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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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 Healthcare, Inc (NPI 1639193212)

Field	Value
Entity Type	Organization
Organization	Horizon Healthcare, Inc
Address	5408 W Burleigh St
City	Milwaukee
State	WI
ZIP	53210
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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…	21,410	$30	$556.6K
Q3014	Telehealth originating site facility fee	31,760	$20	$508.1K
99205	The provider sees a new 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 provider…	2,170	$90	$199.2K
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…	4,380	$40	$157.8K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	660	$70	$46.5K
96103	N/A	110	$40	$4.1K
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…	40	$50	$2K
H0049	Alcohol and/or drug screening	30	$30	$990
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	190	$10	$930

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Horizon Healthcare, Inc — 4 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	225	1,630	270	$40	$205.3K
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…	67	1,760	250	$40	$173.2K
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…	274	350	210	$60	$95.8K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	32	170	110	$80	$62.4K
Q3014	Telehealth originating site facility fee	4	170	250	$20	$44K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	178	260	880	$10	$32.7K
99205	The provider sees a new 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 provider…	3	120	50	$90	$18.9K
H0049	Alcohol and/or drug screening	12	10	130	$20	$18.6K
96103	N/A	1	10	20	$30	$1.4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clovis Homecare, Inc.	NM	Home Health Agency	$0	$84M
Vgm Group, Inc.	IA	Durable Medical Equipment & Medical Supplies	$0	$54.4M
Ascension Medical Group-southeast Wisconsin Inc	WI	Internal Medicine Physician	$0	$44.8M
Horizon Home Care & Hospice, Inc.	WI	Home Health Agency	$0	$15.6M
Horizon Healthcare, Inc	WI	Multi-Specialty Clinic/Center	$0	$10.2M
Lakeview Medical Center Inc Of Rice Lake	WI	Rural Acute Care Hospital	$0	$10M
Lakeview Medical Center Inc Of Rice Lake	WI	Clinic/Center	$0	$1.6M
Ministry Home Care, LLC.	WI	Community Based Hospice Care Agency	$0	$1.5M
Anthony Hale	WI	Psychiatric/Mental Health Nurse Practitioner	$15.9K	$223.4K
Kim Wolf	WI	Nurse Practitioner	$39K	$148.6K

Nearby Providers

Other providers in the same ZIP code as Horizon Healthcare, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ascension Se Wisconsin Hospital, Inc	WI	General Acute Care Hospital	$0	$94.4M
Center For Pain Management, Sc	WI	Interventional Pain Medicine Physician	$0	$1.4M
Wisconsin Community Services, Inc-joshua Glover Rrc	WI	Substance Abuse Rehabilitation Facility	$0	$1.2M
Tahir Khan	WI	Podiatrist	$41.5K	$883.7K
Vipindas Chengat	WI	Internal Medicine Physician	$154.2K	$0
Nosheen Hasan	WI	Anesthesiology Physician	$66.3K	$0
Parag Panchal	WI	Anesthesiology Physician	$61.9K	$0
Michael Toye	WI	Physician Assistant	$60.1K	$0
Aditi Adhikari	WI	Family Nurse Practitioner	$41.8K	$0
Dana Wittenberg	WI	Clinical Social Worker	$34.9K	$0

Horizon Healthcare, Inc — Billing Profile & Reimbursement Data

Sign up for Horizon Healthcare, Inc — Billing Profile & Reimbursement Data policy alerts

Horizon Healthcare, Inc — Billing Profile & Reimbursement Data

Sign up for Horizon Healthcare, Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References