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

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

John Horgan (NPI 1568465680)

Field	Value
Entity Type	Individual
Organization	John Horgan
Address	10707 Pacific St
City	Omaha
State	NE
ZIP	68114
Taxonomy	Urology Physician
NPI Enumerated	May 23, 2005

Payer Source	Total Paid
Medicare	$652.2K
Medicaid	$0

Key Findings

This provider is effectively single‑payer in the claims data: lifetime Medicare revenue is $652.2K while Medicaid shows none on file, so analysis of service mix and financial exposure should focus on Medicare activity only. The absence of Medicaid billing means the practice’s public-payer footprint is concentrated entirely in Medicare reimbursements.

Revenue is highly concentrated in a small set of Medicare codes: the top three codes account for 49.6% of total Medicare revenue, and a single code, J0897, contributes $177.8K (28.5% of Medicare revenue). That concentration indicates a material dependency on injectable therapy reimbursement streams rather than a broadly diversified Medicare revenue base.

The code mix points to a urology practice that combines clinic-based evaluation and management with high-volume outpatient injectable therapies and specialized urology diagnostics and procedures. Dominant codes include J0897 (denosumab) and leuprolide codes (J9217, J1952), alongside frequent E/M codes (99214, 99213) and procedural codes such as 52000 (cystoscopy), 51728 (complex cystometrogram), and 76872 (transrectal ultrasound), implying integrated office-based medical oncology/hormonal management for prostate disease plus diagnostic and procedural urology services.

Clinical visit volume is a key business driver: 99214 ($78.9K) and 99213 ($45K) both rank in the 98th percentile nationally and are labeled notably above typical national volume, while 99215 ranks in the 96th percentile. These high percentiles for established‑patient E/M codes indicate the provider sees substantially more ambulatory urology visits than most peers and likely operates a busy outpatient clinic with sustained follow-up care.

The practice appears to be a significant national participant in medical hormonal therapy for urologic indications: J9217 (leuprolide) generates $52.2K and ranks #170 of 3683 providers nationally (95th percentile; notably above typical national volume). Complementary high‑percentile procedural codes — 51728 (93rd percentile) and 51797 (93rd percentile) — suggest a niche that pairs hormonal therapy administration with urodynamic evaluation.

Although some injectables and procedures are prominent, several imaging and inpatient initial visit codes are comparatively modest: CT abdomen/pelvis codes like 74176 and 74178, and initial hospital visit 99223, rank well below the top percentiles (35th, 89th, and 27th percentile labels respectively), indicating the provider is not a dominant source for advanced cross‑sectional imaging or high volumes of inpatient initial consultations. This pattern reinforces an ambulatory-focused practice rather than a hospital‑based referral center.

The practice provides procedural treatments for benign prostatic hyperplasia and stone disease alongside medical therapies: 53854 (water vapor thermal procedure) accounts for $20.5K (3.3% of Medicare revenue) and 50590 (ESWL) contributes $11.8K (1.9% of Medicare revenue), both with typical, unremarkable national volumes. These entries show diversification into procedural interventions for lower urinary tract symptoms and lithotripsy, but those services are smaller revenue contributors compared with injectables and E/M visits.

This provider has a long tenure in the NPI file, enumerated 2005-05-23 (~21 years ago), which combined with lifetime Medicare revenue of $652.2K suggests an established community practice with consistent Medicare activity over time. The established NPI plus concentrated revenue streams should guide analysts to investigate operational models (office-based injection programs, urodynamics labs) rather than recent startup growth or broad Medicaid expansion.

Medicare: Complete Services Breakdown

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	9,360	$20	$177.8K
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…	990	$80	$78.9K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	380	$140	$52.2K
J1952	Leuprolide injectable, camcevi, 1 mg	880	$60	$52K
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…	830	$50	$45K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	290	$110	$33.1K
51728	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…	90	$260	$24.3K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	520	$50	$23.4K
53854	The provider uses a radiofrequency–generated water vapor thermal device to destroy prostate tissue to treat BPH and lower urinary tract symptoms.	20	$1,210	$20.5K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	230	$80	$16.9K

Showing 1–10 of 48

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 48 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nebraska Distribution

John Horgan — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. state median

48 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1952	3	10	1,430	$70	$85.6K
J0897	18	200	2,040	$20	$62.7K
J9155	2	10	4,000	$1	$21.7K
52000	8	50	120	$120	$20.7K
J9217	2	50	110	$130	$20.6K
53854	1	10	20	$1,200	$20.5K
99214	75	3,210	110	$70	$14.9K
55700	31	50	30	$310	$13.4K
99490	30	180	220	$40	$13K
50590	2	10	20	$540	$12.4K

Showing 1–10 of 48

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rush University Medical Center	IL	General Acute Care Hospital	$0	$4.8M
Jack Cohen	IL	Retina Specialist (Ophthalmology) Physician	$3.8M	$445.2K
Barbara Cook	AZ	Nuclear Medicine Physician	$1.2M	$0
The Urology Center, PC	NE	Ambulatory Surgical Clinic/Center	$909.9K	$2.8K
Ansar Khan	NE	Urology Physician	$483.4K	$0
Andrew Trainer	NE	Urology Physician	$465.1K	$0
John Bishay	NE	Urology Physician	$433.8K	$0
Judson Davies	NE	Urology Physician	$380.6K	$0
Jean Thomsen	IA	Anatomic Pathology & Clinical Pathology Physician	$346.3K	$30.2K
Rebecca Mccrery	NE	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$311.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital & Medical Center	NE	Children's Hospital	$0	$89.8M
Children's Physicians	NE	Pediatrics Physician	$0	$39.4M
Nebraska Pediatric Practice, Inc	NE	Pediatrics Physician	$0	$29M
Physicians Clinic Inc	NE	Family Medicine Physician	$0	$20.5M
Nebraska Methodist Hospital	NE	General Acute Care Hospital	$0	$14.5M
Smiles 4 Kids PC	NE	General Practice Dentistry	$0	$11.5M
Children's Hospital	NE	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$8.4M
Nebraska Methodist Hospital	NE	Emergency Medicine Physician	$0	$5.3M
Unmc College Of Dentistry	NE	Dentist	$0	$4.8M
Stones Worth Stepping, P.C.	NE	Occupational Therapist	$0	$4.7M

John Horgan — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References