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

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

Optimal Behavioral, LLC (NPI 1447629126)

Field	Value
Entity Type	Organization
Organization	Optimal Behavioral, LLC
Address	1311 Catherine Dr
City	Cleveland
State	TN
ZIP	37312
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 23, 2015

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2012	Behavioral health day treatment, per hour	9,720	$200	$1.9M
T1017	Targeted case management, each 15 minutes	2,090	$270	$557K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Optimal Behavioral, LLC — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	2	10	9,720	$140	$3.8M
T1017	Targeted case management, each 15 minutes	2	10	1,060	$40	$948.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Staffco Of Eastern Tennessee, LLC.	TN	Home Health Agency	$0	$9.6M
Urgent Care Centers Of East Tennessee, P.C.	TN	Internal Medicine Physician	$0	$7.7M
Ocoee Pediatrics Of Cleveland, PC	TN	Family Nurse Practitioner	$0	$6.1M
County Of Bradley County Fund	TN	Land Ambulance	$1M	$3.9M
Eagle Home Care, L.L.C.	TN	In Home Supportive Care Agency	$0	$4.3M
Silver Angels Of Tennessee - Bradley, LLC	TN	In Home Supportive Care Agency	$0	$3.4M
Voytik Center For Orthopedic Care, PC	TN	Orthopaedic Surgery Physician	$0	$2.5M
Robbins Family Dental PLLC	TN	Dentist	$0	$2.2M
Can Do Kids Pediatric Therapy Services, LLC	TN	Pediatric Occupational Therapist	$0	$2.1M
Paul Pinson	TN	Pain Medicine (Anesthesiology) Physician	$178.7K	$1.7M

Optimal Behavioral, LLC — Billing Profile & Reimbursement Data

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Optimal Behavioral, 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