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.

Pediatric Ophthalmology & Strabismus Associates Inc (NPI 1578678777)

Field	Value
Entity Type	Organization
Organization	Pediatric Ophthalmology & Strabismus Associates Inc
Address	2 Dudley St
City	Providence
State	RI
ZIP	02905
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 20, 2006

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
V2020	Frames, purchases	14,360	$60	$804.3K
V2784	Lens, polycarbonate or equal, any index, per lens	24,740	$30	$717.4K
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…	12,580	$60	$692K
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…	6,020	$100	$626.5K
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…	6,960	$70	$501K
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.	3,880	$120	$480.7K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	15,250	$20	$320.1K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	11,260	$30	$315.3K
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.	7,600	$20	$167.1K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	4,440	$30	$133.3K

Showing 1–10 of 21

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

Pediatric Ophthalmology & Strabismus Associates Inc — 13 of 21 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1	10	1,450	$60	$145.8K
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…	1,689	1,730	220	$70	$75.2K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	2	110	200	$40	$44K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	84	100	70	$50	$42.2K
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…	254	300	50	$130	$40.6K
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	190	230	$40	$35K
V2020	Frames, purchases	2	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…	1	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.	6	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.	1	120	100	$70	$22.1K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pediatric Ophthalmology & Strabismus Associates Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Tien	RI	Ophthalmology Physician	$1.1K	$1M
Michael Langue	RI	Ophthalmology Physician	$9.1K	$471.2K
Tineke Chan	RI	Ophthalmology Physician	$2.9K	$341.6K

Nearby Providers

Other providers in the same ZIP code as Pediatric Ophthalmology & Strabismus Associates Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Women & Infants Hospital Of Rhode Island	RI	General Acute Care Hospital	$0	$132.1M
Elmwood Home Care, Inc.	RI	Home Health Agency	$0	$38.6M
H&t Medicals, Inc	RI	Home Health Agency	$0	$14.8M
R.i.s.a.t., LLC	RI	Methadone Clinic	$321.1K	$14M
Meeting Street Center	RI	Early Intervention Provider Agency	$0	$13.8M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$13.4M
Rhode Island Hospital	RI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$13.2M
Women And Infants Hospital	RI	General Acute Care Hospital	$0	$12.6M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Renaissance Adhc, LLC	RI	Adult Day Care Clinic/Center	$0	$7.4M

Pediatric Ophthalmology & Strabismus Associates Inc — Billing Profile & Reimbursement Data

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Pediatric Ophthalmology & Strabismus Associates 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