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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

En Ophthalmology Services P S C (NPI 1487041968)

Field	Value
Entity Type	Organization
Organization	En Ophthalmology Services P S C
Address	E1 Calle Fernandez Vanga Suite 2
City	Manati
State	PR
ZIP	00674
Taxonomy	Ophthalmology Physician
NPI Enumerated	April 22, 2015

Payer Source	Total Paid
Medicaid	$952.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	8,330	$70	$575K
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.	1,020	$120	$124.7K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	2,350	$50	$112.6K
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.	3,070	$30	$98.3K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	2,790	$10	$22.4K
92226	N/A	2,480	$1	$5K
92225	N/A	700	$10	$4.9K
V2020	Frames, purchases	60	$80	$4.4K
92020	The provider examines the angle of the anterior chamber of the eye (the angle where the iris and cornea meet) using a special lens (goniolens) and slit–lamp or operating microscope to diagnose and…	1,920	$1	$3.8K
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,…	70	$10	$870

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

En Ophthalmology Services P S C — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	19	350	540	$50	$96.4K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	50	440	370	$40	$38.5K
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.	76	530	630	$20	$32K
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.	21	200	120	$80	$30.5K
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,…	126	160	420	$20	$26.4K
V2020	Frames, purchases	167	230	230	$40	$17.5K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	69	80	180	$30	$16.8K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	5	80	200	$20	$15.1K
92226	N/A	13	80	740	$10	$9.5K
92225	N/A	30	120	280	$10	$7.8K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as En Ophthalmology Services P S C, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Pathology Csp	PR	Clinical Medical Laboratory	$0	$16.9M
Pci Group LLC	PR	Interventional Cardiology Physician	$0	$9.6M
Centro Cardiovascular De Manati Iii Csp	PR	Cardiovascular Disease Physician	$0	$5.7M
Anestesia Del Norte P.s.c.	PR	Specialist	$0	$5M
Mogic Ob-gyn Psc	PR	Obstetrics & Gynecology Physician	$0	$4.9M
Dorado Health Inc	PR	General Acute Care Hospital	$0	$3.7M
Dentistas Asociados Del Norte	PR	General Practice Dentistry	$0	$3M
Crilomil Corp.	PR	Pediatric Dentistry	$0	$2.8M
Hospitalist Medical Services, Psc	PR	Anesthesiology Physician	$0	$2.7M
Atlantic Pathology	PR	Clinical Medical Laboratory	$0	$2.5M

En Ophthalmology Services P S C — Billing Profile & Reimbursement Data

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En Ophthalmology Services P S C — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References