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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Horizon Health Care Inc (NPI 1104248475)

Field	Value
Entity Type	Organization
Organization	Horizon Health Care Inc
Address	506 S Wilson St
City	Aberdeen
State	SD
ZIP	57401
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 6, 2014

Payer Source	Total Paid
Medicaid	$185.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	690	$150	$100K
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…	320	$160	$51.7K
W0037	N/A	840	$20	$15K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	90	$130	$12.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	40	$170	$6.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	140	$0	$0
90661	This code represents a vaccine product administered into the muscle to protect against the flu virus. This is a trivalent vaccine, meaning it protects against three different strains of influenza.…	20	$0	$0
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	10	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Horizon Health Care Inc — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	190	340	1,010	$100	$511K
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…	172	260	860	$80	$222.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	77	110	990	$20	$82.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	102	160	180	$40	$59.6K
W0037	N/A	78	160	690	$20	$50.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	95	130	110	$10	$6.9K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	17	20	30	$1	$240
90661	This code represents a vaccine product administered into the muscle to protect against the flu virus. This is a trivalent vaccine, meaning it protects against three different strains of influenza.…	12	20	40	$1	$80

Related Providers

Other providers that share a Tax Identification Number (TIN) with Horizon Health Care Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Horizon Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$9.7M
Horizon Health Care Inc.	SD	Federally Qualified Health Center (FQHC)	$0	$3.3M
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$3.2M
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$2.3M
Horizon Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$1.2M
Horizon Health Care Inc	SD	Family Medicine Physician	$0	$1.1M
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$915.7K
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$705.3K
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$507.3K
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$437.3K

Nearby Providers

Other providers in the same ZIP code as Horizon Health Care Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adjustment Training Center, Inc.	SD	Developmentally Disabled Services Day Training Agency	$0	$40.3M
Northeastern Mental Health Center	SD	Mental Health Counselor	$0	$10.1M
Vision Care Associates, LLP	SD	Optometrist	$0	$6M
Sanford Health Network	SD	General Acute Care Hospital	$0	$4.4M
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Avera St. Luke's	SD	Family Medicine Physician	$0	$2.3M
Sanford Health Network	SD	General Acute Care Hospital	$0	$1.9M
Avera At Home	SD	Home Health Agency	$0	$1.6M
Avera St Lukes	SD	General Acute Care Hospital	$0	$1.5M
Ty Hanson	SD	Dermatology Physician	$1.2M	$0

Horizon Health Care Inc — Billing Profile & Reimbursement Data

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Horizon Health Care Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References