Horizon Health Care, INC
Horizon Health Care, INC was paid $9.68M by Medicaid between Jan 2018 and Dec 2024, across 62 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 46% of everything it billed.
MISSION, SD 57555
Next to other Federally Qualified Health Center (FQHC) providers in South Dakota
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 17,451 | $2.59M | |
| 2019 | 17,774 | $2.66M | |
| 2020 | 7,493 | $692K | |
| 2021 | 9,663 | $913K | |
| 2022 | 9,568 | $935K | |
| 2023 | 15,062 | $939K | |
| 2024incomplete | 13,448 | $946K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 46% | 26,128 | 21,609 | $4.44M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 10% | 6,682 | 5,890 | $1.00M |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 5.7% | 6,677 | 6,308 | $550K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.3% | 1,724 | 1,672 | $317K |
| 90686 | 2.6% | 2,255 | 2,134 | $249K | |
| 81003 | 2.5% | 1,460 | 1,090 | $247K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.4% | 1,287 | 1,218 | $232K |
| 36415 | Collection of venous blood by venipuncture | 2.3% | 4,765 | 4,168 | $220K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 2.2% | 1,217 | 575 | $212K |
| 36416 | 2.2% | 2,052 | 1,807 | $210K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 1.8% | 1,790 | 1,532 | $177K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.8% | 976 | 918 | $170K |
50 more codes
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.4% | 947 | $138K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.4% | 711 | $133K |
| W0037 | 1.3% | 12,919 | $127K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.2% | 648 | $118K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 1.2% | 708 | $116K |
| 85018 | 1.2% | 641 | $113K | |
| 81025 | <1% | 542 | $94K | |
| 83655 | <1% | 504 | $90K | |
| 80053 | Comprehensive metabolic panel | <1% | 527 | $86K |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,601 | $79K |
| 99000 | <1% | 402 | $67K | |
| 99188 | <1% | 541 | $65K | |
| 90670 | <1% | 1,694 | $57K | |
| 87807 | <1% | 227 | $39K | |
| 90474 | <1% | 414 | $37K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 218 | $36K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 193 | $29K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 159 | $28K |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 181 | $27K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 227 | $23K |
| 94760 | <1% | 127 | $22K | |
| 80305 | <1% | 119 | $19K | |
| 99382 | <1% | 97 | $17K | |
| 99381 | <1% | 88 | $13K | |
| 90710 | <1% | 635 | $13K | |
| 90685 | <1% | 67 | $12K | |
| 90651 | <1% | 462 | $12K | |
| 90696 | <1% | 124 | $6K | |
| 90715 | <1% | 288 | $6K | |
| Q3014 | Telehealth originating site facility fee | <1% | 191 | $5K |
| 80061 | Lipid panel | <1% | 32 | $5K |
| G0467 | Community health center visit, returning patient | <1% | 151 | $4K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 26 | $4K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 17 | $3K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 16 | $2K |
| 90734 | <1% | 284 | $183.08 | |
| 90633 | <1% | 757 | $183.08 | |
| 90647 | <1% | 1,352 | $183.08 | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 18 | $65.37 |
| 90681 | 0% | 426 | $0.00 | |
| 90661 | 0% | 245 | $0.00 | |
| 90700 | 0% | 66 | $0.00 | |
| 90707 | 0% | 28 | $0.00 | |
| 90723 | 0% | 1,387 | $0.00 | |
| 90677 | 0% | 257 | $0.00 | |
| 90620 | 0% | 61 | $0.00 | |
| 90674 | 0% | 63 | $0.00 | |
| 90480 | 0% | 12 | $0.00 | |
| 90716 | 0% | 30 | $0.00 | |
| 91307 | 0% | 16 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Horizon Health Care INC. | Martin, SD | $3.32M |
| Horizon Health Care INC | Huron, SD | $3.21M |
| Horizon Health Care INC | Eagle Butte, SD | $2.31M |
| Horizon Health Care, INC | White River, SD | $1.19M |
| Horizon Health Care INC | Howard, SD | $1.13M |
| Horizon Health Care INC | Plankinton, SD | $914K |
| Horizon Health Care INC | Fort Thompson, SD | $706K |
| Horizon Health Care INC | Yankton, SD | $507K |
| Horizon Health Care INC | Elk Point, SD | $437K |
| Horizon Health Care INC | De Smet, SD | $380K |
| Horizon Health Care INC | Desmet, SD | $347K |
| Horizon Health Care INC | Howard, SD | $327K |
| Horizon Health Care INC | Wessington Springs, SD | $323K |
| Horizon Health Care INC | Aberdeen, SD | $185K |
| Horizon Health Care INC | Wessington Springs, SD | $176K |
| Horizon Health Care INC | Faith, SD | $154K |
| Horizon Health Care INC | Alcester, SD | $133K |
| Horizon Health Care INC | Howard, SD | $99K |
| Horizon Health Care INC | Woonsocket, SD | $71K |
| Horizon Health Care INC | Yankton, SD | $51K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.