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

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

Planned Parenthood Of Wisconsin (NPI 1184897027)

Field	Value
Entity Type	Organization
Organization	Planned Parenthood Of Wisconsin
Address	508 W Wisconsin Ave
City	Appleton
State	WI
ZIP	54911
Taxonomy	Ambulatory Family Planning Facility
NPI Enumerated	April 11, 2008

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H1010	Non-medical family planning education, per session	7,910	$90	$703.8K
S4993	Contraceptive pills for birth control	5,250	$70	$383K
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…	2,290	$30	$68.6K
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…	1,290	$50	$63.2K
A4267	Contraceptive supply, condom, male, each	2,810	$10	$33.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,090	$30	$33.7K
J8499	Prescription drug, oral, non chemotherapeutic, nos	1,120	$30	$28.1K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1,270	$20	$22.9K
99203	The provider sees a new 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 provider…	380	$60	$21K
87806	The lab analyst may conduct tests to identify the presence of HIV type 1 or type 2 strain in the patient’s blood.	880	$20	$20.3K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Planned Parenthood Of Wisconsin — 0 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H1010	Non-medical family planning education, per session	16	50	3,770	$90	$744.2K
S4993	Contraceptive pills for birth control	17	50	3,210	$70	$732.6K
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…	478	1,630	270	$40	$205.3K
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…	415	1,760	250	$40	$173.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	133	350	300	$50	$157.9K
A4267	Contraceptive supply, condom, male, each	19	40	2,160	$10	$89.7K
Q3014	Telehealth originating site facility fee	98	170	250	$20	$44K
99203	The provider sees a new 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 provider…	131	440	90	$50	$41K
87806	The lab analyst may conduct tests to identify the presence of HIV type 1 or type 2 strain in the patient’s blood.	13	20	1,020	$20	$40.2K
99204	The provider sees a new 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 provider…	144	330	110	$70	$37.7K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with Planned Parenthood Of Wisconsin, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$22M
Planned Parenthood Of Wisconsin, Inc	WI	Ambulatory Family Planning Facility	$0	$10.6M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$10.4M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$5.6M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$5.2M
Planned Parenthood Of Wi, Inc	WI	Ambulatory Family Planning Facility	$0	$4.8M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$3.5M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$3.3M
Planned Parenthood Of Wi, Inc.	WI	Ambulatory Family Planning Facility	$0	$3.1M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M

Nearby Providers

Other providers in the same ZIP code as Planned Parenthood Of Wisconsin, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Outagamie	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$45.5M
Thedacare Regional Medical Center - Appleton, Inc.	WI	General Acute Care Hospital	$0	$11.5M
Milwaukee Health Services System, LLC	WI	Methadone Clinic	$0	$9.4M
Mooring Programs, Inc	WI	Substance Abuse Rehabilitation Facility	$0	$7.3M
Appleton Area School District	WI	Local Education Agency (LEA)	$0	$5.6M
Richard Santa Cruz	WI	Cardiovascular Disease Physician	$477.8K	$0
David Anderla	WI	Family Medicine Physician	$402K	$0
Toni Jo Neal	WI	Foot & Ankle Surgery Podiatrist	$241.6K	$0
Mac Weninger	WI	Physical Medicine & Rehabilitation Physician	$215.7K	$0
Ameer Kabour	WI	Cardiovascular Disease Physician	$202.9K	$0

Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data

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Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References