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.

Advanced Eye Care P A (NPI 1467420414)

Field	Value
Entity Type	Organization
Organization	Advanced Eye Care P A
Address	213 Greenhill Ave
City	Wilmington
State	DE
ZIP	19805
Taxonomy	Corneal and Contact Management Optometrist
NPI Enumerated	March 8, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

26 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…	5,170	$50	$237.7K
V2020	Frames, purchases	5,360	$30	$176.7K
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…	3,390	$40	$148.9K
S0621	Routine ophthalmological examination including refraction; established patient	2,220	$50	$119.6K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	2,060	$50	$106.9K
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…	2,860	$30	$80K
S0620	Routine ophthalmological examination including refraction; new patient	1,230	$60	$76.4K
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.	1,070	$60	$68.3K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1,710	$30	$53K
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,…	2,650	$20	$50.3K

Showing 1–10 of 26

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

Advanced Eye Care P A — 2 of 25 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	7	10	1,460	$50	$429.3K
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…	149	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…	275	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…	5	40	330	$50	$172.4K
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.	6	20	1,530	$20	$170.6K
92226	N/A	2	10	80	$20	$109K
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…	164	180	220	$90	$101.5K
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…	173	190	240	$60	$90.8K
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.	7	30	150	$70	$55.7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	8	50	540	$40	$53.9K

Showing 1–10 of 26

Related Providers

Other providers that share a Tax Identification Number (TIN) with Advanced Eye Care P A, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wayne Dunn	PA	Ophthalmology Physician	$425.6K	$0
Michael Brosman	DE	Ophthalmology Physician	$344.5K	$0
Jurij Bilyk	PA	Ophthalmic Plastic and Reconstructive Surgery Physician	$205K	$0

Nearby Providers

Other providers in the same ZIP code as Advanced Eye Care P A, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$56.8M
St. Francis Hospital Inc.	DE	General Acute Care Hospital	$0	$43.2M
Always Best Care Of Delaware	DE	Home Health Agency	$0	$38.1M
State Of Delaware Dscyf	DE	Adolescent and Children Mental Health Clinic/Center	$0	$36.5M
Westside Family Healthcare, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$34.3M
Brandywine Counseling & Community Services, Inc.	DE	Adult Mental Health Clinic/Center	$170.8K	$23.9M
Connections Community Support Programs, Inc.	DE	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.4M
St Anthony's Community Center Inc	DE	Meals Provider	$0	$4.6M
Emergency Physician Associates Of Delaware PC	DE	Emergency Medicine Physician	$0	$4.2M
Horizon House Delaware Inc	DE	Case Management Agency	$0	$3.8M

Advanced Eye Care P A — Billing Profile & Reimbursement Data

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Advanced Eye Care P A — 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