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

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

North Valley Pediatric Therapy, LLC (NPI 1366899171)

North Valley Pediatric Therapy, LLC is a multi-specialty clinic/center provider located in Phoenix, Arizona. This profile covers 0 Medicare and 15 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	North Valley Pediatric Therapy, LLC
Address	1831 W Rose Garden Ln Ste 4
City	Phoenix
State	AZ
ZIP	85027
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 22, 2016

Payer Source	Total Paid
Medicaid	$11.1M
Medicare	$0

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

15 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.	67,150	$60	$3.8M
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…	117,340	$30	$3.8M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	82,310	$30	$2.1M
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…	4,400	$160	$708.1K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	4,180	$120	$489.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	2,970	$50	$133.7K
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	770	$100	$77.4K
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	1,260	$40	$55.4K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	70	$70	$4.8K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	120	$40	$4.7K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

North Valley Pediatric Therapy, LLC — 4 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

15 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…	20	50	2,740	$190	$1.2M
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…	8	400	2,110	$70	$800.7K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	8	310	960	$60	$705.5K
92609	The provider performs therapeutic services to enable the patient to make the best use of his speech generating device and also trains the patient’s caregiver.	8	10	1,680	$250	$505.1K
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.	12	510	1,320	$60	$454.9K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	10	40	650	$70	$280.9K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	4	70	80	$120	$112.1K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	37	50	530	$70	$90.3K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	11	20	150	$80	$48.2K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	21	30	70	$40	$29.6K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Networks, L.L.C.	AZ	Case Management Agency	$0	$159.4M
Rescare Arizona, Inc.	AZ	Intellectual Disabilities Intermediate Care Facility	$0	$99.3M
Honorhealth	AZ	General Acute Care Hospital	$0	$65.7M
Sonoran Sky Community Services, Inc.	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$38.9M
United Cerebral Palsy Association Of Central Arizona	AZ	Developmentally Disabled Services Day Training Agency	$0	$31.1M
Tp Deer Valley Operations, LLC	AZ	Assisted Living Facility	$0	$18.8M
Kci Usa, Inc.	AZ	Durable Medical Equipment & Medical Supplies	$0	$15.9M
Neighborhood Outreach Access To Health	AZ	Federally Qualified Health Center (FQHC)	$0	$14.1M
Loop 101 Emergency Physicians LLC	AZ	Emergency Medicine Physician	$0	$9.1M
Uhs Of Phoenix, LLC	AZ	Psychiatric Hospital	$0	$7.3M

North Valley Pediatric Therapy, LLC — Billing Profile & Reimbursement Data

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North Valley Pediatric Therapy, 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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Frequently Asked Questions

References