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

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

Heights Eyecare, Inc. (NPI 1558431148)

Field	Value
Entity Type	Organization
Organization	Heights Eyecare, Inc.
Address	430 Lake Elmo Dr
City	Billings
State	MT
ZIP	59105
Taxonomy	Optometrist
NPI Enumerated	November 9, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 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…	6,400	$100	$614K
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.	3,090	$110	$352.1K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	6,370	$30	$178.4K
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.	10,810	$20	$173K
92065	The physician or other qualified healthcare professional trains the patient to perform exercises for vision therapy.	620	$40	$27.2K
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…	260	$70	$17.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Heights Eyecare, Inc. — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

6 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…	346	520	730	$40	$196.4K
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…	7	130	600	$90	$120.9K
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.	9	120	440	$110	$96K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	7	120	760	$20	$40.9K
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	130	1,300	$20	$37K
92065	The physician or other qualified healthcare professional trains the patient to perform exercises for vision therapy.	1	10	250	$40	$12.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Heights Eyecare, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brian Linde	MT	Optometrist	$67.6K	$0
Brad Kimball	MT	Optometrist	$59K	$0

Nearby Providers

Other providers in the same ZIP code as Heights Eyecare, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Option 1 Nutrition Solutions LLC	MT	Durable Medical Equipment & Medical Supplies	$0	$3.7M
Trailhead Pediatric Dentistry	MT	Pediatric Dentistry	$0	$2.5M
Lasting Legacy Assisted Living, LLC	MT	Assisted Living Facility	$0	$1.2M
J&j Caregivers, LLC	MT	Assisted Living Facility	$0	$1.1M
Edgewood Vista	MT	Assisted Living Facility	$0	$853.6K
Crossway Incorporated	MT	Mental Health Counselor	$0	$622.6K
Mark S Rosebush	MT	General Practice Dentistry	$0	$572.4K
Steven Biondich	MT	Professional Counselor	$0	$530.3K
Destination Zen	MT	Professional Counselor	$0	$480.9K
Primrose Inc	MT	Assisted Living Facility	$0	$388.8K

Heights Eyecare, Inc. — Billing Profile & Reimbursement Data

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Heights Eyecare, Inc. — 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