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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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 Associates (NPI 1518973056)

Field	Value
Entity Type	Organization
Organization	Advanced Eye Care Associates
Address	780 North Main St.
City	Providence
State	RI
ZIP	02904
Taxonomy	Optometrist
NPI Enumerated	August 1, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,540	$50	$265.8K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	7,520	$30	$188.1K
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.	8,140	$20	$154.7K
V2020	Frames, purchases	7,690	$20	$138.3K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	6,600	$20	$118.8K
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…	1,690	$30	$57.5K
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…	700	$70	$49.7K
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…	570	$80	$47.5K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	5,930	$10	$47.4K
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.	460	$60	$27.4K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Advanced Eye Care Associates — 6 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

19 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…	463	1,730	220	$70	$75.2K
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…	88	2,050	300	$50	$72.3K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	4	110	200	$40	$44K
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…	161	300	50	$130	$40.6K
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…	55	350	80	$90	$40.5K
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…	26	190	230	$40	$35K
V2020	Frames, purchases	9	180	380	$20	$31K
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…	15	40	70	$50	$27.6K
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.	5	200	360	$20	$23.8K
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.	24	120	100	$70	$22.1K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jared Cox	GA	Optometrist	$23.3K	$525.1K
Scott Sylvia	RI	Optometrist	$10K	$316.6K
Matthew Doyle	RI	Optometrist	$78.8K	$95.5K
Monserrat Arias	MA	Optometrist	$16.5K	$24.2K
John Corrow	RI	Optometrist	$26.4K	$13.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Providence Center Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$170.9M
Re-focus Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$102.5M
Hopehealth Hospice & Palliative Care	RI	Community Based Hospice Care Agency	$0	$33.3M
Mas Medical Staffing	RI	Home Health Agency	$0	$24.5M
Generations Adult Day Health Center	RI	Adult Day Care Clinic/Center	$0	$16.3M
Prospect Chartercare Sjhsri, LLC	RI	General Acute Care Hospital	$0	$10.9M
Global Homecare And Staffing Inc	RI	Home Health Agency	$0	$8.3M
Emergency Care Services Of New England PC	RI	Emergency Medicine Physician	$0	$6.9M
State Of Rhode Island	RI	Clinical Medical Laboratory	$570	$6.4M
The Providence Center	RI	Community/Behavioral Health Agency	$0	$5.9M

Advanced Eye Care Associates — Billing Profile & Reimbursement Data

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Advanced Eye Care Associates — 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