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

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

Hope Pediatrics LLC (NPI 1336572692)

Field	Value
Entity Type	Organization
Organization	Hope Pediatrics LLC
Address	500 Industrial Dr Ste 100
City	Richardson
State	TX
ZIP	75081
Taxonomy	Home Health Agency
NPI Enumerated	August 9, 2013

Payer Source	Total Paid
Medicaid	$77.9M
Medicare	$0

Key Findings

HOPE PEDIATRICS LLC is effectively a Medicaid-only biller: there is no Medicare billing on file and the provider reports $77.9M in lifetime Medicaid revenue. The dataset also notes that the provider's top three Medicaid codes account for 100.0% of its Medicaid revenue, indicating extremely concentrated revenue sourcing within Medicaid.

The provider's activity and billing mix align with its Home Health Agency taxonomy: T1000 (Private duty / independent nursing service(s) - licensed, up to 15 minutes) drives the operation, with 153.6K claims, a $498 avg paid/claim, and $76.5M in revenue (98.2% of the provider's total Medicaid revenue). This concentration in short-interval licensed nursing suggests the business model is focused on one-to-one private-duty nursing delivered in frequent 15-minute units.

Revenue concentration is very high: T1000 alone accounts for 98.2% of Medicaid revenue and, together with H2015 and T1005, the top three codes make up 100.0% of Medicaid revenue. That degree of dependence on a single code implies the provider’s financial performance is materially sensitive to reimbursement changes, utilization edits, or policy shifts that affect T1000.

Secondary service lines are present but modest in scale: H2015 (Comprehensive community support services, per 15 minutes) generated $958.1K (1.2% of Medicaid revenue) across 4.4K claims at a $217 avg paid/claim, and T1005 (Respite care services, up to 15 minutes) produced $472.1K (0.6% of Medicaid revenue) from 2.2K claims at a $212 avg paid/claim. These figures indicate limited diversification into community support and respite relative to the dominant private-duty nursing business.

State-level competitive standing is mixed by service line: for T1000 HOPE PEDIATRICS ranks #6 of 140 providers in-state (96th percentile), which positions it among the higher earners for that code statewide; however, the dataset characterizes its volume for T1000 as "typical, unremarkable volume for this code." For H2015 and T1005 the provider ranks #51 of 116 (57th percentile) and #429 of 564 (24th percentile), respectively, both also described as "typical, unremarkable volume for this code," indicating it is not broadly dominant outside its core nursing line.

Operational scale is reflected in both claim counts and unit economics: 153.6K T1000 claims at a $498 avg paid/claim imply high throughput of short-duration nursing units billed in 15-minute increments, consistent with an agency operating high-volume, episodic private-duty nursing. The relatively high per-claim payment for T1000 compared with the secondary codes underscores how much of the provider's dollar volume is concentrated in licensed nursing services.

The provider has an established tenure: the NPI was enumerated on 2013-08-09 (~13 years ago), indicating a multi-year presence in the Texas Medicaid market. Coupled with $77.9M in reported Medicaid revenue and the high rank on T1000, this tenure supports the interpretation of an established, specialized Medicaid-focused home-health operator.

Taken together, HOPE PEDIATRICS presents as a tightly specialized, Medicaid-focused home health agency that is a leading state-level participant for private-duty licensed nursing (T1000) while maintaining only modest activity in community support (H2015) and respite care (T1005). Analysts evaluating competitive risk or contract negotiations should treat the provider as highly dependent on T1000 reimbursement and utilization trends given that the top three codes equal 100.0% of Medicaid revenue.

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
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	153,620	$500	$76.5M
H2015	Comprehensive community support services, per 15 minutes	4,420	$220	$958.1K
T1005	Respite care services, up to 15 minutes	2,230	$210	$472.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Hope Pediatrics LLC — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	6	140	29,740	$490	$24.4M
H2015	Comprehensive community support services, per 15 minutes	51	120	2,880	$100	$1.2M
T1005	Respite care services, up to 15 minutes	429	560	8,490	$50	$842.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caregivers Home Health Tx Inc	TX	Home Health Agency	$0	$478M
Apple Homecare Medical Supply LLC	TX	Durable Medical Equipment & Medical Supplies	$0	$123.3M
Abc Home Medical Supply, Inc.	TX	Durable Medical Equipment & Medical Supplies	$0	$22.8M
Trident Diagnostics Limited Liability Company	TX	Clinical Medical Laboratory	$14.9M	$66.7K
Rfa Medical Solutions LLC	TX	Clinical Medical Laboratory	$6.4M	$0
Cabot Lab LLC	TX	Clinical Medical Laboratory	$278.1K	$1.2M
Curie Dx Laboratory LLC	TX	Clinical Medical Laboratory	$664.4K	$2.8K
Shahida Rafiq	TX	Family Medicine Physician	$232.7K	$0
Pearl Ezegrim	TX	Psychiatric/Mental Health Nurse Practitioner	$110.1K	$40
Francis Lister	TX	Optometrist	$23.8K	$0

Hope Pediatrics LLC — Billing Profile & Reimbursement Data

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Hope Pediatrics 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