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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

West Virginia Eye Consultants, LLC (NPI 1801171517)

Field	Value
Entity Type	Organization
Organization	West Virginia Eye Consultants, LLC
Address	501 Summers St
City	Charleston
State	WV
ZIP	25301
Taxonomy	Ophthalmology Physician
NPI Enumerated	October 13, 2011

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

33 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…	6,850	$70	$506.8K
V2020	Frames, purchases	6,030	$70	$398K
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.	4,060	$90	$349.2K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	1,780	$170	$305.5K
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…	2,070	$70	$140.6K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	3,830	$40	$138K
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.	7,540	$20	$120.6K
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…	1,370	$80	$115.4K
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…	2,000	$50	$104K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	2,300	$30	$57.5K

Showing 1–10 of 33

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

West Virginia Eye Consultants, LLC — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

33 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…	541	1,270	1,240	$30	$245K
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…	352	1,030	890	$50	$221K
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…	45	340	140	$90	$97.5K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	3	20	100	$180	$81.5K
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.	23	30	390	$30	$79.1K
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…	2	140	550	$70	$70.2K
V2020	Frames, purchases	3	130	510	$60	$61.5K
99203	The provider sees a new 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 provider…	100	440	110	$60	$57.2K
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	270	$80	$42.5K
V2303	Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens	1	10	720	$60	$41.1K

Showing 1–10 of 33

Related Providers

Other providers that share a Tax Identification Number (TIN) with West Virginia Eye Consultants, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amy Armstrong	WV	Ophthalmology Physician	$349K	$0
Joseph Sinclair	WV	Ophthalmology Physician	$334K	$0
Brian Griffith	WV	Ophthalmology Physician	$214.9K	$0
Jason Ludlow	WV	Ophthalmology Physician	$211.8K	$0
Matthew Thompson	WV	Ophthalmology Physician	$162.9K	$0
Steven Odekirk	WV	Optometrist	$110.3K	$0
Christopher Stansbury	WV	Optometrist	$81.6K	$0
Steven Potwin	WV	Optometrist	$72.1K	$0

Nearby Providers

Other providers in the same ZIP code as West Virginia Eye Consultants, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Area Medical Center Inc	WV	General Acute Care Hospital	$0	$200.1M
Wv Birth To Three	WV	Early Intervention Provider Agency	$0	$59.9M
Charleston Area Medical Center, Inc.	WV	General Acute Care Hospital	$0	$50.9M
Children's Home Society Of West Virginia	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$44.1M
Kanawha County Emergency Ambulance Authority	WV	Land Ambulance	$2.3M	$31.9M
Maxim Healthcare Services, Inc.	WV	Home Health Agency	$0	$19.9M
All-aid Services, Inc.	WV	Home Health Agency	$0	$16.3M
The Arc Of The Three Rivers, Inc.	WV	Case Management Agency	$0	$15.6M
Retina Consultants, PLLC	WV	Retina Specialist (Ophthalmology) Physician	$0	$13.6M
Dolan & Kalaskey Ltd	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8.3M

West Virginia Eye Consultants, LLC — Billing Profile & Reimbursement Data

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West Virginia Eye Consultants, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References