams and optical products given its top rankings and revenue concentration. Absent any Medicare billing, contracting or utilization reviews should be framed around Medicaid volumes, optical dispensing practices, and the high concentration in a small set of claim lines rather than a diversified medical ophthalmology service mix.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	20,450	$80	$1.7M
V2020	Frames, purchases	25,110	$60	$1.4M
V2199	Not otherwise classified, single vision lens	19,830	$60	$1.2M
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	8,610	$110	$964.7K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	28,720	$10	$287.2K
V2299	Specialty bifocal (by report)	2,780	$90	$260.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2,490	$30	$69.6K
V2784	Lens, polycarbonate or equal, any index, per lens	1,400	$40	$50.2K
V2781	Progressive lens, per lens	180	$140	$23.8K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	410	$30	$13.1K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

Claims Volume vs. South Dakota Distribution

Vision Care Associates, LLP — 8 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	109	340	1,010	$100	$511K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	236	260	860	$80	$222.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	75	160	210	$120	$97.4K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	1	130	390	$90	$86.6K
V2020	Frames, purchases	1	110	550	$50	$82K
V2199	Not otherwise classified, single vision lens	1	100	410	$60	$75.3K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	1	110	180	$110	$72.7K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	17	30	210	$80	$40.5K
V2299	Specialty bifocal (by report)	1	10	30	$90	$32.5K
V2784	Lens, polycarbonate or equal, any index, per lens	6	50	190	$40	$25.5K

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with Vision Care Associates, LLP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Craig Dockter	SD	Optometrist	$109K	$0
Aaron Feser	SD	Optometrist	$103.4K	$0
Marshall Dorsett	SD	Optometrist	$66.4K	$0
John Olson	SD	Optometrist	$55.4K	$0
Elizabeth Groetken	IA	Optometrist	$25.5K	$0
Dawn Wattenhofer	SD	Optometrist	$23.7K	$0

Nearby Providers

Other providers in the same ZIP code as Vision Care Associates, LLP, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Northeastern Mental Health Center	SD	Mental Health Counselor	$0	$10.1M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Fettig And Drake Dds PC	SD	General Practice Dentistry	$0	$1M

Vision Care Associates, LLP — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References