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

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

Premier Eye Care Of Florida LLC (NPI 1932363934)

Field	Value
Entity Type	Organization
Organization	Premier Eye Care Of Florida LLC
Address	4565 Ponce De Leon Blvd Ste 200
City	Coral Gables
State	FL
ZIP	33146
Taxonomy	Exclusive Provider Organization
NPI Enumerated	July 18, 2008

Payer Source	Total Paid
Medicaid	$53.6M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operation: it reports $53.6M in lifetime Medicaid revenue and has no Medicare billing on file. The absence of Medicare activity combined with the Medicaid scale indicates the organisation’s commercial footprint is concentrated in state Medicaid programs rather than in the Medicare market.

Revenue is highly concentrated in a small set of ophthalmic and optical codes: the top three Medicaid codes (92014, 92004, V2020) account for 84.3% of the provider’s total Medicaid revenue. Specifically, 92014 generated $22.1M (41.6% of Medicaid revenue), 92004 generated $15.6M (29.3%), and V2020 generated $7.1M (13.4%), so clinical eye exams plus frame sales drive the majority of receipts.

The code mix indicates a combined clinical ophthalmology and high-volume optical dispensing model: large volumes of comprehensive eye exams (92014: 273.1K claims; 92004: 176.9K claims) paired with very large frame/lens dispensing (V2020: 357.3K claims; V2103: 215.5K claims) suggest the provider operates both exam services and point-of-sale optical retail. Average paid-per-claim levels ($81 for 92014, $88 for 92004, $20 for V2020) are consistent with routine ophthalmic examinations and optical product reimbursement patterns.

State-level competitive standing is dominant for the provider’s principal services: 92014 ranks #2 of 978 providers in-state (100th percentile; extreme outlier), 92004 ranks #2 of 904 (100th percentile; extreme outlier), and V2020 ranks #1 of 875 (100th percentile; extreme outlier). Those ranks indicate this entity is a major outlier and one of the largest Medicaid suppliers of comprehensive eye exams and frames in Florida.

While optical dispensing and comprehensive exams drive the business, the provider also bills a range of diagnostic and procedure codes at materially smaller revenue levels, indicating ancillary clinical capacity. Examples include 92250 (8K claims, $143.2K revenue), 92134 (7.8K claims, $140.3K revenue), and 67028 (1.4K claims, $414.7K revenue), showing the presence of retinal imaging and intravitreal injection services but not at the same revenue scale as exams and frames.

Evaluation-and-management (E/M) activity shows a mix of new and established visit complexity but represents modest shares of total Medicaid revenue, consistent with high-volume ophthalmology clinic throughput rather than primary-care level revenue. Notable E/M entries include 99214 (10K claims, $1M revenue, 1.9% of Medicaid revenue) and 99204 (6.1K claims, $890.3K revenue, 1.7% of Medicaid revenue), which together reflect both ongoing management of established patients and a regular flow of new patient evaluations.

Operational throughput is large across many optical items beyond the top three codes, reinforcing a retail dispensing scale: for example, V2103 (215.5K claims, $861.9K revenue), V2100 (116.4K claims, $582.1K revenue), and V2784 (69.3K claims, $69.3K revenue) are all ranked at or near the top of in-state provider lists (several at 100th percentile; extreme outlier). These volumes imply a sustained, high-frequency eyewear production and fulfillment operation.

The provider has long-standing enumeration: NPI was registered on 2008-07-18 (≈18 years ago), which supports that the observed high-volume Medicaid activity and optical dispensing footprint are established operations rather than a recent or short-lived pattern.

Medicaid: Complete Services Breakdown

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

103 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…	273,060	$80	$22.1M
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.	176,920	$90	$15.6M
V2020	Frames, purchases	357,280	$20	$7.1M
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…	29,760	$60	$1.8M
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…	10,040	$100	$1M
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…	6,100	$150	$890.3K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	215,480	$1	$861.9K
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…	9,630	$80	$770.2K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	116,420	$10	$582.1K
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.	233,870	$1	$467.7K

Showing 1–10 of 103

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Premier Eye Care Of Florida LLC — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

103 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…	535	5,930	460	$40	$169.3K
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…	314	6,380	430	$50	$139.3K
J0178	Injection, aflibercept, 1 mg	11	20	300	$140	$126.8K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	60	220	150	$160	$117.4K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	117	150	150	$110	$107.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	522	1,500	470	$30	$87.2K
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…	2	980	270	$60	$85.1K
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…	36	70	90	$260	$78.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	535	980	120	$90	$76.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,625	1,980	660	$20	$74.4K

Showing 1–10 of 103

Nearby Providers

Other providers in the same ZIP code as Premier Eye Care Of Florida LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Pediatric Services, PA	FL	Pediatric Critical Care Medicine Physician	$0	$14M
Kidz Medical Services, Inc	FL	Children's Hospital	$0	$12.7M
Kidz Medical Services	FL	Pediatrics Physician	$0	$10.1M
Alysa Herman	FL	MOHS-Micrographic Surgery Physician	$847.1K	$0
Ralph Nader	FL	Cardiovascular Disease Physician	$729K	$0
Carina Wiklund Saba	FL	Physical Therapist	$536K	$0
Ruben Penaranda	FL	Pulmonary Disease Physician	$434.4K	$0
Stephen Blythe	FL	Orthopaedic Surgery Physician	$239K	$0
Patricia Delgado	FL	Anatomic Pathology & Clinical Pathology Physician	$190.7K	$0
Kirill Ilalov	FL	Orthopaedic Surgery of the Spine Physician	$170.2K	$0

Premier Eye Care Of Florida LLC — Billing Profile & Reimbursement Data

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Premier Eye Care Of Florida LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References