HORIZON CLINICIANS PLLC

NPI 1063978427, organization, Sevierville, TN, Family Medicine

Evidence tier

documented action, then payment

Listed on the Medicare revocation list since May 1, 2023.
Medicaid still paid claims in 2 later months, $1,418 in total.

score 93 of 100, rank 381, $1K at stake

Public list actions

Medicare revocation effective May 1, 2023, barred from re-enrolling until May 1, 2033

424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, TN

Paid after the action

Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.

list	identity check	action date	window closed	months paid after	first	last	paid after	12 months before
Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies	Exact NPI, name verified	May 1, 2023	May 1, 2033	2	Jun 2023	Jul 2023	$1K	$21K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	HORIZON CLINICIANS PLLC
Type	Organization
Status	Active
NPI issued	February 11, 2019, last updated May 8, 2019
Practice location	215 FORKS OF THE RIVER PKWY STE 2, Sevierville, TN 37862-3410, 865-366-4070
Authorized official	CAROLYN THOMPSON (Office Administrator)
Specialties	Family Medicine (207Q00000X, primary)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$61K	56%	$33	$44 (top 5% from $110)	too few months to rank
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$44K	40%	$47	$60 (top 5% from $133)	too few months to rank
96372	Injection of drug or substance under skin or into muscle	$2K	2%	$20	$12 (top 5% from $49)	too few months to rank
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$1K	1%	$17	$28 (top 5% from $147)	too few months to rank
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	$1K	1%	$109	$95 (top 5% from $171)	too few months to rank
36415	Insertion of needle into vein for collection of blood sample	$188	0%	$0.85	$1.97 (top 5% from $12)	too few months to rank
G0008	Administration of influenza virus vaccine	$49	0%	$3.48	$0.25 (top 5% from $17)	too few months to rank
81002	Urinalysis, manual test	$17	0%	$0.69	$2.15 (top 5% from $4.65)	too few months to rank

In this area

216 providers in TN carry an indicator in the public record, with $202.8M at stake between them. The most common is more hours than a day holds, on 139 of them, followed by part of a provider network on 42. 23 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	POPLAR AVENUE CLINIC PLLC Memphis, TN, ranked 54	$1.5M	Adjudicated (sentenced, convicted) per a Department of Justice release dated January 8, 2026. Medicaid paid $1,519,438 in the last 12 observed months.
1	SANJEEV KUMAR Memphis, TN, ranked 75	$707K	Adjudicated (sentenced, indicted, convicted) per a Department of Justice release dated February 28, 2025. Medicaid paid $707,185 in the last 12 observed months.
1	TRENT CROSS Oneida, TN, ranked 173	$61K	Listed on the Medicare revocation list since September 19, 2017. Medicaid still paid claims in 8 later months, $60,816 in total.
1	HARROGATE FAMILY & HEALTH CARE, INC. Harrogate, TN, ranked 189	$51K	Listed on the KY Medicaid exclusion list since June 5, 2020. Medicaid still paid claims in 8 later months, $51,396 in total.
1	OTYLIA PRIMARY CARE, LLC Memphis, TN, ranked 207	$37K	Listed on the Medicare revocation list since December 6, 2022. Medicaid still paid claims in 21 later months, $36,734 in total.
1	DAVID SINCAVAGE Brentwood, TN, ranked 215	$33K	Listed on the KY Medicaid exclusion list since February 7, 2017. Medicaid still paid claims in 2 later months, $33,294 in total.
1	ALEXANDER ALPEROVICH Jackson, TN, ranked 269	$12K	Listed on the Medicare revocation list since May 20, 2021. Medicaid still paid claims in 20 later months, $12,483 in total.
1	RAMON AQUINO Clarksville, TN, ranked 357	$3K	Listed on the Medicare revocation list since September 14, 2024. Medicaid still paid claims in 2 later months, $2,639 in total. and 2 more

All 216 in TN

Recent enforcement in TN

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJCivil settlementAug 10, 2026

Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances

The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.

DOJSentencedJul 8, 2026

Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud

Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.

DOJSentencedJun 24, 2026

Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud

The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.

DOJChargedJun 23, 2026

Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme

Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.

DOJIndictedJun 23, 2026

Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges

Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

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