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

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

Sophia Horwath (NPI 1417395880)

Field	Value
Entity Type	Individual
Organization	Sophia Horwath
Address	2112 Harrisburg Pike
City	Lancaster
State	PA
ZIP	17601
Taxonomy	Family Medicine Physician
NPI Enumerated	June 7, 2013

Payer Source	Total Paid
Medicare	$33.8K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	100	$120	$12K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	120	$70	$8.6K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	40	$140	$5.1K
G0317	Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary…	200	$20	$4.6K
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…	20	$90	$2.1K
99204	The provider sees a new 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 provider…	10	$120	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Sophia Horwath — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	997	1,660	170	$80	$27.4K
99214	20,146	23,230	100	$80	$14.5K
99310	263	780	60	$110	$13.8K
99306	426	760	50	$140	$11.4K
99204	9,769	10,290	30	$110	$5K
G0317	3	50	50	$20	$1.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sophia Horwath, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lancaster General Hospital	PA	General Acute Care Hospital	$0	$33.7M
Rebecca Shepherd	PA	Rheumatology Physician	$1.3M	$0
Lisa Allen	PA	Rheumatology Physician	$863.6K	$0
Sandhya Adusumilli	PA	Rheumatology Physician	$817.3K	$0
Charles Henderson	PA	Rheumatology Physician	$556.3K	$500
Paul Sieber	PA	Urology Physician	$518K	$0
Andrew Old	PA	Orthopaedic Surgery Physician	$420.7K	$0
Sriram Venigalla	CO	Radiation Oncology Physician	$344.2K	$0
Matthew Bernabei	PA	Clinical Cardiac Electrophysiology Physician	$248.7K	$2.8K
Paul Russinko	PA	Urology Physician	$250.9K	$0

Nearby Providers

Other providers in the same ZIP code as Sophia Horwath, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$34.4M
Andventure, LLC	PA	Home Health Agency	$0	$26.7M
Efcc Acquisition Corp	PA	Home Health Agency	$0	$13.1M
Smilebuilderz LLC	PA	Dentist	$0	$11.5M
Teamcare Behavioral Health, LLC	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.3M
Horizon Healthcare Services, LLC	PA	Home Infusion Therapy Pharmacy	$12.2K	$6.5M
Penn State Health Lancaster Medical Center	PA	General Acute Care Hospital	$0	$5.4M
Advanced Surgery Center Of Lancaster, LLC	PA	Ambulatory Surgical Clinic/Center	$4M	$0
Roy Brod	PA	Retina Specialist (Ophthalmology) Physician	$2.8M	$0
Dina Gewaily	PA	Ophthalmology Physician	$1.8M	$2.7K

Sophia Horwath — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References