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

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

Healthcare Innovations Private Services (NPI 1326264359)

Field	Value
Entity Type	Organization
Organization	Healthcare Innovations Private Services
Address	7101 Nw Expressway Ste 325
City	Oklahoma City
State	OK
ZIP	73132
Taxonomy	Home Health Agency
NPI Enumerated	April 18, 2007

Payer Source	Total Paid
Medicaid	$49.1M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and Total Medicaid revenue is $49.1M, indicating that all documented fee‑for‑service activity in our dataset is Medicaid‑driven. The absence of Medicare volume means comparisons to national Medicare peers are not applicable for this entity.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicaid codes account for 98.1% of this provider’s total Medicaid revenue, with T1016 alone generating $40.1M (81.7% of Medicaid revenue). This level of concentration implies that the provider’s financial performance is tightly linked to reimbursement and utilization patterns for a handful of home‑health case management and nursing codes.

T1016 (Case management, each 15 minutes) dominates the billing profile by claim volume and dollars: 617.3K claims at $65 avg paid/claim producing $40.1M. This suggests the organization’s operations emphasize recurring case management encounters at scale rather than a broad mix of episodic home‑health procedures.

Clinical service mix points to a care model centered on case management and routine nursing visits: the top codes are T1016 (case management), T1002 (RN services, up to 15 minutes), and G0300 (LPN skilled nursing, each 15 minutes). Together these codes (T1016, T1002, G0300) capture the main service lines billed and indicate a home health agency workflow focused on frequent, short‑interval nursing and case management encounters.

State competitive standing is dominant for multiple Medicaid codes: T1002 ranks #1 of 49 providers in‑state (100th percentile; extreme outlier) with 71.5K claims and $5.9M revenue, and G0300 ranks #1 of 20 providers in‑state (100th percentile; extreme outlier) with 33.9K claims and $2.2M revenue. T1016 also ranks very highly at #2 of 137 providers (99th percentile; extreme outlier), indicating this provider operates at volumes far above typical state peers for its primary service lines.

A secondary but notable component of the billing mix is G0299 (RN skilled nursing), which accounts for $941K (1.9% of Medicaid revenue) on 14.3K claims at $66 avg paid/claim and ranks #1 of 19 providers in‑state (100th percentile; extreme outlier). While smaller as a revenue share, G0299 reinforces that registered nurse visits are part of the agency’s clinical footprint.

Operational and payer‑mix implications: the provider’s reliance on high volumes of short‑interval case management and nursing claims (e.g., 617.3K T1016 claims) creates operational scale in those specific workflows but also means limited revenue diversification given no Medicare billing and the precomputed top 3 codes accounting for 98.1% of Medicaid revenue. Strategic or reimbursement changes to these few codes could materially affect overall revenue.

Tenure data show an established presence: NPI enumerated on 2007-04-18 (~19 years ago), indicating long‑running participation in Medicaid markets and suggesting the organization has had time to build the high volumes and specialized operations reflected in the billing profile.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1016	Case management, each 15 minutes	617,310	$70	$40.1M
T1002	Rn services, up to 15 minutes	71,490	$80	$5.9M
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	33,900	$70	$2.2M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	14,260	$70	$941K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oklahoma Distribution

Healthcare Innovations Private Services — 4 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. Oklahoma median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1016	Case management, each 15 minutes	2	140	3,200	$60	$2.3M
T1002	Rn services, up to 15 minutes	1	50	1,690	$80	$367.6K
G0300	Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each 15 minutes	1	20	140	$60	$199.6K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	1	20	1,830	$70	$188.8K

Nearby Providers

Other providers in the same ZIP code as Healthcare Innovations Private Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Dental Partners PLLC	OK	Pediatric Dentistry	$0	$39.4M
Quick Test Lab Diagnostics LLC	OK	Clinical Medical Laboratory	$3.8M	$248.5K
Red Dirt Orthodontics PLLC	OK	Dental Clinic/Center	$0	$3.9M
Express Family Care LLC	OK	Primary Care Clinic/Center	$0	$2M
Miracles Counseling Services, LLC	OK	Community/Behavioral Health Agency	$0	$1.7M
Perigon Imaging LLC	OK	Radiology Clinic/Center	$478.8K	$0
Travis Gittins	OK	Optometrist	$35.4K	$294.2K
Sams East Inc	OK	Community/Retail Pharmacy	$100.5K	$0
Jerry Mullen	OK	Optometrist	$20.3K	$0
Jenny Mikes	OK	Registered Dietitian	$2.4K	$0

Healthcare Innovations Private Services — Billing Profile & Reimbursement Data

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Healthcare Innovations Private Services — 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