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

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

Southeast Eye Specialists PLLC (NPI 1518961176)

Southeast Eye Specialists PLLC is a ophthalmology physician provider located in Chattanooga, Tennessee. This profile covers 0 Medicare and 35 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Southeast Eye Specialists PLLC
Address	7268 Jarnigan Rd
City	Chattanooga
State	TN
ZIP	37421
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 10, 2005

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

35 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…	17,270	$60	$967.2K
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…	10,160	$60	$640.3K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	7,140	$90	$620.9K
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…	13,780	$30	$468.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,610	$90	$321.5K
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.	7,850	$40	$298.1K
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.	2,610	$40	$114.9K
92285	Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.	1,720	$30	$54.9K
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…	1,700	$30	$52.8K
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,…	1,240	$40	$51.9K

Showing 1–10 of 35

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Southeast Eye Specialists PLLC — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

35 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…	188	3,760	610	$40	$202.3K
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.	11	40	760	$50	$193K
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…	1,296	4,050	620	$30	$183.9K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	1	70	250	$110	$96.9K
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…	2	40	660	$40	$92.1K
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…	19	1,080	120	$80	$90.7K
J9035	Injection, bevacizumab, 10 mg	13	30	780	$20	$65.7K
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…	466	710	340	$50	$60K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	660	190	$60	$53.3K
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…	296	1,240	120	$60	$53.1K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Randall Funderburk	TN	Retina Specialist (Ophthalmology) Physician	$2.4M	$0
Maria Stephanie Jardeleza	NC	Ophthalmology Physician	$1.4M	$0
John Stone	TN	Retina Specialist (Ophthalmology) Physician	$724.5K	$0
Heikki Kostamaa	TN	Retina Specialist (Ophthalmology) Physician	$608K	$0
Daryl Mcdaniel	TN	Glaucoma Specialist (Ophthalmology) Physician	$476.8K	$0
John Bierly	TN	Ophthalmology Physician	$423.8K	$0
Daniel Bregman	TN	Ophthalmology Physician	$416.9K	$0
John Kim	TN	Ophthalmology Physician	$285K	$0
Morgan Parker	TN	Ophthalmology Physician	$270.6K	$0
Trey Pegram	TN	Ophthalmic Plastic and Reconstructive Surgery Physician	$225.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Parkridge Medical Center, Inc.	TN	Psychiatric Hospital Unit	$0	$52.8M
Dx Mso, PLLC	TN	Urgent Care Clinic/Center	$0	$13.3M
Independent Physical Therapy, LLC	TN	Physical Therapist	$0	$12.3M
Comprehensive Medical Care, P.C.	TN	Pediatrics Physician	$0	$12M
Chattanooga Allergy Clinic , PLLC	TN	Allergy & Immunology Physician	$0	$9M
Hospice Of Chattanooga Holdings, LLC	TN	Community Based Hospice Care Agency	$0	$5.3M
Advanced Respiratory, Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$4.6M
Allied Pediatrics PLLC	TN	Pediatrics Physician	$0	$4.2M
Restoration Recovery, PLLC	TN	Addiction Medicine (Preventive Medicine) Physician	$0	$4.1M
Hamilton County Department Of Education	TN	Local Education Agency (LEA)	$0	$3.7M

Southeast Eye Specialists PLLC — Billing Profile & Reimbursement Data

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Southeast Eye Specialists PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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