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

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

Sunny Horizons, LLC (NPI 1144524166)

Field	Value
Entity Type	Organization
Organization	Sunny Horizons, LLC
Address	305 W Peachtree St
City	Scottsboro
State	AL
ZIP	35768
Taxonomy	Speech-Language Pathologist
NPI Enumerated	January 5, 2011

Payer Source	Total Paid
Medicaid	$7.3M
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
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…	64,770	$70	$4.3M
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.	47,110	$50	$2.4M
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…	12,440	$40	$472.7K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	1,290	$110	$144.9K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	390	$40	$16.2K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	70	$40	$2.6K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	50	$50	$2.3K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	20	$30	$660

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Sunny Horizons, LLC — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	3	180	1,490	$50	$404.5K
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.	5	320	1,170	$40	$182.3K
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	320	670	$20	$69.3K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	5	80	60	$110	$27.5K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	30	30	180	$30	$24.2K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	5	30	40	$30	$4.2K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	8	20	30	$30	$2.8K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	10	30	30	$30	$2.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kids 1st Pediatrics, LLC	AL	Pediatrics Physician	$0	$14.6M
New Beacon Healthcare Group, LLC	AL	Community Based Hospice Care Agency	$0	$6.2M
American Drug Testing Lab LLC	AL	Clinical Medical Laboratory	$0	$5.4M
Scottsboro Pediatrics PC	AL	Primary Care Clinic/Center	$0	$4M
Northeast Alabama Health Services, Inc	AL	Federally Qualified Health Center (FQHC)	$0	$3.7M
Premier Medical Clinic LLC	AL	Multi-Specialty Clinic/Center	$0	$3.6M
Valley Medical Clinic LLC	AL	Rural Health Clinic/Center	$0	$1.6M
Hh Health System - Jackson LLC	AL	Land Ambulance	$934.4K	$406K
Scottsboro Ent, PC	AL	Otolaryngology Physician	$0	$1.2M
Adl Occupational Therapy, LLC	AL	Occupational Therapist	$0	$1.1M

Sunny Horizons, LLC — Billing Profile & Reimbursement Data

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Sunny Horizons, 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

Nearby Providers

Frequently Asked Questions

References