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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Whole Child Wellness, LLC (NPI 1639613912)

Field	Value
Entity Type	Organization
Organization	Whole Child Wellness, LLC
Address	526 W Jackson Blvd
City	Spearfish
State	SD
ZIP	57783
Taxonomy	Occupational Therapist
NPI Enumerated	December 6, 2016

Payer Source	Total Paid
Medicaid	$84.1K
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
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…	740	$110	$81.7K
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.	70	$30	$2.3K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Whole Child Wellness, LLC — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

2 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.	42	50	400	$30	$76.4K
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	400	$70	$29.1K

Nearby Providers

Other providers in the same ZIP code as Whole Child Wellness, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Hills Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$39.3M
Lutheran Social Services Of Sd	SD	Psychiatric Residential Treatment Facility	$0	$16.9M
A.w. Holdings, LLC	SD	Case Manager/Care Coordinator	$0	$3.7M
Edgewood Spearfish Senior Living LLC	SD	Assisted Living Facility (Behavioral Disturbances)	$0	$2.3M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$2M
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$1.8M
Spearfish Emergency Ambulance Service	SD	Land Ambulance	$540.7K	$302.3K
West River Transit Authority, Inc.	SD	Bus	$0	$788.1K
Monument Health Network, Inc.	SD	Multi-Specialty Clinic/Center	$0	$745.7K
Spearfish Collaborative Care LLC	SD	Assisted Living Facility	$0	$657.7K

Whole Child Wellness, LLC — Billing Profile & Reimbursement Data

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Whole Child Wellness, 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