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

Why is the Medicaid comparison limited to Alabama 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. Alabama (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 Medical Clinic LLC (NPI 1588904791)

Horizon Medical Clinic LLC is a multi-specialty clinic/center provider located in Oneonta, Alabama. This profile covers 0 Medicare and 44 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 Medical Clinic LLC
Address	2345 2nd Ave E Ste B
City	Oneonta
State	AL
ZIP	35121
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	February 25, 2013

Payer Source	Total Paid
Medicaid	$7.2M
Medicare	$0

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	42,940	$150	$6.4M
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	12,460	$20	$186.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,140	$150	$171.8K
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.	17,140	$10	$171.4K
87807	The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation.	3,000	$10	$24K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	2,970	$10	$23.8K
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…	10,090	$1	$20.2K
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…	17,180	$1	$17.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	830	$20	$13.2K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	880	$20	$13.2K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Horizon Medical Clinic LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	39	240	6,820	$120	$2.9M
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…	155	1,990	680	$60	$201.7K
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…	134	1,990	560	$40	$185.6K
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…	73	270	1,360	$60	$159.7K
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…	106	300	1,160	$50	$147.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	109	320	640	$50	$98.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	271	300	210	$40	$77.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	144	230	410	$40	$59.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	127	300	330	$50	$56.3K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	54	260	910	$20	$47.2K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alabama Pediatric Therapy Services, LLC	AL	Occupational Therapist	$0	$7.1M
Midway Medical Clinic LLC	AL	Multi-Specialty Clinic/Center	$0	$6.6M
St. Vincent's Blount	AL	Rural Health Clinic/Center	$0	$1.9M
St Vincents Blount	AL	Critical Access Hospital	$0	$1.1M
Mina Khan	AL	Family Medicine Physician	$37.9K	$0
Lisa Buchanon	AL	Family Nurse Practitioner	$23.3K	$0

Horizon Medical Clinic LLC — Billing Profile & Reimbursement Data

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Horizon Medical Clinic LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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