Physician

Richard J Horbal, M.D.

According to 2025 Medicare claims, Richard Horbal, M.D. (NPI: 1548244619) practices allergy/immunology in the Bay City, MI market, with the plurality of this provider's patient population coming from Bay, MI. This provider's primary affiliated billing organization is RICHARD J HORBAL MD PC (NPI: 1336228360; TIN: 382434929) and primary practice location at 48640-4712. Horbal is affiliated with the POM ACO (ACO ID: A1297), participating under the MSSP model.

Horbal's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 660 traditional Medicare patients, billed 35,287 HCPCS/CPT codes, and received $511,635 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 3,659 prescription claims across 808 beneficiaries totaling $572,815 in drug costs, led by Nucala (Mepolizumab). 2023 DME data shows 30 claims. Open Payments data shows 2 records totaling $69. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $286,491 to $572,815. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $3,565 to $380.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	939	46,983	$393,932
2016	941	43,803	$396,205
2017	958	46,589	$419,396
2018	1,004	49,845	$452,937
2019	1,033	45,072	$412,644
2020	843	32,366	$343,779
2021	803	43,146	$505,180
2022	672	30,470	$374,076
2023	675	32,027	$458,744
2024	660	35,287	$511,635

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	684	2,844	$286,491
2016	667	2,553	$228,904
2017	546	2,202	$234,722
2018	559	2,104	$170,056
2019	904	3,546	$297,547
2020	919	3,726	$388,421
2021	1,058	4,594	$552,417
2022	908	4,224	$581,517
2023	800	3,617	$535,502
2024	808	3,659	$572,815

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	11	228	$14,239
2016	N/R	170	$8,546
2017	N/R	140	$5,122
2018	N/R	78	$2,348
2019	N/R	58	$1,725
2020	N/R	41	$1,474
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	30	$581
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$115
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	277	361	$64
95165	Professional service for preparation and provision of 1 or more antigens	463	8,998	$10
95115	Professional service for single injection of allergen	439	8,745	$7
95004	Test for allergy using allergenic extract	68	4,979	$3

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Nucala	Mepolizumab	25	700	$88,134
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	104	4,184	$87,735
Xolair	Omalizumab	26	728	$71,618
Breo Ellipta	Fluticasone/Vilanterol	86	4,020	$50,954
Dupixent Syringe	Dupilumab	12	336	$45,754

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	2	$69	ADMA BioManufacturing LLC
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

Explore More Providers

FAQ

What Medicare data is available for Richard J. Horbal, M.D.?

Tedicare shows public-source Medicare data for Richard J. Horbal, M.D. (NPI 1548244619), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Richard J. Horbal, M.D. have ACO affiliation data?

Richard J. Horbal, M.D. is shown with ACO affiliation data for POM ACO (MSSP, ACO ID A1297).

What billing organization is linked to Richard J. Horbal, M.D.?

Richard J. Horbal, M.D. is linked to RICHARD J HORBAL MD PC (billing NPI 1336228360) in the available physician profile data.

Does Richard J. Horbal, M.D. have Open Payments data?

Richard J. Horbal, M.D. has 2 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.