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

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

James Henderson (NPI 1699962001)

Field	Value
Entity Type	Individual
Organization	James Henderson
Address	462 River Cross Rd
City	Spanish Fork
State	UT
ZIP	84660
Taxonomy	Physical Therapist
NPI Enumerated	September 29, 2007

Payer Source	Total Paid
Medicare	$49K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	480	$30	$14.4K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	570	$20	$11.4K
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…	580	$20	$9.8K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	580	$20	$9.8K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	40	$70	$2.6K
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.	20	$20	$420

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

James Henderson — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	248	640	410	$20	$13.3K
97530	367	370	290	$20	$12.1K
97112	104	400	290	$20	$10.2K
97116	14	70	130	$20	$5.6K
97163	17	80	20	$70	$3.1K
97161	1	250	30	$70	$2.9K

Nearby Providers

Other providers in the same ZIP code as James Henderson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nebo School District	UT	Local Education Agency (LEA)	$0	$4.4M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$3.5M
Building Beginnings	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$2.1M
Spanish Fork City Corporation	UT	Land Ambulance	$154.1K	$1.7M
Canyon View Medical Group LLC	UT	Family Medicine Physician	$0	$1.5M
Cameron Egbert	UT	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M
Life Balance	UT	Community/Behavioral Health Agency	$0	$1.3M
Magellan Academy, Inc	UT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$737.7K
Michael Peterson	UT	Dermatology Physician	$644.3K	$26.9K
Ihc Health Services Inc	UT	Urgent Care Clinic/Center	$0	$622.8K

James Henderson — Billing Profile & Reimbursement Data

Sign up for James Henderson — Billing Profile & Reimbursement Data policy alerts

James Henderson — Billing Profile & Reimbursement Data

Sign up for James Henderson — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References