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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Women Care Inc (NPI 1194759290)

Key Findings

Field	Value
Entity Type	Organization
Organization	Women Care Inc
Address	97 Great Teays Blvd
City	Scott Depot
State	WV
ZIP	25560
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$20.5M
Medicare	$0

This provider is effectively single-payer in the Medicare/Medicaid mix: there is no Medicare billing on file while total Medicaid revenue is $20.5M, indicating reliance on Medicaid as the dominant revenue source. The NPI was enumerated on 2006-07-11 (~20 years ago), so this is an established FQHC practice with a long operating history in-state.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three Medicaid codes account for 91.6% of the provider's total Medicaid revenue. Those top contributors are T1015 ($16.7M, 83.6% of Medicaid revenue), 99213 ($1.3M, 6.4%), and 99214 ($336.4K, 1.7%), which together drive nearly the entire Medicaid revenue base and imply operational sensitivity to changes in reimbursement or utilization patterns for these codes.

The code mix and taxonomy are tightly consistent with an FQHC primary-care model: T1015 (Clinic visit/encounter, all-inclusive) alone produces $16.7M (83.6% of Medicaid revenue), signaling that bundled clinic-visit billing is the center of the business. Heavy reliance on all-inclusive clinic encounter billing suggests the site delivers broad primary care and wraparound services (prevention, chronic care management, immunizations and screenings) under FQHC encounter reporting rather than fee-for-service specialization.

Competitive standing on key primary-care codes is strong in-state: T1015 ranks #5 of 385 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), indicating the provider is a dominant statewide player for FQHC-style encounter billing. 99213 ranks #22 of 1273 (98th percentile; notably above typical state volume for this code), confirming unusually high E/M visit volume, while 99214 ranks #38 of 1031 (96th percentile; typical, unremarkable volume for this code) — together these ranks show market leadership on lower-level E/M work and very high encounter throughput.

Behavioral health and screening services appear embedded in the operating model: 90834 psychotherapy (11.8K claims, $153.2K) ranks #4 of 214 providers in-state (99th percentile; notably above typical state volume for this code), and 96127 (brief emotional/behavioral assessment) is an outlier at rank #2 of 151 (99th percentile; extreme outlier, far above typical state volume for this code). These high ranks and claim volumes for psychotherapy and brief behavioral assessments suggest integrated behavioral health or routine mental health screening as a meaningful service line within the clinic mix.

Preventive and immunization services are another clear focus: 90649 (HPV vaccine) is rank #1 of 20 in-state (100th percentile; extreme outlier, far above typical state volume for this code), and other vaccine codes such as 90686, 90471/90472, and 90715 appear among the top-25 Medicaid codes. The combination of high vaccine volumes and well-child/annual preventive visit codes (99393, 99394, 99392) points to a significant pediatric/adolescent immunization and preventive-care workload.

Ancillary on-site diagnostics are present to support primary care workflows: high-volume point-of-care and routine labs appear in the mix (87880 strep test, 87804 flu test, 83036 A1C, 81002/81025 urinalysis and pregnancy testing) with most of these codes at typical in-state percentiles, indicating the clinic operates basic lab and rapid-test capabilities to manage acute visits and chronic disease monitoring. These services align with the high encounter volumes rather than specialty procedural services.

The Medicaid reimbursement profile shows high visit volume combined with low per-claim payments for core E/M codes (for example 99213 average paid/claim $22 and 99214 average paid/claim $16), which is consistent with Medicaid fee schedules and an FQHC model where total revenue is driven by scale of encounters. Given the extreme concentration (top three = 91.6% of Medicaid revenue), financial performance will be particularly sensitive to changes in encounter volume, vaccine delivery, or Medicaid policy affecting T1015 and related E/M reimbursement.

Medicaid: Complete Services Breakdown

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

102 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	125,890	$130	$16.7M
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…	58,040	$20	$1.3M
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…	21,020	$20	$336.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,630	$30	$157.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	11,780	$10	$153.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	5,960	$20	$125.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	3,270	$40	$114.6K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	10,860	$10	$108.6K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	2,290	$40	$100.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	1,580	$60	$95K

Showing 1–10 of 102

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Women Care Inc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

102 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	5	390	4,610	$130	$2.2M
T1016	Case management, each 15 minutes	84	100	2,790	$90	$496.2K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	11	30	1,020	$50	$438.2K
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…	17	20	150	$700	$308.2K
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…	22	1,270	1,240	$30	$245K
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…	38	1,030	890	$50	$221K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	50	310	740	$80	$178.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	38	50	730	$60	$126.6K
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…	60	340	140	$90	$97.5K
82948	The clinician performs a test to measure the amount of glucose in a patient's blood using a reagent strip test method.	12	20	490	$30	$91.2K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$6.3M
Teays Valley Volunteer Fire Department Inc	WV	Ambulance	$235.1K	$657.5K
Lydia Smith	WV	Family Nurse Practitioner	$54.2K	$0
Nicole Clendenin	WV	Family Nurse Practitioner	$50.8K	$0
Christopher Kennedy	WV	Physician Assistant	$19.1K	$0
Lisa Burke	WV	Obstetrics & Gynecology Physician	$11.2K	$0
James Nottingham	WV	Nurse Practitioner	$10.7K	$0
Kara Cipriani	WV	Family Nurse Practitioner	$8.3K	$0
Mary Jenkins	WV	Family Medicine Physician	$7.2K	$0

Women Care Inc — Billing Profile & Reimbursement Data

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Women Care Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.7M
Womencare, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.6M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.4M
Womencare, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$5.9M
Womencare, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$2.9M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$2.3M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.8M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.6M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$838.1K