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

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

Advanced Eyecare PC (NPI 1790739340)

Advanced Eyecare PC is a ophthalmology physician provider located in Bennington, Vermont. This profile covers 0 Medicare and 11 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	Advanced Eyecare PC
Address	322 Dewey St
City	Bennington
State	VT
ZIP	05201
Taxonomy	Ophthalmology Physician
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$803.9K
Medicare	$0

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

11 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…	6,360	$70	$432.7K
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.	2,100	$100	$199.6K
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.	10,670	$10	$128K
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…	370	$40	$15K
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…	430	$30	$13.4K
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…	130	$70	$8.7K
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…	250	$10	$3K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	120	$20	$2.3K
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.	60	$10	$790
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	30	$20	$460

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Advanced Eyecare PC — 3 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	194	320	680	$30	$146.1K
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…	191	320	760	$20	$88.2K
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…	1	50	290	$70	$66.1K
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.	3	60	170	$100	$52.9K
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…	11	20	240	$60	$31.9K
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.	3	70	850	$10	$26.9K
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.	4	10	60	$10	$12.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	95	110	150	$10	$4.6K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	3	10	120	$30	$4K
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…	2	10	30	$10	$3K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jonathan Huz	NY	Retina Specialist (Ophthalmology) Physician	$1.9M	$40.1K
Scott Greenberg	RI	Retina Specialist (Ophthalmology) Physician	$1.8M	$1.6K
Naomi Falk	NY	Retina Specialist (Ophthalmology) Physician	$1.6M	$9.5K
Pawan Bhatnagar	NY	Retina Specialist (Ophthalmology) Physician	$1.5M	$16.4K
Estela Ogiste	MA	Ophthalmology Physician	$357.5K	$21.3K
Erik Niemi	VT	Ophthalmology Physician	$361.1K	$0
Brett Smith	VT	Ophthalmology Physician	$238.9K	$5.5K
Matthew Habib	NY	Retina Specialist (Ophthalmology) Physician	$233.3K	$160
Michael Porter	VT	Optometrist	$89.6K	$0
Heidi Welnak	VT	Optometrist	$41.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Counseling Service Of Bennington County, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$72.5M
Vermont Permanency Initiative, Inc.	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$27.9M
Savida Health, PC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$12M
Sunrise Family Resource Center	VT	Social Worker	$0	$7M
Seall Inc	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$6.6M
United Counseling Service Of Bennington County, Inc.	VT	Clinic/Center	$0	$6M
Southwestern Vermont Medical Center Inc.	VT	General Acute Care Hospital	$0	$5.1M
Town Of Bennington Rescue Squad, Inc.	VT	Land Ambulance	$683.4K	$2.7M
Southwestern Vermont Medical Center Inc.	VT	Internal Medicine Physician	$0	$2.9M
Oral And Facial Surgery Associates,plc	VT	Oral and Maxillofacial Surgery (Dentist)	$0	$1.8M

Advanced Eyecare PC — Billing Profile & Reimbursement Data

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Advanced Eyecare PC — 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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