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.

Henley Pediatrics PLLC (NPI 1497336572)

Henley Pediatrics PLLC is a pediatrics physician provider located in Hot Springs, Arkansas. This profile covers 0 Medicare and 38 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	Henley Pediatrics PLLC
Address	3604 Central Ave Ste B
City	Hot Springs
State	AR
ZIP	71913
Taxonomy	Pediatrics Physician
NPI Enumerated	April 19, 2021

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	24,380	$30	$804.4K
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…	8,280	$70	$537.9K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,650	$50	$178.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,590	$50	$175.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,260	$50	$103.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,910	$40	$72.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	870	$50	$41.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,040	$10	$22.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,860	$10	$20.4K
90680	This code represents a live pentavalent rotavirus vaccine given by mouth in a three–dose schedule to protect against rotavirus infection.	1,630	$10	$19.6K

Showing 1–10 of 38

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

Henley Pediatrics PLLC — 1 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	117	1,520	550	$40	$128.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	35	210	500	$50	$106.5K
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…	40	1,740	550	$30	$88.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	32	250	460	$50	$86.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	32	280	190	$50	$48.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	43	270	110	$50	$28.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	36	360	240	$30	$27.7K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	43	160	470	$10	$21.5K
90619	Report this code for meningococcal conjugate vaccine in a tetanus toxoid carrier for intramuscular administration that protects against four common forms of the virus and to prevent the patient from…	19	50	60	$20	$19.6K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	16	90	80	$30	$18.4K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rock Dental Arkansas PLLC	AR	Dentist	$0	$128.8M
Superior Senior Care	AR	In Home Supportive Care Agency	$0	$22.5M
Ouachita Regional Counseling & Mental Health Center, Inc.	AR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22.4M
Chi St Vincent Hospital Hot Springs	AR	General Acute Care Hospital	$0	$16.4M
Chi St. Vincent Medical Group Hot Springs	AR	Specialist	$0	$13.8M
Tlc Home Care Of Arkansas	AR	In Home Supportive Care Agency	$0	$7M
Little Bitty City Therapeutic Services LLC	AR	Developmental Disabilities Clinic/Center	$0	$6.9M
Healthy Connections Incorporated	AR	Federally Qualified Health Center (FQHC)	$0	$5.5M
Abilities Unlimited Of Hot Springs Ar Inc	AR	Developmentally Disabled Services Day Training Agency	$0	$4.9M
A-o-m-s, PLLC	AR	Oral and Maxillofacial Surgery (Dentist)	$0	$4.2M

Henley Pediatrics PLLC — Billing Profile & Reimbursement Data

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Henley Pediatrics PLLC — 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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