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

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

Autism Sparkles LLC (NPI 1184386120)

Field	Value
Entity Type	Organization
Organization	Autism Sparkles LLC
Address	19 S George Washington Rd
City	Enfield
State	CT
ZIP	06082
Taxonomy	Behavior Analyst
NPI Enumerated	October 7, 2021

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	28,870	$240	$6.9M
H0046	Mental health services, not otherwise specified	8,830	$170	$1.5M
H0031	Mental health assessment, by non-physician	130	$680	$85.4K
H0032	Mental health service plan development by non-physician	450	$120	$54.7K
97158	The provider administers adaptive behavior treatment to multiple patients in a social skills group. Report this code for each 15 minutes that the provider spends face–to–face with multiple patients…	70	$20	$1.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Autism Sparkles LLC — 2 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	1	50	2,690	$170	$869.8K
H0046	Mental health services, not otherwise specified	1	50	510	$150	$187K
H0031	Mental health assessment, by non-physician	4	10	30	$100	$24.6K
H0032	Mental health service plan development by non-physician	2	10	60	$140	$23.9K
97158	The provider administers adaptive behavior treatment to multiple patients in a social skills group. Report this code for each 15 minutes that the provider spends face–to–face with multiple patients…	2	10	70	$20	$6.8K

Nearby Providers

Other providers in the same ZIP code as Autism Sparkles LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Town Of Enfield Board Of Education	CT	Ambulance	$644.9K	$3.3M
Enfield Public Schools	CT	Local Education Agency (LEA)	$0	$3.7M
Hemant Panchal	CT	Pediatric Adolescent Medicine Physician	$0	$3.3M
New England Urgent Care Enfield LLC	CT	Urgent Care Clinic/Center	$0	$2.6M
Nanas 247 Home Care & Companion Agency LLC	CT	Home Health Agency	$0	$2.4M
Anne Marie Villa, M.d., P.C.	CT	Pediatrics Physician	$0	$1.8M
I Smile Dental Studio, P.C.	CT	Dental Clinic/Center	$0	$1.7M
Enfield Plaza Family Dental	CT	General Practice Dentistry	$0	$1.5M
Hemant K. Panchal, Md, PC.	CT	Pediatrics Physician	$0	$1.3M
Gus J Pappas Theodore J Pappas	CT	General Practice Dentistry	$0	$1.2M

Autism Sparkles LLC — Billing Profile & Reimbursement Data

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Autism Sparkles 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

Nearby Providers

Frequently Asked Questions

References