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 1225411945)

Horizon Health Care Inc is a federally qualified health center (fqhc) provider located in Fort Thompson, South Dakota. 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	Horizon Health Care Inc
Address	125 Sd Hwy 249
City	Fort Thompson
State	SD
ZIP	57339
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 30, 2015

Payer Source	Total Paid
Medicaid	$705.3K
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
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…	2,770	$160	$453.5K
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…	1,280	$160	$201.8K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	90	$160	$14.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	80	$160	$12.5K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	50	$180	$8.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	120	$50	$5.7K
99203	The provider sees a new 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 provider…	10	$200	$2.6K
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…	10	$180	$2.6K
87807	The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation.	10	$170	$2.2K
W0037	N/A	520	$1	$1.6K

Showing 1–10 of 11

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 10 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

11 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…	101	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…	109	260	860	$80	$222.6K
99203	The provider sees a new 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 provider…	98	100	160	$60	$64.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	96	160	180	$40	$59.6K
W0037	N/A	95	160	690	$20	$50.1K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	12	20	220	$20	$24.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	55	80	210	$30	$18K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	43	70	210	$20	$14.7K
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…	125	130	110	$10	$6.9K
87807	The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation.	25	30	70	$20	$3.7K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fort Thompson Indian Health Service	SD	Clinic/Center	$0	$10.8M
Crow Creek Sioux Tribe	SD	Land Ambulance	$37.7K	$202K
John Mcfee	SD	Family Medicine Physician	$25.6K	$0
Renette Kroupa	SD	Medical Physician Assistant	$7.2K	$0
Patricia Hamiel	SD	Family Nurse Practitioner	$3.7K	$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

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	$507.3K
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$437.3K
Horizon Health Care Inc	SD	Federally Qualified Health Center (FQHC)	$0	$379.8K