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

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

Sensational Kids, LLC (NPI 1851605604)

Field	Value
Entity Type	Organization
Organization	Sensational Kids, LLC
Address	727 E Brundage Ln Ste E
City	Sheridan
State	WY
ZIP	82801
Taxonomy	Pediatric Occupational Therapist
NPI Enumerated	August 4, 2010

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $2.1M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation based on the available claims data. The absence of Medicare activity means analyses should focus on Medicaid reimbursement policy, utilization changes, and state-level competitive dynamics.

Revenue is extremely concentrated: the precomputed top three Medicaid codes account for 99.3% of the provider's total Medicaid revenue, with a single code, 97530, contributing the lion’s share. That concentration indicates that most of the business is driven by a small set of session-based therapy services rather than a broad mix of procedures.

Code mix and descriptions indicate a pediatric therapy practice focused on hands-on, direct therapeutic activities: 97530 (therapeutic activities, billed per 15 minutes) is the dominant procedure, complemented by speech/communication work (92507) and therapeutic exercise (97110). This mix is consistent with an occupational-therapy–centric operation that delivers frequent, short-duration treatment sessions to pediatric patients.

97530 is a statewide outlier in both volume and rank: 18.7K claims, $2M revenue (95.4% of the provider's Medicaid revenue), $105 avg paid/claim, and it ranks #1 of 39 providers in-state (100th percentile; notably above typical state volume for this code). This position makes the provider a dominant in-state supplier of the specific service captured by 97530.

The secondary codes show typical, unremarkable participation in the state market: 92507 generated 930 claims and $55.8K revenue (2.7% of Medicaid revenue), $60 avg paid/claim, and ranks #17 of 25 (33th percentile; typical, unremarkable volume for this code); 97110 generated 587 claims and $24.7K revenue (1.2% of Medicaid revenue), $42 avg paid/claim, and ranks #19 of 44 (58th percentile; typical, unremarkable volume for this code). These positions suggest the provider is not notably differentiated on speech or therapeutic-exercise services.

Operationally, the dominance of 97530—a code billed in 15-minute units with a relatively high avg paid/claim ($105)—suggests a throughput model of many short therapy visits rather than a focus on longer, higher-complexity procedures. That service-delivery pattern has implications for scheduling, staffing, and billing workflows that are optimized for high-frequency, short-duration pediatric therapy encounters.

The provider has an established presence by tenure: NPI enumerated 2010-08-04 (~16 years ago). Combined with the concentrated code mix and leading in-state rank for 97530, tenure suggests long-standing specialization in the particular therapeutic activity driving revenue.

From a business-risk and competitive-monitoring perspective, this practice’s heavy reliance on one Medicaid service and lack of Medicare revenue creates concentrated exposure to changes in Medicaid reimbursement, utilization policy, or in-state competitive shifts for 97530. Analysts should prioritize monitoring reimbursement changes, claim-volume trends for 97530, and any state policy developments affecting pediatric occupational therapy billing.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	18,750	$110	$2M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	930	$60	$55.8K
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…	590	$40	$24.7K
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…	460	$30	$13.9K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Sensational Kids, LLC — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

4 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.	1	40	1,590	$50	$181.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17	30	1,410	$50	$144.2K
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…	19	40	470	$30	$75.1K
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…	10	20	440	$20	$32.2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sensational Kids, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bailey Ready	WY	Occupational Therapist	$40.4K	$0

Nearby Providers

Other providers in the same ZIP code as Sensational Kids, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Normative Services, Inc.	WY	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$8.5M
Lgbtq Telepsychiatry	WY	Psychiatric/Mental Health Nurse Practitioner	$0	$3.9M
Rehabilitation Enterprises Of Northeastern Wyoming	WY	Clinical Psychologist	$0	$3.5M
Northeast Wyoming Pediatric Associates, P.C.	WY	Pediatrics Physician	$0	$3.2M
Gillette Pediatric Dentistry LLC	WY	Pediatric Dentistry	$0	$2.9M
Eagle Ridge Rehabilitative Services	WY	Case Management Agency	$0	$2.6M
David Bailey	WY	Pediatric Dentistry	$0	$2.6M
Memorial Hospital Of Sheridan County	WY	General Acute Care Hospital	$0	$989.7K
Linda Garretson	WY	Developmentally Disabled Services Day Training Agency	$0	$989.3K
Senior Citizens Council	WY	Home Health Agency	$0	$959.7K

Sensational Kids, LLC — Billing Profile & Reimbursement Data

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Sensational Kids, LLC — 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