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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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.

Metro Womens Health PLLC (NPI 1093145377)

Metro Womens Health PLLC is a obstetrics physician provider located in Detroit, Michigan. This profile covers 0 Medicare and 45 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	Metro Womens Health PLLC
Address	4727 Saint Antoine St
City	Detroit
State	MI
ZIP	48201
Taxonomy	Obstetrics Physician
NPI Enumerated	November 22, 2013

Payer Source	Total Paid
Medicaid	$13.4M
Medicare	$0

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	3,920	$850	$3.3M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	3,850	$750	$2.9M
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	1,980	$840	$1.7M
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	1,570	$470	$739K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	3,370	$220	$731.3K
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…	12,810	$50	$627.8K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	6,410	$80	$512.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7,600	$70	$494K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	10,680	$30	$299.2K
99385	The provider performs a well–patient visit for a patient who is between the ages of 18 and 39.	2,650	$100	$254.1K

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Metro Womens Health PLLC — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	8	130	200	$750	$636K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	6	50	230	$760	$523.3K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	2	160	260	$820	$506.6K
J7300	Intrauterine copper contraceptive (paragard)	6	10	80	$630	$301.6K
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…	1,561	4,380	1,000	$70	$289.9K
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…	465	4,770	1,060	$50	$247.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	520	950	740	$40	$166.5K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	72	90	400	$90	$145.8K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	17	240	1,040	$50	$133.3K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	3	60	70	$410	$126K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Palmer	PA	Otolaryngology Physician	$213.1K	$0
Nithin Adappa	PA	Otolaryngology Physician	$203K	$0
Peter Abt	PA	Transplant Surgery Physician	$111K	$0
Ronald Parsons	PA	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$99K	$0
Ty Dunn	WI	Transplant Surgery Physician	$83.7K	$0
Kristin Hammersmith	PA	Ophthalmology Physician	$78.7K	$0
Venkat Kalapatapu	AR	Vascular Surgery Physician	$56.9K	$0
Robert Redfield	CA	Transplant Surgery Physician	$52.8K	$0
Mark Sperry	MA	Internal Medicine Physician	$40.1K	$11.1K
Said Azoury	PA	Surgery Physician	$35.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Childrens Hospital Of Michigan Inc	MI	Children's Hospital	$0	$180.4M
University Pediatricians	MI	Pediatrics Physician	$0	$106.9M
University Physician Group	MI	Internal Medicine Physician	$0	$87.4M
Vhs Harper-hutzel Hospital Inc	MI	General Acute Care Hospital	$0	$76.6M
The Children's Center Of Wayne Co., Inc.	MI	Community/Behavioral Health Agency	$0	$74.3M
Vhs Detroit Receiving Hospital Inc	MI	General Acute Care Hospital	$0	$60.6M
Medical Center Emergency Services	MI	Emergency Medical Services (Emergency Medicine) Physician	$0	$44.1M
Barbara Ann Karmanos Cancer Hospital	MI	General Acute Care Hospital	$0	$42.5M
Detroit Central City Community Mental Health Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$29.2M
Vhs University Laboratories Inc	MI	Clinical Medical Laboratory	$677.7K	$26.3M

Metro Womens Health PLLC — Billing Profile & Reimbursement Data

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Metro Womens Health PLLC — 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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