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.

Preferred Home Health Agency (NPI 1639278187)

Field	Value
Entity Type	Organization
Organization	Preferred Home Health Agency
Address	306 W. Third Street
City	Buffalo
State	SD
ZIP	57720
Taxonomy	Home Health Agency
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$11.2M
Medicare	$0

Key Findings

This provider effectively operates as a single-payer Medicaid home health agency: Total Medicare revenue is listed as none and total Medicaid revenue is $11.2M, indicating its entire reported lifetime revenue in the data set comes from Medicaid. Analysts should treat Medicare comparisons as inapplicable for this entity because there is no Medicare billing on file.

Revenue is highly concentrated in a single service line: the precomputed top-3 Medicaid codes account for 100.0% of the provider's Medicaid revenue, and S5125 alone represents 99.5% of that total. That concentration means nearly all of the $11.2M Medicaid revenue is driven by one code-driven activity rather than a diversified mix of services.

The code mix shows the organization is focused on personal attendant and homemaker support rather than clinical skilled services: the top code S5125 is for attendant care services (per 15 minutes) and the next two codes are S5130 (homemaker service, nos; per 15 minutes) and S5115 (home care training, non-family; per 15 minutes). This pattern is consistent with a custodial/personal care-oriented home health operation that bills time-based attendant and homemaker units.

S5125 activity is large in absolute claim volume but modest in statewide standing: S5125 has 37.8K claims with a $296 avg paid/claim and $11.2M revenue, yet it ranks #3 of 4 providers in-state (33th percentile; typical, unremarkable volume for this code). The combination of very high claim count and a middle-to-low percentile rank suggests the provider participates heavily in this service but is not a dominant statewide leader on that code.

Other Medicaid codes are minor contributors and reflect limited service diversification: S5130 produced 238 claims, $199 avg paid/claim and $47.4K revenue (0.4% of Medicaid revenue) and ranks #46 of 48 providers in-state (4th percentile; typical, unremarkable volume). S5115 generated 227 claims, $16 avg paid/claim and $3.6K revenue (0.0% of Medicaid revenue) and ranks #2 of 2 providers in-state (0th percentile; typical, unremarkable volume), indicating these services are marginal to the provider's overall revenue profile.

The provider’s business model is therefore operationally sensitive to utilization and reimbursement changes for attendant care: with 99.5% of Medicaid revenue coming from S5125, any policy, rate, or utilization shift affecting time-based attendant care will disproportionately affect the organization’s financials. From a payer-analytic perspective, monitoring rate updates and authorization patterns for S5125 is critical when assessing financial and utilization risk for this entity.

Longevity on file suggests an established presence: the NPI was enumerated on 2006-09-21 (~20 years ago), which implies long-term participation in Medicaid despite the concentrated service footprint. That tenure may reflect stable provider relationships with state Medicaid programs even though the provider is not a large statewide leader on its main code.

The billing footprint shows scale but limited competitive reach: the large absolute volume for S5125 (37.8K claims) drives scale in dollar terms ($11.2M), yet statewide ranking and low-percentile positions on the other codes indicate the provider is a modest participant in the broader in-state market. For payer or provider strategists, this profile reads as an established, single-service-line Medicaid operator with limited diversification and only moderate competitive standing within the state for its primary code.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	37,800	$300	$11.2M
S5130	Homemaker service, nos; per 15 minutes	240	$200	$47.4K
S5115	Home care training, non-family; per 15 minutes	230	$20	$3.6K

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

Preferred Home Health Agency — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	3	10	42,360	$210	$8.2M
S5130	Homemaker service, nos; per 15 minutes	46	50	5,130	$70	$607.5K
S5115	Home care training, non-family; per 15 minutes	2	10	840	$20	$19.9K

Preferred Home Health Agency — Billing Profile & Reimbursement Data

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Preferred Home Health Agency — Billing Profile & Reimbursement Data

Sign up for Preferred Home Health Agency — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References