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

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

Craig K. Small O.d. Family Eye Care (NPI 1891905493)

Craig K. Small O.d. Family Eye Care is a optometrist provider located in Caribou, Maine. This profile covers 0 Medicare and 14 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	Craig K. Small O.d. Family Eye Care
Address	37 Herschel St
City	Caribou
State	ME
ZIP	04736
Taxonomy	Optometrist
NPI Enumerated	May 23, 2007

Payer Source	Total Paid
Medicaid	$522.7K
Medicare	$0

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

14 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…	5,130	$50	$276.9K
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.	1,250	$60	$79K
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.	2,530	$20	$48.1K
92342	The provider fits eyeglasses that are multifocal other than bifocal, for example trifocal glasses. These are lenses that have more than two separate areas providing best vision are varying focal…	2,500	$20	$47.4K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	2,640	$20	$44.9K
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…	510	$30	$13.6K
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,…	580	$20	$11.6K
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.	900	$1	$900
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…	20	$10	$240
2022F	The ophthalmology or optometry provider performs a dilated retinal eye exam in a diabetic patient with evidence of diabetic retinopathy. He interprets the findings and documents them in the patient’s…	10	$0	$0

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Craig K. Small O.d. Family Eye Care — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

14 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…	294	480	1,030	$20	$128.9K
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…	12	120	680	$50	$84.3K
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.	23	90	540	$70	$75.9K
92342	The provider fits eyeglasses that are multifocal other than bifocal, for example trifocal glasses. These are lenses that have more than two separate areas providing best vision are varying focal…	1	10	2,500	$20	$48.4K
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.	3	10	660	$20	$26.5K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	6	50	460	$20	$16.2K
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,…	84	230	210	$10	$11.3K
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…	20	30	180	$10	$1.7K
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.	44	100	600	$1	$1.7K
2022F	The ophthalmology or optometry provider performs a dilated retinal eye exam in a diabetic patient with evidence of diabetic retinopathy. He interprets the findings and documents them in the patient’s…	5	10	40	$1	$1

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aroostook Home Health Services	ME	Home Health Agency	$0	$15.8M
Pines Health Services	ME	Internal Medicine Physician	$0	$7.6M
Pines Health Services	ME	Obstetrics & Gynecology Physician	$0	$7.1M
City Of Caribou	ME	General Acute Care Hospital	$0	$3M
City Of Caribou	ME	Land Ambulance	$312.2K	$1.6M
Lincare Inc.	ME	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Healing Hearts LLC	ME	Mental Health Counselor	$0	$1M
County Physical Therapy, LLC	ME	Physical Therapist	$0	$802.4K
Your Journey, LLC	ME	Community/Behavioral Health Agency	$0	$676.2K
David Conner	ME	Family Medicine Physician	$45.4K	$579.4K

Craig K. Small O.d. Family Eye Care — Billing Profile & Reimbursement Data

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Craig K. Small O.d. Family Eye Care — 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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