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

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

Children's Optical, LLC (NPI 1609112465)

Field	Value
Entity Type	Organization
Organization	Children's Optical, LLC
Address	13123 E 16th Ave # B430
City	Aurora
State	CO
ZIP	80045
Taxonomy	Pediatric Optometrist
NPI Enumerated	December 26, 2012

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
V2020	Frames, purchases	40,750	$40	$1.6M
V2784	Lens, polycarbonate or equal, any index, per lens	30,000	$30	$960.1K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	40,910	$20	$940.9K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	19,490	$40	$682K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	13,680	$40	$547.2K
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…	3,080	$90	$283.2K
V2025	Deluxe frame	3,060	$90	$275K
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.	2,370	$110	$263.3K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	5,150	$40	$185.3K
V2107	Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens	4,560	$40	$177.6K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Children's Optical, LLC — 9 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	60	410	370	$90	$187.5K
V2025	Deluxe frame	10	70	470	$90	$167.7K
V2020	Frames, purchases	6	320	440	$40	$122.9K
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.	56	450	250	$100	$120.7K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	10	210	540	$40	$115.1K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	1	90	350	$50	$93.6K
V2784	Lens, polycarbonate or equal, any index, per lens	9	320	510	$30	$87.3K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	6	290	560	$20	$67.4K
V2105	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens	3	40	260	$60	$57.8K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	13	170	150	$40	$41.1K

Showing 1–10 of 21

Nearby Providers

Other providers in the same ZIP code as Children's Optical, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Physicians Incorporated	CO	Internal Medicine Physician	$0	$190.8M
Children's Hospital Colorado	CO	Children's Hospital	$0	$114.9M
University Of Colorado Hospital Authority	CO	General Acute Care Hospital	$0	$58.1M
Prosthetic & Orthotic Group Pediatric Specialists - Colorado LLC	CO	Prosthetic/Orthotic Supplier	$0	$7.3M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$0	$6.7M
Rmchs Management	CO	Pediatric Dentistry	$0	$4.4M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$271.4K	$3.4M
Marisa Lau	CO	Ophthalmology Physician	$2M	$0
Jorge Monge Urrea	CO	Hematology & Oncology Physician	$1.9M	$18.9K
University Physicians Incorporated	CO	Clinical Medical Laboratory	$509.9K	$886.9K

Children's Optical, LLC — Billing Profile & Reimbursement Data

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Children's Optical, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References