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 1558335349)

Horizon Health Care Inc is a federally qualified health center (fqhc) provider located in Eagle Butte, South Dakota. This profile covers 0 Medicare and 33 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	8000 E Hwy 212
City	Eagle Butte
State	SD
ZIP	57625
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 16, 2006

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

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

33 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…	8,070	$170	$1.3M
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…	1,660	$140	$238.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,140	$70	$145.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	560	$170	$93.5K
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.	530	$170	$89K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	490	$170	$85.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	330	$170	$56.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	270	$160	$41.9K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	740	$50	$39.4K
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…	430	$90	$38.4K

Showing 1–10 of 33

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 23 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

33 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…	51	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…	90	260	860	$80	$222.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	36	40	1,100	$80	$181.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22	50	410	$80	$127.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	48	160	210	$120	$97.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	72	110	990	$20	$82.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	27	60	170	$90	$66.3K
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…	66	80	120	$80	$61.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	26	160	180	$40	$59.6K
W0037	N/A	35	160	690	$20	$50.1K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eagle Butte Indian Health Service Hospital	SD	Public Health or Welfare Agency	$0	$19.2M
Cheyenne River Sioux Tribe Field Health Clinic	SD	Primary Care Clinic/Center	$0	$8M
Blackhills Dialysis, L.L.C.	SD	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.6M
Missouri Breaks Industries Research, Inc.	SD	Durable Medical Equipment & Medical Supplies	$0	$2M
Cheyenne River Dental Clinic	SD	Public Health Dentistry	$0	$1.6M
Margaret Upell	SD	Family Medicine Physician	$21.2K	$377.7K
Medicine Wheel Village	SD	Assisted Living Facility	$0	$119.7K
Jaime Aguilar	SD	Physician Assistant	$8K	$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	$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	$705.3K
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