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

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

Opportunities Unlimited, Inc. (NPI 1295850493)

Field	Value
Entity Type	Organization
Organization	Opportunities Unlimited, Inc.
Address	325 Snake River Ave
City	Lewiston
State	ID
ZIP	83501
Taxonomy	Specialist
NPI Enumerated	March 20, 2007

Payer Source	Total Paid
Medicaid	$9.1M
Medicare	$0

Key Findings

OPPORTUNITIES UNLIMITED, INC. is effectively a Medicaid-focused provider with no Medicare billing on file and $9.1M in lifetime Medicaid revenue, indicating a single-payer operational footprint concentrated on state Medicaid programs rather than traditional Medicare fee-for-service. The provider’s NPI was enumerated on 2007-03-20 (~19 years ago), showing long-standing enrollment and operational tenure in the market.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes by revenue account for 78.3% of this provider’s total Medicaid revenue. The three dominant codes are H0004 ($3.6M, 39.5%), H2032 ($2M, 21.9%), and 97537 ($1.5M, 16.9%), so strategic shifts or reimbursement changes to any of these three lines would materially affect overall revenue.

The code mix indicates a service model centered on behavioral health and community-based rehabilitation: H0004 is behavioral health counseling and therapy per 15 minutes, H2032 is activity therapy per 15 minutes, and 97537 is community work reintegration training billed in 15-minute units. High claim volumes — 24.5K claims for H0004, 45.4K claims for H2032, and 61.7K claims for 97537 — combined with time-based unit pricing (e.g., $147 avg paid/claim for H0004, $44 for H2032, $25 for 97537) suggest an operational emphasis on high-frequency, short-interval therapeutic services.

Competitive standing across these key Medicaid services is mixed but generally above average in-state: H0004 ranks #20 of 157 providers in-state (88th percentile; typical, unremarkable volume for this code), and H2032 ranks #8 of 41 providers in-state (83th percentile; typical, unremarkable volume for this code), indicating the provider is above many peers on these behavioral health activities. 97537 ranks #12 of 41 providers in-state (73th percentile; typical, unremarkable volume for this code), reflecting a solid but not dominant position in community work reintegration training.

Certain specialty services show pockets of stronger relative positioning: H2015 (Comprehensive community support services) generated $1.1M (11.9% of Medicaid revenue) and ranks #5 of 45 providers in-state (91th percentile; typical, unremarkable volume for this code), suggesting the provider is among the more active statewide for that specific community support service even while the dataset labels overall volume as typical. In contrast, T1019 (personal care services) and T1027 (family training and counseling for child development) are lower-volume lines (T1019: $336.8K, 6.4K claims, rank #66 of 101, 35th percentile; T1027: $10.4K, 432 claims, rank #32 of 44, 28th percentile), indicating limited exposure in those ancillary service areas.

The profile implies an operational model optimized for high-volume, time-based billing rather than high-dollar single procedures: numerous per-15-minute codes dominate revenue and claims counts, with the lower average paid/claim on high-volume codes (e.g., $25 avg for 97537) balanced by very large claim volumes. This pattern points to workforce-intensive service delivery (many short therapy or activity units) and sensitivity to per-unit rate changes and utilization management policies.

From a payer or contracting perspective, this provider represents a concentrated Medicaid risk partner: with 78.3% of Medicaid revenue coming from three codes, payers should expect material utilization and cost exposure tied to behavioral health counseling, activity therapy, and work reintegration services. Given the absence of Medicare revenue, contracting strategies, network adequacy assessments, or population health interventions should be evaluated primarily through the Medicaid lens and the specific service lines highlighted here.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	24,540	$150	$3.6M
H2032	Activity therapy, per 15 minutes	45,450	$40	$2M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	61,740	$30	$1.5M
H2015	Comprehensive community support services, per 15 minutes	14,750	$70	$1.1M
H2019	Therapeutic behavioral services, per 15 minutes	3,020	$110	$343.7K
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…	6,360	$50	$336.8K
96152	N/A	1,540	$130	$201.3K
T1027	Family training and counseling for child development, per 15 minutes	430	$20	$10.4K
H2000	Comprehensive multidisciplinary evaluation	30	$40	$1.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Opportunities Unlimited, Inc. — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

9 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…	66	100	11,400	$80	$2M
H0004	Behavioral health counseling and therapy, per 15 minutes	20	160	4,020	$140	$1.6M
H2032	Activity therapy, per 15 minutes	8	40	19,190	$50	$1.6M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	12	40	30,150	$20	$1.2M
H2019	Therapeutic behavioral services, per 15 minutes	29	60	2,960	$120	$609.8K
96152	N/A	43	70	2,270	$80	$608.8K
H2015	Comprehensive community support services, per 15 minutes	5	50	2,960	$100	$570.3K
T1027	Family training and counseling for child development, per 15 minutes	32	40	1,050	$40	$66.8K
H2000	Comprehensive multidisciplinary evaluation	12	20	40	$30	$8.3K

Nearby Providers

Other providers in the same ZIP code as Opportunities Unlimited, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Nursing Services, Inc.	ID	Adult Day Care Clinic/Center	$0	$29.3M
Catalyst Medical Group, PLLC	ID	Multi-Specialty Clinic/Center	$0	$11.4M
St. Joseph Hospital LLC	ID	General Acute Care Hospital	$0	$4.7M
County Of Nez Perce Independent School District No 1	ID	Local Education Agency (LEA)	$0	$3.5M
Community Health Association Of Spokane	ID	Federally Qualified Health Center (FQHC)	$0	$3.2M
City Of Lewiston	ID	Land Ambulance	$697.3K	$1.9M
Riverside Recovery LLC	ID	Addiction (Substance Use Disorder) Counselor	$0	$2.1M
Addus Healthcare (idaho), Inc	ID	In Home Supportive Care Agency	$0	$2M
Emeritus Properties Ii, Inc.	ID	Assisted Living Facility	$0	$1.9M
Hospitalist Medicine Physicians Of Idaho- Nampa PLLC	ID	Emergency Medicine Physician	$0	$1.7M

Opportunities Unlimited, Inc. — Billing Profile & Reimbursement Data

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Opportunities Unlimited, 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

Nearby Providers

Frequently Asked Questions

References