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

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

E & R Health Care Inc (NPI 1235401357)

Field	Value
Entity Type	Organization
Organization	E & R Health Care Inc
Address	12750 Nw 17th St Unit 111
City	Sweetwater
State	FL
ZIP	33182
Taxonomy	Home Health Agency
NPI Enumerated	February 5, 2012

Payer Source	Total Paid
Medicaid	$46.9M
Medicare	$0

Key Findings

E & R HEALTH CARE INC is effectively a Medicaid-focused operator: there is no Medicare billing on file and reported lifetime revenue is $46.9M from Medicaid. This concentration means the provider’s financial performance and strategic position are tightly linked to Medicaid policy and payment rates in Florida rather than Medicare dynamics.

Revenue is highly concentrated in a small set of service codes: the precomputed top three Medicaid codes account for 84.6% of the provider’s total Medicaid revenue, driven by T1019 (50.1%, $23.5M), S5130 (26.3%, $12.3M), and S5135 (8.2%, $3.8M). That concentration indicates the business is heavily reliant on personal-care and homemaker/companion service lines for its revenue base.

The code mix (T1019, S5130, S5135, plus other home-care codes) points to an operation focused on non‑skilled, in‑home support services — personal care, homemaker services, and companion care provided in short increments (per 15 minutes) rather than episodic skilled nursing or therapy. This pattern is consistent with a labor‑intensive, community‑based home care agency model emphasizing activities of daily living and instrumental ADL support.

Competitive standing within Florida is large and atypical for the top codes: T1019 (672K claims, $35 avg paid/claim, $23.5M revenue) ranks #7 of 762 providers in-state (99th percentile; extreme outlier), S5130 (560.3K claims, $22 avg paid/claim, $12.3M revenue) ranks #8 of 1073 (99th percentile; extreme outlier), and S5135 (175K claims, $22 avg paid/claim, $3.8M revenue) ranks #7 of 540 (99th percentile; extreme outlier). These rankings signal that the provider is a major state‑level participant for these Medicaid personal‑care and homemaker codes, well above typical state volume.

The provider shows established tenure: NPI enumerated on 2012-02-05 (~14 years ago), which suggests a multi‑year operating history that could support developed referral relationships and operational processes for high‑volume home care delivery. Longevity combined with extreme volume rankings for core codes implies an ingrained presence in the Florida Medicaid home‑care market.

Several additional Medicaid codes show meaningful but more typical contributions to revenue and volume: S9122 (46.6K claims, $67 avg paid/claim, $3.1M revenue; 6.7% of Medicaid revenue) ranks #43 of 348 providers in-state (88th percentile; typical, unremarkable volume), and T1004 (42.2K claims, $50 avg paid/claim, $2.1M revenue; 4.5%) ranks #57 of 511 (89th percentile; typical, unremarkable volume). S5150 (98.8K claims, $14 avg paid/claim, $1.4M revenue; 2.9%) ranks #7 of 123 providers in-state (95th percentile; notably above typical state volume for this code), indicating some areas of elevated market activity beyond the top three codes.

Operational scale is substantial based on claim counts for primary services — 672K claims for T1019, 560.3K claims for S5130, and 175K claims for S5135 — which implies a large frontline workforce and administrative capacity to deliver and bill frequent, short‑interval home‑care services. That scale creates operational leverage but also exposure to changes in Medicaid authorization, audit attention on high‑volume service lines, and sensitivity to per‑unit reimbursement shifts.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	672,040	$40	$23.5M
S5130	Homemaker service, nos; per 15 minutes	560,320	$20	$12.3M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	174,990	$20	$3.8M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	46,610	$70	$3.1M
T1004	Services of a qualified nursing aide, up to 15 minutes	42,180	$50	$2.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	98,760	$10	$1.4M
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…	4,860	$90	$417.7K
T1002	Rn services, up to 15 minutes	1,830	$110	$208.2K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	390	$0	$0
G0157	Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes	1,210	$0	$0

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

E & R Health Care Inc — 4 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	7	760	13,520	$50	$2.5M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	43	350	8,550	$120	$2.2M
S5130	Homemaker service, nos; per 15 minutes	8	1,070	11,250	$40	$1.3M
S5150	Unskilled respite care, not hospice; per 15 minutes	7	120	5,280	$50	$1M
T1004	Services of a qualified nursing aide, up to 15 minutes	57	510	7,390	$50	$958.8K
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	7	540	5,780	$40	$596.2K
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…	538	2,100	1,280	$40	$206.9K
Q5001	Hospice or home health care provided in patient's home/residence	79	220	250	$200	$123.4K
T1002	Rn services, up to 15 minutes	31	50	4,450	$10	$47.1K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	32	200	960	$10	$14.6K

Showing 1–10 of 12

E & R Health Care Inc — Billing Profile & Reimbursement Data

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E & R Health Care Inc — 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

Frequently Asked Questions

References