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

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

Vav Operations LLC (NPI 1942576905)

Key Findings

Field	Value
Entity Type	Organization
Organization	Vav Operations LLC
Address	1827 E Ireland Rd
City	South Bend
State	IN
ZIP	46614
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	March 23, 2012

Payer Source	Total Paid
Medicaid	$198.8M
Medicare	$0

VAV OPERATIONS LLC reports no Medicare billing on file and $198.8M in lifetime Medicaid revenue, making its business effectively single‑payer Medicaid in scale. The absence of Medicare claims means all measurable reimbursement exposure in our dataset comes from Medicaid-funded services, concentrating payor risk entirely on state program rules and rates.

Revenue is extremely concentrated in a very small set of procedure codes: the precomputed top three Medicaid codes (97153, 97155, 96152) account for 99.0% of the provider's Medicaid revenue. Specifically, 97153 produces $179.1M (90.1% of Medicaid revenue), 97155 produces $16.6M (8.4%), and 96152 produces $1.1M (0.6%), per the provided figures.

The code mix indicates VAV operates primarily as an adaptive behavior/ABA services provider: 97153 and 97155 are supervised technician and clinician-delivered adaptive behavior treatment units reported in 15‑minute increments, and high counts of these units drive the revenue profile. For example, 97153 shows 307.8K claims with an average paid/claim of $582, and 97155 shows 139.6K claims at $119 avg paid/claim, suggesting a high-volume, short‑unit service delivery model with many technician‑level sessions overseen by qualified professionals.

On competitive standing within the state, VAV is a dominant provider for its core ABA codes. 97153 ranks #1 of 96 providers in-state (100th percentile; extreme outlier) and 97155 ranks #1 of 84 providers in-state (100th percentile; extreme outlier), which together indicate the organization is a statewide outlier in volume and revenue for those services.

Other codes associated with assessment and caregiver interaction show notable but much smaller presence: 97156 (face‑to‑face caregiver treatment) reports 10.1K claims and $775K revenue and ranks #1 of 42 providers in-state (100th percentile; extreme outlier), while 97151 (assessment/planning) reports 4.7K claims and $683.1K revenue and ranks #2 of 30 providers in-state (97th percentile; notably above typical state volume). In contrast, codes such as 96152 (8.8K claims, $1.1M revenue) rank #8 of 43 providers in-state (83th percentile; typical, unremarkable volume) and therapy codes like 92507 (4.6K claims, $217.7K revenue) sit near median state participation (rank #174 of 388; 55th percentile).

The provider’s operational and financial profile shows high exposure to unit‑based Medicaid reimbursement dynamics because 97153 alone accounts for $179.1M and 90.1% of Medicaid revenue, with 307.8K claims concentrated in that single code. That level of concentration makes overall revenue highly sensitive to reimbursement rate changes, utilization management, or policy edits specific to adaptive behavior service codes.

VAV has an established NPI tenure, enumerated on 2012-03-23 (~14 years ago), which along with the reported claim volumes suggests a sustained, large-scale in‑state presence in pediatric/adaptive behavior services. The combination of long tenure and outsized rank for core ABA codes supports interpreting the entity as an established statewide provider rather than a recent entrant.

For payer/provider analysts, these facts combine into a clear signal: VAV should be evaluated as a Medicaid-centric, ABA-focused operator whose material financial performance is driven by a tiny set of high-volume codes (97153 and 97155) and by state Medicaid policy. Monitoring utilization trends and reimbursement changes for 97153, 97155, and related caregiver/assessment codes will capture the lion’s share of any future revenue impact for this provider.

Medicaid: Complete Services Breakdown

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

16 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…	307,820	$580	$179.1M
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…	139,640	$120	$16.6M
96152	N/A	8,830	$120	$1.1M
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	10,070	$80	$775K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	4,740	$140	$683.1K
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…	4,630	$50	$217.7K
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.	2,070	$60	$130.7K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	3,020	$30	$78.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	520	$130	$67.7K
96130	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…	330	$40	$11.8K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Vav Operations LLC — 4 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

16 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…	1	100	3,740	$430	$7.7M
96152	N/A	8	40	720	$200	$1.1M
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…	1	80	1,360	$150	$1M
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…	174	390	3,600	$50	$511.6K
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.	153	400	1,100	$40	$382.2K
97154	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	9	10	3,370	$40	$219.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	184	520	240	$80	$165K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	2	30	520	$140	$135.1K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	1	40	210	$70	$57.8K
96155	N/A	7	10	230	$40	$24.8K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cynthia Mayfield	IN	Dermatology Physician	$320K	$0
Luiz Pantalena Filho	IN	Dermatology Physician	$308.8K	$0
Walgreen Co	IN	Pharmacy	$142.7K	$0
Kathleen Kelley	IN	Dermatology Physician	$114.6K	$0
Heather Campion	IN	Orthopaedic Hand Surgery Physician	$61.1K	$0
Sean Horner	IN	Physician Assistant	$60.6K	$0
John Mahon	IN	Orthopaedic Hand Surgery Physician	$53.3K	$0
Jennifer Besemer	IN	Registered Dietitian	$4K	$0
Lisa Levin	IN	Clinical Social Worker	$1K	$0

Vav Operations LLC — Billing Profile & Reimbursement Data

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Vav Operations 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

Nearby Providers

Frequently Asked Questions

References