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

Why is the Medicaid comparison limited to Arkansas 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. Arkansas (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 Pain And Wellness (NPI 1487920146)

Optimal Pain And Wellness is a physical medicine & rehabilitation physician provider located in Fayetteville, Arkansas. This profile covers 0 Medicare and 58 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	Optimal Pain And Wellness
Address	1708 E Joyce Blvd
City	Fayetteville
State	AR
ZIP	72703
Taxonomy	Physical Medicine & Rehabilitation Physician
NPI Enumerated	March 28, 2012

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	19,430	$20	$466.4K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	5,100	$20	$97K
80373	The lab analyst measures the amount of or detects the presence of tramadol, which is a centrally acting opioid pain medication, in the patient specimen.	9,740	$10	$87.7K
80369	The lab analyst measures the amount of or detects the presence of one or two skeletal muscle relaxants in the patient specimen. These drugs reduce the tone of skeletal muscles and thus alleviate…	9,740	$10	$87.7K
80365	The lab analyst measures the amount of or detects the presence of oxycodone, a synthetic opioid pain medication, in a patient specimen.	9,720	$10	$87.5K
80354	The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen.	9,710	$10	$87.4K
80356	The lab analyst measures the amount of or detects the presence of heroin metabolite in the patient specimen.	9,340	$10	$84.1K
80372	The lab analyst measures the amount of or detects the presence of tapentadol, a centrally acting opioid pain medication, in the patient specimen.	9,730	$10	$77.8K
80362	The lab analyst measures the amount of or detects the presence of one or two opioids and opiate analogs, narcotic analgesics that depress the central nervous system, in the specimen.	9,450	$10	$75.6K
80348	The lab analyst measures the amount of or detects the presence of buprenorphine in a patient specimen. Buprenorphine is a drug used to treat opioid addiction, to control acute pain in individuals who…	9,430	$10	$75.4K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Optimal Pain And Wellness — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	39	80	1,090	$70	$210.4K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	13	100	900	$40	$168.5K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	36	1,520	550	$40	$128.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	217	1,740	550	$30	$88.8K
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	9	20	290	$70	$84.1K
80354	The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen.	3	10	3,030	$10	$71.1K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	183	230	470	$40	$67.2K
80348	The lab analyst measures the amount of or detects the presence of buprenorphine in a patient specimen. Buprenorphine is a drug used to treat opioid addiction, to control acute pain in individuals who…	3	20	2,640	$10	$60K
80373	The lab analyst measures the amount of or detects the presence of tramadol, which is a centrally acting opioid pain medication, in the patient specimen.	3	10	1,970	$10	$56K
80372	The lab analyst measures the amount of or detects the presence of tapentadol, a centrally acting opioid pain medication, in the patient specimen.	3	10	860	$10	$50.4K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ornette Gaines	AR	Family Medicine Physician	$428.3K	$0
Heather Hale	AR	Nurse Practitioner	$267.3K	$0
Mary Frances Daut	AR	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$171.3K	$0
Karen Reynolds	AR	Family Nurse Practitioner	$139.6K	$0
Regina Thurman	AR	Physical Medicine & Rehabilitation Physician	$19.6K	$760

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanders, Tompkins, Schiro, Landers And Sanders PLLC	AR	Pediatric Dentistry	$0	$30.4M
Children's Therapy Services, Inc.	AR	Pediatric Physical Therapist	$0	$29.2M
Life Styles Inc.	AR	Case Management Agency	$0	$19.6M
Washington Regional Medical Center	AR	General Acute Care Hospital	$0	$10.9M
Cross Therapy Services, Ltd	AR	Pediatric Occupational Therapist	$0	$5.8M
Medical Associates Of Northwest Arkansas PA	AR	Pediatrics Physician	$0	$5.8M
Oral & Facial Surgery Center PA	AR	Oral and Maxillofacial Surgery (Dentist)	$0	$4.8M
Matthew Lockwood	AR	Hematology & Oncology Physician	$4.2M	$0
Thomas A. Sarna, Dds PLLC	AR	Oral and Maxillofacial Surgery Clinic/Center	$0	$3.4M
Washington Regional Medical System	AR	Hospitalist Physician	$0	$3.4M

Optimal Pain And Wellness — Billing Profile & Reimbursement Data

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Optimal Pain And Wellness — 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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