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

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

Tri-state Doctors Of (NPI 1275617276)

Field	Value
Entity Type	Organization
Organization	Tri-state Doctors Of
Address	4655 Outer Loop
City	Louisville
State	KY
ZIP	40219
Taxonomy	Eyewear Supplier
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 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…	24,310	$60	$1.3M
V2020	Frames, purchases	39,610	$20	$792.3K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	27,450	$20	$631.3K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	38,140	$20	$610.2K
V2784	Lens, polycarbonate or equal, any index, per lens	27,260	$10	$354.3K
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.	3,780	$40	$162.4K
V2781	Progressive lens, per lens	2,130	$30	$61.6K
V2200	Sphere, bifocal, plano to plus or minus 4.00d, per lens	2,430	$20	$51K
92341	Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision.	1,480	$20	$32.5K
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.	3,100	$10	$27.9K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Tri-state Doctors Of — 11 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

23 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…	2,648	3,340	1,020	$30	$296K
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…	1,850	2,460	580	$40	$245K
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…	3	710	790	$60	$98.4K
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.	32	680	410	$80	$69.5K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	1	590	730	$40	$62.5K
V2020	Frames, purchases	4	530	530	$20	$55.2K
99203	The provider sees a new 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 provider…	747	1,400	130	$50	$45.8K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	4	360	270	$20	$33.2K
V2781	Progressive lens, per lens	3	30	360	$30	$23K
V2200	Sphere, bifocal, plano to plus or minus 4.00d, per lens	6	60	170	$20	$18.1K

Showing 1–10 of 23

Related Providers

Other providers that share a Tax Identification Number (TIN) with Tri-state Doctors Of, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$4.3M
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$3.8M
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$3.6M
Dr. Mark Lynn & Associates, PLLC	TN	Optometrist	$0	$3.2M
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$2.9M
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$2.8M
Ronald Fary	IL	Optometrist	$167.3K	$349.7K
Adam Mueller	KY	Optometrist	$141.5K	$277.7K
Joseph Summers	TN	Optometrist	$51.4K	$345.5K
Haleigh Shipp	KY	Optometrist	$91.1K	$257.1K

Nearby Providers

Other providers in the same ZIP code as Tri-state Doctors Of, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nulease Medical Solutions LLC	KY	Addiction Medicine (Family Medicine) Physician	$0	$23.6M
Kids Dentistry-jefferson Mall,pllc	KY	Dental Clinic/Center	$0	$9.8M
Kentuckiana Foot & Ankle PLLC	KY	Foot & Ankle Surgery Podiatrist	$0	$4.4M
Okolona Fire Protection District	KY	Land Ambulance	$659.2K	$2.9M
Landmark Recovery Of Kentucky LLC	KY	Substance Abuse Rehabilitation Facility	$0	$3.3M
Bita Tabassi	KY	Optometrist	$10.8K	$142.4K
Charla Glover	KY	Family Nurse Practitioner	$144.4K	$0
Joshua Quaye	KY	Internal Medicine Physician	$140.3K	$0
Amanda Denzik	KY	Foot & Ankle Surgery Podiatrist	$113.6K	$0
Mark Harris	KY	Family Nurse Practitioner	$89.1K	$0

Tri-state Doctors Of — Billing Profile & Reimbursement Data

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Tri-state Doctors Of — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References