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

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

Idaho Eye Pros Idaho Falls LLC (NPI 1528494465)

Field	Value
Entity Type	Organization
Organization	Idaho Eye Pros Idaho Falls LLC
Address	2990 S 25th E
City	Idaho Falls
State	ID
ZIP	83404
Taxonomy	Optometrist
NPI Enumerated	September 24, 2013

Payer Source	Total Paid
Medicaid	$349.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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…	2,290	$90	$201.1K
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.	840	$110	$95.3K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	1,680	$20	$38.6K
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…	70	$110	$7.4K
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.	3,060	$1	$3.1K
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…	30	$80	$2.2K
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…	20	$80	$1.4K
V2020	Frames, purchases	1,420	$0	$0
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	20	$0	$0
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	890	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Idaho Eye Pros Idaho Falls LLC — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	598	670	740	$40	$193.6K
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…	583	620	560	$60	$191.8K
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…	17	160	320	$90	$92.8K
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.	20	130	120	$110	$50.2K
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…	90	180	70	$110	$45.6K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	29	130	460	$20	$35.7K
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.	12	120	350	$1	$1.9K
V2020	Frames, purchases	2	10	250	$1	$110
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	3	10	370	$0	$0
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	2	10	890	$0	$0

Related Providers

Other providers that share a Tax Identification Number (TIN) with Idaho Eye Pros Idaho Falls LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lwk, P.C.	ID	Optometrist	$0	$484.6K
James Else	IA	Optometrist	$35.4K	$237.7K
Kacey Blaylock	ID	Optometrist	$92.7K	$0
Zachary Oswald	MT	Optometrist	$75.3K	$0
Jason Besecker	ID	Optometrist	$35.1K	$0

Nearby Providers

Other providers in the same ZIP code as Idaho Eye Pros Idaho Falls LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain View Hospital LLC	ID	General Acute Care Hospital	$0	$45.7M
Eastern Idaho Health Services Inc	ID	General Acute Care Hospital	$0	$12.1M
Rm Lab LLC	ID	Clinical Medical Laboratory	$1.1M	$8.2M
Medical Center For Children & Adolescents, PA	ID	Pediatrics Physician	$0	$8.8M
Aaa American Healthcare LLC	ID	Mental Health Counselor	$0	$8.7M
Intermountain Emergency Physicians	ID	Emergency Medicine Physician	$0	$6.6M
24-7 Professional Solutions	ID	In Home Supportive Care Agency	$0	$5.9M
Just 4 Kids Health LLC	ID	Urgent Care Clinic/Center	$0	$5.2M
Foothills Rehabilitation & Performance Services, PLLC	ID	Physical Therapist	$0	$5M
Innovative Health Care Concepts, Inc	ID	Developmental Disabilities Clinic/Center	$0	$4.8M

Idaho Eye Pros Idaho Falls LLC — Billing Profile & Reimbursement Data

Sign up for Idaho Eye Pros Idaho Falls LLC — Billing Profile & Reimbursement Data policy alerts

Idaho Eye Pros Idaho Falls LLC — Billing Profile & Reimbursement Data

Sign up for Idaho Eye Pros Idaho Falls LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References