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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Abound Health, LLC (NPI 1992980387)

Field	Value
Entity Type	Organization
Organization	Abound Health, LLC
Address	5309 Idlewild Rd N
City	Mint Hill
State	NC
ZIP	28227
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	January 3, 2008

Payer Source	Total Paid
Medicaid	$324.1M
Medicare	$0

Key Findings

ABOUND HEALTH, LLC has no Medicare billing on file and $324.1M in Medicaid revenue, making it effectively a single-payer (Medicaid) operator in the claims data. This concentration of billing with Medicaid indicates that analyses of network participation, utilization, and rate negotiations should focus on Medicaid waiver and community behavioral health programs rather than Medicare products.

Revenue is highly concentrated in a small set of waiver/habilitation codes: T2013 ($113.5M, 35.0% of Medicaid revenue), T2012 ($55.7M, 17.2%), and T2021 ($37.4M, 11.6%), which together account for 63.8% of the provider’s Medicaid receipts. That concentration means changes to reimbursement or utilization policies for these specific codes would have outsized impact on the provider’s topline.

The provider’s code mix (T2013, T2012, T2021, H2016, H2015, S5150 and related codes) indicates a core business in Medicaid waiver habilitation, day habilitation, comprehensive community support services, and respite/attendant services. This pattern is consistent with a community/behavioral health agency operating at scale in Medicaid developmental-disability and community support programs.

ABOUND is a dominant statewide player for multiple high-revenue items: it ranks #1 in-state and at the 100th percentile for T2013, T2012, H2016, H2015 and other codes, and ranks #2 (99th percentile) for T2021. These rank/percentile signals characterize the provider as an outsized competitor in North Carolina’s Medicaid waiver market rather than a modest participant.

While revenue is concentrated in the top three codes, the organization also reports sizable secondary revenue lines within the waiver ecosystem — H2016 ($32M), H2015 ($20M), S5150 ($12M), and H2025 ($7.2M) — showing operational breadth across habilitation, community support, respite, and employment-support services. This suggests the provider’s business model is diversified within the waiver/service-line family even as it remains concentrated on waiver habilitation overall.

Multiple top-line codes are flagged as statistical outliers in-state (labels such as "extreme outlier" or "notably above typical state volume" are applied to numerous high-revenue codes), which confirms volumes far above typical state peers for these service categories. From a competitive-intelligence perspective, these outlier statuses imply that the provider is a focal point for any payer initiatives addressing utilization or cost containment in waiver services.

Unit-level payment patterns amplify the scale impact: high claim counts (e.g., T2013 with 772K claims, T2012 with 301K claims, T2021 with 279.3K claims) combined with mid-hundreds average paid-per-claim rates (T2013 $147 avg, T2012 $185 avg, T2021 $134 avg) generate the large absolute revenues reported. Analysts should therefore consider both per-unit reimbursement and extremely high utilization when modeling spend exposure to this provider.

The NPI was enumerated on 2008-01-03 (~18 years ago), indicating an established presence in the market. Coupled with the $324.1M lifetime Medicaid revenue and repeated top-state rankings, the tenure and scale together signal a long-standing, high-capacity operator in North Carolina’s Medicaid community/behavioral health space.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2013	Habilitation, educational, waiver; per hour	772,010	$150	$113.5M
T2012	Habilitation, educational; waiver, per diem	300,980	$190	$55.7M
T2021	Day habilitation, waiver; per 15 minutes	279,330	$130	$37.4M
H2016	Comprehensive community support services, per diem	166,520	$190	$32M
H2015	Comprehensive community support services, per 15 minutes	220,270	$90	$20M
T2020	Day habilitation, waiver; per diem	98,900	$170	$17.1M
S5150	Unskilled respite care, not hospice; per 15 minutes	123,850	$100	$12M
T2016	Habilitation, residential, waiver; per diem	47,470	$160	$7.7M
H2025	Ongoing support to maintain employment, per 15 minutes	59,900	$120	$7.2M
T2014	Habilitation, prevocational, waiver; per diem	44,340	$150	$6.7M

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Abound Health, LLC — 10 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2013	Habilitation, educational, waiver; per hour	1	190	29,090	$150	$9.1M
H2016	Comprehensive community support services, per diem	1	70	28,040	$220	$8.2M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	3	10	130	$90	$6.9M
T2020	Day habilitation, waiver; per diem	3	50	22,570	$180	$6.2M
T2012	Habilitation, educational; waiver, per diem	1	110	21,340	$180	$6.1M
T2021	Day habilitation, waiver; per 15 minutes	2	200	25,740	$130	$4.6M
T2014	Habilitation, prevocational, waiver; per diem	5	20	16,540	$150	$4.2M
S5125	Attendant care services; per 15 minutes	393	400	15,030	$100	$3M
T2027	Specialized childcare, waiver; per 15 minutes	3	10	4,050	$90	$2.5M
H2015	Comprehensive community support services, per 15 minutes	1	250	10,060	$130	$2.4M

Showing 1–10 of 24

Nearby Providers

Other providers in the same ZIP code as Abound Health, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abound Health, LLC	NC	Community/Behavioral Health Agency	$0	$200.8M
United Support Services Inc.	NC	Community/Behavioral Health Agency	$0	$61.6M
Abound Health, LLC	NC	Community/Behavioral Health Agency	$0	$49.8M
Ryan's Place, LLC	NC	Community/Behavioral Health Agency	$0	$24.7M
Divine Health Consultants	NC	Home Health Agency	$0	$22.8M
Still Family, LLC	NC	Community/Behavioral Health Agency	$0	$20.3M
Unique Caring Foundation, Inc	NC	Community/Behavioral Health Agency	$0	$11.2M
Securing Resources For Consumers, Inc.	NC	Community/Behavioral Health Agency	$0	$10.6M
Smiles For Life Orthodontics	NC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8M
Scott Baker	NC	Physical Therapist	$109.9K	$0

Abound Health, LLC — Billing Profile & Reimbursement Data

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Abound Health, LLC — 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