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

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

Playful Learning Pediatric Therapy, LLC (NPI 1407129745)

Field	Value
Entity Type	Organization
Organization	Playful Learning Pediatric Therapy, LLC
Address	12812 Old Glenn Hwy Ste A4
City	Eagle River
State	AK
ZIP	99577
Taxonomy	Pediatric Occupational Therapist
NPI Enumerated	February 16, 2012

Payer Source	Total Paid
Medicaid	$15.8M
Medicare	$0

Key Findings

PLAYFUL LEARNING PEDIATRIC THERAPY, LLC is effectively a Medicaid-focused pediatric therapy practice with no Medicare billing on file and $15.8M in lifetime Medicaid revenue; the absence of Medicare revenue indicates operations are concentrated on child-focused services covered by state Medicaid programs rather than the older-adult population served by Medicare.

Revenue is heavily concentrated in a very small set of procedures: the top three Medicaid codes account for 98.8% of the provider's total Medicaid revenue, indicating a narrow service mix driving almost all reimbursement for the practice.

97530 (therapeutic activities) is the dominant revenue driver with $13.5M in revenue (85.5% of total Medicaid revenue) and 74.4K claims; the provider ranks #1 of 118 in-state and is described as an extreme outlier, signaling this clinic delivers very high volume of activity-based pediatric occupational therapy relative to peers in Alaska.

92507 (speech-language/hearing services) contributes $1.8M (11.4% of Medicaid revenue) across 18.3K claims and ranks #5 of 69 providers in-state (94th percentile), which shows a meaningful secondary focus on direct speech and language therapy and places the provider well above typical state volume for that code.

97533 (sensory integrative techniques) accounts for $303.3K (1.9% of Medicaid revenue) and ranks #2 of 12 providers in-state (91st percentile); this placement suggests additional specialization in sensory integration services commonly used for children with autism or sensory-processing dysfunction, but at far lower aggregate volume than 97530.

Other listed codes (92526, 97110, 97535, 92523) together represent only a small share of revenue (each under 1%), indicating the practice’s service portfolio beyond its top three codes is modest and likely supportive or adjunctive to the core occupational-therapy and speech services.

The provider’s NPI was enumerated on 2012-02-16 (~14 years ago), indicating over a decade of active enrollment in the healthcare system; that tenure aligns with the development of significant Medicaid billing volume and the establishment of high regional market share for key pediatric therapy codes.

Competitive standing in-state is pronounced for its flagship service mix: being the top statewide biller for 97530 at the 100th percentile and an extreme outlier suggests the practice is a dominant provider of activity-based pediatric occupational therapy in Alaska, while top-five placement for 92507 (94th percentile) confirms a second strong regional position in speech services.

Medicaid: Complete Services Breakdown

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

7 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.	74,440	$180	$13.5M
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…	18,310	$100	$1.8M
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	3,650	$80	$303.3K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	670	$110	$72.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	650	$100	$62.7K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	620	$50	$30.5K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	60	$250	$15.4K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Playful Learning Pediatric Therapy, LLC — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

7 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.	1	120	970	$140	$652.1K
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…	5	70	2,310	$100	$531.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	61	120	720	$110	$300.2K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	2	10	700	$130	$190K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	2	10	400	$100	$43.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	9	10	90	$200	$37.5K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	4	20	70	$40	$21.9K

Nearby Providers

Other providers in the same ZIP code as Playful Learning Pediatric Therapy, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
All For Kids Pediatric Therapy Clinic	AK	Pediatric Occupational Therapist	$0	$11M
Family Outreach Center For Understanding Special Needs Inc	AK	Social Worker	$0	$10.5M
Orion Behavioral Health Network LLC	AK	Developmental - Behavioral Pediatrics Physician	$0	$2.5M
Select Physical Therapy Holdings Inc	AK	Physical Therapy Clinic/Center	$0	$1.6M
Vision Therapy Center Inc.	AK	Vision Therapy Optometrist	$0	$1.6M
Behavior Matters LLC	AK	Behavior Analyst	$0	$1.5M
Alaska Pediatric Night Clinic, Inc.	AK	Pediatrics Physician	$0	$1.3M
Dennis Walker	AK	Case Manager/Care Coordinator	$0	$1.1M
Jeanne Moore-kettell	AK	Case Manager/Care Coordinator	$0	$1.1M
Heart Of Eagle River Medical Clinic	AK	Family Medicine Physician	$0	$933.6K

Playful Learning Pediatric Therapy, LLC — Billing Profile & Reimbursement Data

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Playful Learning Pediatric Therapy, 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