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

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

Advanced Eyecare, LLC (NPI 1376931329)

Field	Value
Entity Type	Organization
Organization	Advanced Eyecare, LLC
Address	736 Route 4
City	Sinajana
State	GU
ZIP	96910
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 29, 2014

Payer Source	Total Paid
Medicaid	$813.8K
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only biller: there is no Medicare revenue on file and total Medicaid revenue is $813.8K, indicating reliance on a single public payer for all reported fee-for-service activity. Analysts should treat payer-mix risk as concentrated on Medicaid reimbursement and utilization trends.

Revenue is highly concentrated in a few procedures: the precomputed top 3 Medicaid codes by revenue account for 80.5% of this provider's total Medicaid revenue, with a single code, J0178, contributing $361.5K (44.4% of Medicaid revenue). That concentration makes the practice financially sensitive to changes in anti-VEGF utilization, pricing, or coverage for aflibercept.

The code mix points to a retina-focused ophthalmology practice that delivers high-volume injection and diagnostic services: J0178 (224 claims, $1614 avg paid/claim), 67028 (1K claims, $94 avg paid/claim), and supporting diagnostic codes such as 92250 (2.6K claims, $27 avg paid/claim) and 92134 (292 claims, $27 avg paid/claim) together suggest routine intravitreal injection clinics plus ongoing retinal imaging. These procedure and imaging volumes imply regular follow-up care for retinal disease rather than a predominantly surgical cataract practice.

J0178 shows dominant revenue share within this provider but limited peer context: it ranks #1 of 1 providers in-state and is described as "0th percentile; no state peer volume comparison available," meaning this provider is the sole in-state reporter for aflibercept at Medicaid in the dataset and direct state-peer volume comparisons are not available. Operationally, that sole-reporter status should be interpreted cautiously—high local dependence on aflibercept is clear, but competitive positioning versus other in-state offices is not measurable from these data.

For routine ophthalmic visits and follow-up care the provider appears competitive in-state: 92014 has 2.4K claims and $198.7K revenue and ranks #1 of 4 providers in-state (100th percentile; typical, unremarkable volume for this code), while 67028 ranks #1 of 3 (100th percentile; typical, unremarkable volume). In plain terms, the practice is the highest-volume biller among a small set of in-state peers for these common codes, but the underlying report labels these volumes as typical rather than unusually high relative to normal clinical expectations.

Ancillary and compound services are present but small in revenue: 92250 accounts for $70.9K and 92134 for $7.9K, while J7999 (compounded drug) appears with 71 claims and $5.2K revenue (rank #1 of 2 in-state, 100th percentile; typical). This mix indicates an operational model that pairs therapeutic injections with imaging and occasional compounded medications for retinal care and monitoring.

The provider shows ongoing new-patient intake as well as high follow-up throughput: 99204 appears with 399 claims and $58.3K revenue (rank #4 of 20 in-state, 84th percentile; typical), while 92014 (established patient comprehensive exams) is a large volume service. This combination suggests a workflow that accommodates both initial evaluations and frequent established-patient management, consistent with chronic retinal disease care pathways.

Tenure in the Medicare/Medicaid enrollment file is long-standing: the NPI was enumerated on 2014-12-29 (~12 years ago), indicating the provider has been active under this identifier for over a decade. That duration supports interpretation of the observed code mix as a stable practice pattern rather than a short-term or new entrant phenomenon.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	220	$1,610	$361.5K
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…	2,370	$80	$198.7K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,010	$90	$94.8K
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,…	2,630	$30	$70.9K
99204	The provider sees a new 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 provider…	400	$150	$58.3K
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…	130	$60	$8.2K
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.	290	$30	$7.9K
J7999	Compounded drug, not otherwise classified	70	$70	$5.2K
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.	30	$130	$4.1K
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.	140	$20	$2.6K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Guam Distribution

Advanced Eyecare, LLC — 4 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. Guam median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	1	10	220	$1,610	$361.5K
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	10	1,030	$80	$92.4K
V2199	Not otherwise classified, single vision lens	4	10	480	$120	$63.3K
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,…	1	10	1,320	$30	$36.3K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1	10	40	$90	$32.7K
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…	3	10	350	$70	$28.2K
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.	4	10	230	$120	$27.3K
99204	The provider sees a new 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 provider…	4	20	60	$140	$20.8K
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.	4	10	900	$20	$15.9K
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.	2	10	290	$30	$13.1K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as Advanced Eyecare, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rsa - Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.4M
Pacific Med & Nephrology	GU	Multi-Specialty Clinic/Center	$0	$2.3M
Guam Fire Department	GU	Land Ambulance	$277.5K	$1.3M
Peter Lombard	GU	Ophthalmology Physician	$575.7K	$0
Robert Nerves	GU	Nephrology Physician	$238.7K	$0
Kunsun Lee	GU	Dentist	$0	$168.2K
Ideal Vision Center LLC	GU	Clinic/Center	$0	$81.5K
Saied Safabakhsh	GU	Nephrology Physician	$68K	$0
Evangeline Claassens	GU	Family Nurse Practitioner	$39.4K	$0
Carla Haddock	GU	Family Nurse Practitioner	$34K	$0

Advanced Eyecare, LLC — Billing Profile & Reimbursement Data

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Advanced Eyecare, LLC — 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

Nearby Providers

Frequently Asked Questions

References