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

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

Eye Clinic Of Fairbanks, Inc (NPI 1689903965)

Eye Clinic Of Fairbanks, Inc is a ophthalmology physician provider located in Fairbanks, Alaska. This profile covers 0 Medicare and 28 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Eye Clinic Of Fairbanks, Inc
Address	116 Minnie St
City	Fairbanks
State	AK
ZIP	99701
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 15, 2009

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

28 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…	9,980	$150	$1.5M
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.	4,770	$190	$895.8K
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.	17,230	$30	$465.1K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	9,980	$50	$459.2K
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…	3,450	$90	$310.7K
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…	1,320	$70	$88.4K
92341	Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision.	1,360	$50	$70.7K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	560	$60	$35K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	1,130	$30	$28.2K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	610	$40	$23.7K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Eye Clinic Of Fairbanks, Inc — 5 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

28 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…	191	490	680	$260	$1M
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…	337	440	580	$170	$458.7K
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	100	460	$250	$317.6K
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.	4	100	350	$260	$254.6K
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…	2	30	160	$310	$209.3K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	2	60	900	$80	$174.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2	10	140	$70	$137.1K
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.	2	110	1,210	$30	$82.6K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	2	10	370	$30	$56.9K
92341	Code 92341 describes the fitting of eyeglasses of bifocal type, i.e., the lens has two separate areas of focus such as an area which gives best near vision and another area giving best far vision.	3	40	160	$60	$20.7K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stanley Fuller	AK	Ophthalmology Physician	$916.2K	$0
Damien Delzer	AK	Optometrist	$171.2K	$0
Ronald Zamber	AK	Ophthalmology Physician	$111K	$0
Jeremy Fulk	AK	Optometrist	$83.7K	$0
Natalie Macke	AK	Optometrist	$47.1K	$0
Larry Coon	AK	Optometrist	$37.1K	$0
Rebecca Wilbur	AK	Optometrist	$23K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$107.5M
Fairbanks Memorial Hospital, LLC	AK	General Acute Care Hospital	$0	$83.6M
Fairbanks Resource Agency Inc	AK	Community/Behavioral Health Agency	$0	$48M
Presbyterian Hospitality House	AK	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$34.9M
Fairbanks Native Association	AK	Substance Abuse Rehabilitation Facility	$0	$32.6M
Tanana Chiefs Confenerce	AK	Transportation Broker	$0	$24.1M
Tanana Chiefs Conference	AK	Community/Behavioral Health Agency	$0	$17M
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$16.3M
Restore LLC	AK	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.3M
Tanana Valley Clinic LLC	AK	Multi-Specialty Clinic/Center	$0	$15.2M

Eye Clinic Of Fairbanks, 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

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