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.

Specialeyes Professional Eye Care Services, PLLC (NPI 1790917102)

Field	Value
Entity Type	Organization
Organization	Specialeyes Professional Eye Care Services, PLLC
Address	27 Main St
City	Vergennes
State	VT
ZIP	05491
Taxonomy	Optometrist
NPI Enumerated	August 18, 2009

Payer Source	Total Paid
Medicaid	$87.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	370	$110	$41.8K
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.	1,630	$10	$22.8K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	440	$30	$11.8K
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…	120	$90	$10.7K

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

Specialeyes Professional Eye Care Services, PLLC — 0 of 4 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

4 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…	34	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.	19	60	170	$100	$52.9K
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.	26	70	850	$10	$26.9K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	15	30	440	$30	$21.8K

Nearby Providers

Other providers in the same ZIP code as Specialeyes Professional Eye Care Services, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vergennes Area Rescue Squad Inc.	VT	Ambulance	$111.1K	$244.8K
David Congalton	VT	Dentist	$0	$177.4K
Daniel Huber	VT	Family Medicine Physician	$92.2K	$0
Kph Healthcare Services, Inc.	VT	Community/Retail Pharmacy	$74.7K	$0
Amanda Dingman-parini	VT	Clinical Psychologist	$0	$64.3K
Dylan Estes	VT	Family Medicine Physician	$44K	$0
Karen Fromhold	VT	General Practice Physician	$36.7K	$0
Joel Palmer	VT	Chiropractor	$27.2K	$0
Shauna Mckeon	VT	Adult Health Nurse Practitioner	$23K	$0

Specialeyes Professional Eye Care Services, PLLC — Billing Profile & Reimbursement Data

Sign up for Specialeyes Professional Eye Care Services, PLLC — Billing Profile & Reimbursement Data policy alerts

Specialeyes Professional Eye Care Services, PLLC — Billing Profile & Reimbursement Data

Sign up for Specialeyes Professional Eye Care Services, PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References