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

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

Big Horn Enterprises, Inc (NPI 1689793044)

Field	Value
Entity Type	Organization
Organization	Big Horn Enterprises, Inc
Address	641 Warren St
City	Thermopolis
State	WY
ZIP	82443
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	March 28, 2007

Payer Source	Total Paid
Medicaid	$25.1M
Medicare	$0

Key Findings

BIG HORN ENTERPRISES, INC is effectively a Medicaid-focused provider with $25.1M in lifetime Medicaid revenue and no Medicare billing on file; its NPI was enumerated on 2007-03-28 (~19 years ago), indicating long-standing participation in public payer programs. This single-payer footprint makes Medicaid policy and waiver-program changes likely to have outsized effects on the organization.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 96.4% of this provider's total Medicaid revenue, driven primarily by T2016 ($17.9M, 71.4% of Medicaid revenue), S5100 ($5.4M, 21.6%), and T2017 ($864.8K, 3.4%). These three codes together dominate the financial profile and explain the vast majority of billed Medicaid dollars.

The code mix and descriptions indicate BIG HORN operates chiefly as a residential habilitation and adult day services provider: T2016 (habilitation, residential, waiver; per diem) and T2017 (habilitation, residential, waiver; 15 minutes) point to waiver-funded residential habilitation programs, while S5100 (day care services, adult; per 15 minutes) signals substantial day-program activity. The strong dollar share of T2016 versus per-15-minute codes suggests a business model weighted toward per-diem residential services rather than only time-based day services.

Per-claim payment levels amplify revenue concentration: T2016 has an average paid per claim of $4386 across 4.1K claims, which is the main revenue driver, while S5100 averages $627 per claim over 8.6K claims and T2017 averages $339 per claim over 2.6K claims. The high average paid/claim for T2016 means fewer claims can generate disproportionate revenue, making the provider sensitive to changes in per-diem reimbursement rates.

Statewide competitive standing is mixed by code: for T2016 the provider ranks #12 of 19 in-state (39th percentile), a modest position for the largest revenue driver; S5100 is comparatively stronger, ranking #5 of 18 (76th percentile), indicating above-typical market share for adult day services. T2017 ranks #3 of 6 (60th percentile) and S5108 ranks #2 of 6 (80th percentile), so the provider is a meaningful participant on several Medicaid habilitation and home-care training codes but not a dominant statewide leader overall.

Operational volume patterns reinforce the service mix: the provider reported 8.6K S5100 claims and 4.1K T2016 claims as the two largest volume streams, with smaller but material activity in T2017 (2.6K claims) and S5108 (2K claims). This combination of claim counts and the earlier-noted per-claim payment differentials suggests operations split between ongoing residential per-diem care and higher-frequency, lower-unit adult day/home training services.

Because 96.4% of Medicaid revenue is tied to the top three codes, the provider faces concentrated reimbursement exposure: changes to waiver per-diem rates for T2016 or to funding/authorization patterns for S5100 could materially affect revenue. Analysts should monitor state waiver policy updates and utilization trends for these specific codes to assess near-term financial sensitivity.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	4,080	$4,390	$17.9M
S5100	Day care services, adult; per 15 minutes	8,640	$630	$5.4M
T2017	Habilitation, residential, waiver; 15 minutes	2,550	$340	$864.8K
S5108	Home care training to home care client, per 15 minutes	1,970	$440	$862.9K
T1002	Rn services, up to 15 minutes	670	$40	$28.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Big Horn Enterprises, Inc — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	12	20	5,630	$520	$10.5M
S5100	Day care services, adult; per 15 minutes	5	20	3,260	$210	$2.3M
S5108	Home care training to home care client, per 15 minutes	2	10	1,050	$390	$1.7M
T2017	Habilitation, residential, waiver; 15 minutes	3	10	2,290	$160	$1.3M
T1002	Rn services, up to 15 minutes	11	20	670	$120	$283.5K

Nearby Providers

Other providers in the same ZIP code as Big Horn Enterprises, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wyoming Pioneer Home	WY	Assisted Living Facility	$0	$2.2M
Hot Springs County Hospital District	WY	Rural Health Clinic/Center	$0	$1.1M
Community Home Health Services LLC	WY	Home Health Agency	$0	$610.3K
Wendy Carver	WY	Case Manager/Care Coordinator	$0	$198K
County Of Hot Springs	WY	Public Health or Welfare Agency	$46.8K	$42.2K
Red Rock Family Practice, Inc	WY	Rural Health Clinic/Center	$0	$82.8K
High Country Behavioral Health	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$73.5K
Dana Mcdermott	WY	Optometrist	$27.9K	$34K
Ryan Williams	WY	Physical Therapist	$60.8K	$0
Vicklund Inc.	WY	Pharmacy	$54.9K	$90

Big Horn Enterprises, Inc — Billing Profile & Reimbursement Data

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Big Horn Enterprises, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References