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 Healthcare LLC (NPI 1952659419)

Horizon Healthcare LLC is a clinic/center provider located in Fort Payne, Alabama. This profile covers 0 Medicare and 13 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 Healthcare LLC
Address	205 Grand Ave Nw Ste A
City	Fort Payne
State	AL
ZIP	35967
Taxonomy	Clinic/Center
NPI Enumerated	August 15, 2012

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	15,380	$150	$2.3M
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.	690	$140	$95.4K
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…	2,610	$1	$2.6K
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…	30	$70	$2K
90658	This code represents a trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	410	$1	$1.6K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	100	$20	$1.5K
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.	50	$20	$900
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.	70	$10	$880
90649	This code represents a quadrivalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against four HPV types (6, 11, 16,…	40	$1	$110
99204	The provider sees a new 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 provider…	40	$0	$0

Showing 1–10 of 13

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 Healthcare LLC — 0 of 9 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	84	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…	507	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…	242	1,990	560	$40	$185.6K
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…	264	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.	269	320	640	$50	$98.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	269	300	330	$50	$56.3K
99204	The provider sees a new 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 provider…	372	630	60	$80	$45.8K
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.	670	790	390	$10	$33K
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.	482	680	400	$10	$29.2K
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.	50	210	150	$40	$23.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Therapy Junction, LLC	AL	Physical Therapist	$0	$5.2M
Dr Anthony Vizzinia, Dmd PC	AL	General Practice Dentistry	$0	$1.5M
Sherrill Holdings, Inc	AL	Clinic/Center	$0	$1.4M
Fort Payne Mri LLC	AL	Radiology Clinic/Center	$112.9K	$56.9K
Andrew Hatch	AL	Physical Therapist	$99.1K	$0
Dale Stierwalt	AL	Family Medicine Physician	$96.1K	$0
Ghaith Ajamoughli	AL	Family Medicine Physician	$77.3K	$0
Bart Bailey	AL	Pain Medicine (Anesthesiology) Physician	$57.2K	$0
Chad Chaney	AL	Optometrist	$42.7K	$0
Cathy Olinger	AL	Family Nurse Practitioner	$5.5K	$0

Horizon Healthcare LLC — Billing Profile & Reimbursement Data

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Horizon Healthcare 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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