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

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

Visionary Ophthalmology LLC (NPI 1952595084)

Visionary Ophthalmology LLC is a ophthalmology physician provider located in Rockville, Maryland. This profile covers 0 Medicare and 26 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	Visionary Ophthalmology LLC
Address	11300 Rockville Pike Ste 1202
City	Rockville
State	MD
ZIP	20852
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 31, 2007

Payer Source	Total Paid
Medicaid	$5.2M
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	13,040	$80	$1.1M
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	24,240	$30	$751.3K
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…	9,880	$70	$711.6K
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…	4,910	$130	$643.1K
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…	9,180	$60	$587.4K
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.	20,840	$20	$396K
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.	2,640	$90	$248.4K
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…	3,920	$30	$125.4K
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…	3,110	$40	$115K
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…	920	$100	$93.6K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Visionary Ophthalmology LLC — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

26 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…	176	3,670	680	$90	$310K
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…	306	3,280	610	$80	$296.1K
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…	9	30	60	$200	$103.2K
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…	30	930	110	$100	$90.1K
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.	20	80	220	$30	$82K
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…	145	730	110	$70	$81.9K
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…	8	430	440	$40	$59.3K
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	100	210	$40	$40.1K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	1	90	200	$30	$38.9K
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…	5	60	240	$30	$37.6K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jesus Martinez	MD	Ophthalmology Physician	$443K	$14.6K
Daniel Sarezky	MD	Ophthalmology Physician	$234.9K	$13.5K
Rosalie Bair	MD	Ophthalmic Plastic and Reconstructive Surgery Physician	$243.5K	$0
Andrew Hammer	DC	Ophthalmology Physician	$216.4K	$1.9K
Reena Garg	MD	Ophthalmology Physician	$204.2K	$0
Nima Moainie	DC	Ophthalmology Physician	$110.4K	$72.8K
Sandra Cremers	MA	Ophthalmology Physician	$163.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid Atlantic Pemanente Medical Group	MD	Health Maintenance Organization	$0	$317.3M
Adult Day Health, Inc.	MD	Adult Day Care Clinic/Center	$0	$17.5M
Montgomery County Maryland Government	MD	Local Education Agency (LEA)	$0	$12.6M
Reginald S Lourie Center For Infants & Young Children	MD	Clinic/Center	$0	$6.5M
Harcart Health Holdings, LLC	MD	Emergency Medicine Physician	$0	$5.5M
Jewish Social Service Agency	MD	Community Based Hospice Care Agency	$0	$4.5M
Rockville Pediatric Dental LLC	MD	Pediatric Dentistry	$0	$4.4M
Behavioral Framework, LLC	MD	Community/Behavioral Health Agency	$0	$4.3M
Vinay Desai	MD	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
James Xu	MD	Hematology & Oncology Physician	$1.6M	$0

Visionary Ophthalmology LLC — Billing Profile & Reimbursement Data

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Visionary Ophthalmology 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

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