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 Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania 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. Pennsylvania (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.

Lisa Dowling (NPI 1275552721)

Field	Value
Entity Type	Individual
Organization	Lisa Dowling
Address	650 Old Willow Ave Ste L
City	Honesdale
State	PA
ZIP	18431
Taxonomy	Optometrist
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicare	$18.5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 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…	210	$70	$14K
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.	20	$90	$1.9K
92100	Code 92100 describes multiple measurements of intraocular pressure taken over a given time period on a single day in order to monitor response to treatment or document pressure changes throughout the…	20	$50	$900
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	30	$30	$880
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,…	20	$30	$490
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,…	20	$20	$330

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Lisa Dowling — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92014	566	1,570	130	$80	$21K
92134	873	1,320	60	$30	$8.4K
92004	716	1,060	30	$100	$5K
92100	8	10	30	$60	$4.1K
92250	1,120	1,270	60	$30	$2.9K
99212	3,441	4,720	30	$40	$2.3K

Nearby Providers

Other providers in the same ZIP code as Lisa Dowling, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wayne Memorial Community Health Centers	PA	Federally Qualified Health Center (FQHC)	$0	$17.1M
Wayne Memorial Community Health Centers	PA	Federally Qualified Health Center (FQHC)	$0	$10.5M
Wayne Memorial Hospital	PA	General Acute Care Hospital	$0	$9.2M
Mountain Laurel Surgery Center, LLC	PA	Ambulatory Surgical Clinic/Center	$618.5K	$445.8K
Medical Shoppe Ltd	PA	Pharmacy	$104.7K	$789.2K
Philip Liu	PA	Otolaryngology Physician	$468.7K	$0
Glenn Woodley	PA	Foot & Ankle Surgery Podiatrist	$268.1K	$280
David Reynolds	PA	Gastroenterology Physician	$194.7K	$0
Sean Mcveigh	PA	Pulmonary Disease Physician	$108.8K	$0
Walter Kaniefski	PA	Emergency Medicine Physician	$47.3K	$4K

Lisa Dowling — Billing Profile & Reimbursement Data

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Lisa Dowling — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References