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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Kids Co. PLLC (NPI 1932617792)

Whole Kids Co. PLLC is a professional counselor provider located in Colorado Springs, Colorado. This profile covers 0 Medicare and 29 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	Whole Kids Co. PLLC
Address	11681 Voyager Pkwy Ste 150
City	Colorado Springs
State	CO
ZIP	80921
Taxonomy	Professional Counselor
NPI Enumerated	January 15, 2018

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	23,350	$170	$3.9M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	28,400	$80	$2.2M
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.	18,050	$120	$2.2M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	7,890	$140	$1.1M
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…	12,800	$60	$793.7K
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…	12,570	$60	$766.6K
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…	4,280	$60	$248.4K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	2,820	$80	$237K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,170	$90	$103.1K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	690	$120	$79.7K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Whole Kids Co. PLLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	7	150	2,450	$270	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	9	150	800	$210	$457.9K
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…	108	310	1,750	$40	$319.9K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	16	1,670	550	$100	$229.3K
96133	The provider, a physician or other qualified healthcare professional, administers neuropsychological tests, face–to–face with the patient. Report this code in addition to the primary code (96132) for…	12	40	180	$230	$227.5K
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	680	1,160	$50	$223.5K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	6	20	150	$310	$161.8K
96137	Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (List…	3	50	140	$160	$130.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	161	590	200	$80	$119.9K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	11	40	180	$110	$109.7K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elizabeth Ostendorf LLC	CO	Behavior Analyst	$0	$43.8M
Choice Home Care Colorado Springs, LLC	CO	In Home Supportive Care Agency	$0	$11M
Jjn Home Health Agency Inc.	CO	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$6.9M
James Albert	CO	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$656.2K	$0
John Swenson	CO	Podiatrist	$90.4K	$0
Nathanael Brady	CO	Allergy Physician	$73.3K	$0
Terri Nagy	CO	Physician Assistant	$59.6K	$4K
Kathleen Dilday	CO	Family Nurse Practitioner	$47.2K	$0
Allison Wood	CO	Nurse Practitioner	$27.8K	$0
Amy Fitzgerald	CO	Family Nurse Practitioner	$22.9K	$0

Whole Kids Co. PLLC — Billing Profile & Reimbursement Data

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Whole Kids Co. PLLC — 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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