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

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

Periwinkle Children's Therapy (NPI 1184972184)

Field	Value
Entity Type	Organization
Organization	Periwinkle Children's Therapy
Address	1401 W Bizztown Loop
City	Hayden
State	ID
ZIP	83835
Taxonomy	Contractor
NPI Enumerated	August 22, 2012

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	14,690	$70	$1.1M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	11,450	$70	$744.4K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	30	$60	$1.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Periwinkle Children's Therapy — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	29	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	40	210	3,020	$50	$389K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	11	20	20	$60	$12.7K

Nearby Providers

Other providers in the same ZIP code as Periwinkle Children's Therapy, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Renewed Horizons, LLC	ID	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$19.9M
Wellspring Meadows, Inc.	ID	Personal Care Attendant	$0	$3.9M
Dance Dentistry PLLC	ID	General Practice Dentistry	$0	$2.6M
Renewed Horizons, LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$1.3M
Lookout Behavioral Health LLC	ID	Adult Mental Health Clinic/Center	$0	$888.5K
Public Health District 1	ID	Public Health or Welfare Agency	$0	$843.3K
Shaun Joshi	ID	Nephrology Physician	$523.4K	$0
North Idaho Nephrology Associates, Inc.	ID	Medical Specialty Clinic/Center	$0	$504.4K
Robin Lindauer	ID	Optometrist	$129.3K	$330.6K
Joshua Tree Physical Therapy PLLC	ID	Specialist	$0	$373.1K

Periwinkle Children's Therapy — Billing Profile & Reimbursement Data

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Periwinkle Children's Therapy — 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