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.

Pain Treatment Centers Of America, PLLC (NPI 1841619731)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pain Treatment Centers Of America, PLLC
Address	108 N Shackleford Rd
City	Little Rock
State	AR
ZIP	72211
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	April 8, 2014

Payer Source	Total Paid
Medicaid	$19.5M
Medicare	$0

PAIN TREATMENT CENTERS OF AMERICA, PLLC is effectively a single-payer Medicaid operation: there is no Medicare billing on file while lifetime Medicaid revenue totals $19.5M. This provider’s payment footprint is therefore concentrated entirely in the Medicaid program rather than spread across Medicare and Medicaid.

Revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes account for 50.5% of the provider’s total Medicaid revenue, with 99214 generating $4M (22.5%), 80307 generating $2.8M (15.7%), and 64636 generating $2.2M (12.3%). Those three codes alone drive more than half of the $19.5M Medicaid revenue base.

The code mix indicates a pain-management clinic with two clear service lines: high-volume evaluation & management visits and interventional spine procedures. High-revenue E/M codes include 99214 ($4M) and related office visit codes such as 99213 (39.3K claims, $668.4K) and 99204 (11.1K claims, $487.9K), while procedural spine codes like 64636 (3.2K claims, $2.2M), 64635 (4.1K claims, $1.8M), 64493 (6.1K claims, $470.1K) and 64494 (5.8K claims, $228.1K) show active interventional service lines.

Massive volumes of toxicology and drug-testing panels accompany the clinical and procedural work, consistent with chronic pain management and controlled-substance monitoring: 80307 shows 122.1K claims ($2.8M), 80354 51.5K claims ($514.6K), 80372 48.4K claims ($435.3K), 80373 47.6K claims ($428.6K), and 80348 44.8K claims ($403.6K). The repeated appearance of many 803xx codes at substantial claim counts suggests an integrated workflow of frequent specimen testing alongside office visits and procedures.

This provider is a dominant in-state performer for multiple high-volume codes. 99214 ranks #2 of 1523 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), 80307 ranks #1 of 102 (100th percentile; extreme outlier), and 64636 ranks #1 of 25 (100th percentile; notably above typical state volume). Numerous other toxicology codes (for example 80354, 80372, 80373, 80348, 80369, 80363, 80355) also rank #1 in the state and are described as extreme outliers or notably above typical state volume, indicating a leading market position for these services.

Operational scale is reflected in both claim counts and payer-paid amounts: examples include 126K claims for 99214 at $32 avg paid/claim, 122.1K claims for 80307 at $23 avg paid/claim, and multiple 803xx tests in the 30K–51K claim range at single-digit or low-double-digit average payments. This combination of high claim counts with modest per-claim payments implies a high-throughput, volume-driven revenue model rather than reliance on a small number of high-dollar single procedures.

The concentration of revenue in a few high-volume codes (50.5% from the top three) creates clear commercial levers and risk focal points for payers and contracting teams: negotiating, monitoring, or auditing strategies focused on 99214, 80307, and 64636 would address a majority of the Medicaid spend with this provider. Given the provider’s dominant state ranks on many codes, payers should treat these codes as material to network performance and utilization reviews.

The practice has an established enrollment history (NPI enumerated 2014-04-08, ~12 years ago), indicating sustained operations in Arkansas. Over a multi-year tenure it has built a large Medicaid presence centered on high-volume office visits, frequent toxicology testing, and interventional spine procedures rather than any Medicare business line.

Medicaid: Complete Services Breakdown

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

113 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…	125,960	$30	$4M
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.	122,070	$20	$2.8M
64636	In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of…	3,170	$700	$2.2M
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	4,100	$440	$1.8M
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…	39,320	$20	$668.4K
80354	The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen.	51,460	$10	$514.6K
99204	The provider sees a new 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 provider…	11,090	$40	$487.9K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	6,110	$80	$470.1K
80372	The lab analyst measures the amount of or detects the presence of tapentadol, a centrally acting opioid pain medication, in the patient specimen.	48,370	$10	$435.3K
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.	47,620	$10	$428.6K

Showing 1–10 of 113

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

Pain Treatment Centers Of America, PLLC — 23 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

113 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.	444	580	3,620	$60	$712.7K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	1	30	1,080	$360	$415.6K
64636	In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of…	1	30	380	$340	$264.7K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	3	10	80	$630	$178.2K
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.	1	100	900	$40	$168.5K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	2	40	190	$120	$138.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	82	200	1,600	$20	$129.3K
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…	2	1,520	550	$40	$128.7K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	13	80	140	$230	$123.8K
72141	In this diagnostic procedure, the provider performs a magnetic resonance imaging (MRI) study of the cervical spinal canal and contents without using contrast material.	16	40	120	$260	$121.8K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Arkansas For Medical Sciences	AR	General Acute Care Hospital	$0	$87.2M
University Of Arkansas For Medical Sciences	AR	Internal Medicine Physician	$0	$28.6M
University Of Arkansas For Medical Sciences	AR	Pediatrics Physician	$0	$27.6M
Johns Hopkins University	MD	Body Imaging Physician	$0	$15.3M
University Of Arkansas For Medical Sciences	AR	Family Medicine Physician	$0	$3M
University Of Arkansas For Medical Sciences	AR	Developmental - Behavioral Pediatrics Physician	$0	$3M
University Of Arkansas For Medical Sciences	AR	Primary Care Clinic/Center	$0	$2M
Sridhar Chatrathi	MD	Cardiovascular Disease Physician	$2M	$1.7K
Arkansas Health Group	AR	Psychiatry Physician	$0	$1.9M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Independent Case Management, Inc.	AR	Developmentally Disabled Services Day Training Agency	$0	$58.7M
Mct, Inc.	AR	Developmental Disabilities Clinic/Center	$0	$30.5M
Inspiration Day Treatment, Inc.	AR	Community/Behavioral Health Agency	$0	$11.9M
Bhc Pinnacle Pointe Hospital, Inc.	AR	Adolescent and Children Mental Health Clinic/Center	$0	$10.4M
Mct, Inc.	AR	Speech-Language Pathologist	$0	$9.2M
Turcios & Zarruk Dental, P.A.	AR	Dental Clinic/Center	$0	$5M
James Keane	AR	Procedural Dermatology Physician	$4.9M	$0
Odyssey Healthcare Operating A LP	AR	Home Health Agency	$0	$3.6M
Advanced Spine And Pain Centers, Inc.	AR	Pain Clinic/Center	$0	$3.6M
Ashcraft Orthodontics PLLC	AR	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.4M

Pain Treatment Centers Of America, PLLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References