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

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

Theraplay Spot LLC (NPI 1912268392)

Theraplay Spot LLC is a speech-language pathologist provider located in Wichita, Kansas. This profile covers 0 Medicare and 11 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	Theraplay Spot LLC
Address	423 N Mclean Blvd
City	Wichita
State	KS
ZIP	67203
Taxonomy	Speech-Language Pathologist
NPI Enumerated	June 1, 2012

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

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

11 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.	23,550	$70	$1.7M
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…	11,720	$50	$586.2K
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…	190	$40	$6.5K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	1,060	$10	$6.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	30	$150	$4.3K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	60	$60	$3.8K
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…	140	$20	$3.2K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	30	$70	$2.2K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	20	$60	$950
97168	The occupational therapist (OT) performs a re–evaluation focusing on changes in the patient's functional, environment, or medical status that results in a revised plan of care; re–evaluation includes…	10	$50	$660

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Theraplay Spot LLC — 1 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	4	10	1,370	$160	$504.3K
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…	28	290	1,600	$40	$214.2K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	15	20	300	$20	$106.6K
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.	5	310	770	$30	$77.7K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	19	20	620	$30	$50.9K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	19	30	70	$110	$34K
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…	141	210	410	$20	$25.4K
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…	72	110	330	$20	$18.8K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	4	10	140	$60	$13.4K
97167	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of high analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	3	10	70	$60	$4.9K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
All Saints Home Care, Inc.	KS	Home Health Agency	$0	$129.8M
Independent Living Resource Center	KS	Personal Care Attendant	$0	$119.2M
County Of Sedgwick	KS	Mental Health Counselor	$0	$30M
Twin Lakes Dental PA	KS	General Practice Dentistry	$0	$16.8M
Home Buddy	KS	Emergency Response System Companies	$0	$10.6M
Saint Raphael Direct Care, Inc.	KS	Attendant Care Provider	$0	$10.6M
The Arc Of Sedgwick County, Inc.	KS	Case Management Agency	$0	$7M
Abbey Senior Care	KS	Assisted Living Facility	$0	$6.3M
Adventure Vision LLC	KS	Optometrist	$0	$6.1M
Wichita Treatment Center, Inc	KS	Methadone Clinic	$328.2K	$5.2M

Theraplay Spot LLC — Billing Profile & Reimbursement Data

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Theraplay Spot 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

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