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

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

Sussex Eye Center PA (NPI 1427090570)

Field	Value
Entity Type	Organization
Organization	Sussex Eye Center PA
Address	502 W Market St
City	Georgetown
State	DE
ZIP	19947
Taxonomy	Optometrist
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$851.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,150	$70	$286.4K
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…	1,470	$70	$108.8K
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…	2,380	$40	$104.5K
V2020	Frames, purchases	2,310	$40	$89.9K
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.	6,530	$10	$71.8K
S0621	Routine ophthalmological examination including refraction; established patient	890	$60	$51.7K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1,230	$30	$32K
V2784	Lens, polycarbonate or equal, any index, per lens	1,040	$30	$28K
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,…	990	$30	$25.8K
S0620	Routine ophthalmological examination including refraction; new patient	260	$60	$15.4K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Sussex Eye Center PA — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	136	500	1,130	$50	$235.1K
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…	180	540	1,100	$40	$185.3K
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…	26	40	330	$50	$172.4K
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…	37	190	240	$60	$90.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	26	30	460	$20	$68.7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	27	50	540	$40	$53.9K
V2020	Frames, purchases	15	60	530	$30	$46.3K
S0621	Routine ophthalmological examination including refraction; established patient	14	40	420	$40	$42.2K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	5	10	770	$30	$33.9K
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,…	4	10	160	$30	$28.8K

Showing 1–10 of 33

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sussex Eye Center PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aimee Parker	DE	Optometrist	$149.1K	$0
Myloan Nguyen	DE	Optometrist	$129.9K	$3K
Hayley Sprague	DE	Optometrist	$111.2K	$0
Rachel Hartman	DE	Optometrist	$59.9K	$22.4K
Carl Maschauer	VI	Optometrist	$10.8K	$0

Nearby Providers

Other providers in the same ZIP code as Sussex Eye Center PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Packd LLC	DE	In Home Supportive Care Agency	$0	$31M
Sea Care LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$10.1M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$7.3M
Cheer, Inc.	DE	Home Health Agency	$0	$7.3M
Rainbow Pediatrics	DE	Pediatrics Physician	$0	$5.6M
Wilmington Orthodontic Center	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.8M
Horizon House Delaware Inc.	DE	Case Management Agency	$0	$3.3M
La Red Health Center Inc	DE	Federally Qualified Health Center (FQHC)	$0	$3.1M
Fellowship Health Resources, Inc	DE	Community/Behavioral Health Agency	$0	$2.8M
Nutrihealth LLC	DE	Internal Medicine Physician	$0	$994.6K

Sussex Eye Center PA — Billing Profile & Reimbursement Data

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Sussex Eye Center PA — 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