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 1407021900)

Field	Value
Entity Type	Organization
Organization	Planned Parenthood Of Wisconsin
Address	302 N Jackson St
City	Milwaukee
State	WI
ZIP	53202
Taxonomy	Ambulatory Family Planning Facility
NPI Enumerated	April 25, 2008

Payer Source	Total Paid
Medicaid	$22M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $22M in Medicaid revenue, making its commercial payer footprint effectively single‑payer in the available datasets. The absence of Medicare claims indicates the organization’s patient population and service mix are heavily Medicaid‑centric rather than focused on older Medicare beneficiaries.

Revenue is highly concentrated: the top three Medicaid codes (S4993, J7304, H1010) account for 79.0% of the provider’s total Medicaid revenue. S4993 alone represents 59.8% of Medicaid revenue, with J7304 and H1010 contributing 10.4% and 8.9% respectively, signaling that a small set of contraceptive and family‑planning codes drive the vast majority of receipts.

The code mix and descriptions indicate the organization operates primarily as an ambulatory family planning and contraceptive dispensing provider: large volumes of S4993 (Contraceptive pills) and A4267 (male condoms) plus J7304 (hormone patch) and J7303 (vaginal ring) point to high-volume contraceptive supply distribution, while H1010 (family planning education) indicates structured counseling/education sessions are also a major service line. Procedure codes such as 58300 (IUD placement) and J7307 (etonogestrel implant system) show they also deliver long‑acting reversible contraception (LARC) services on site.

The provider is a dominant statewide player for multiple contraceptive supply codes. S4993 is ranked #1 of 48 providers in‑state and labeled an extreme outlier (100th percentile), A4267 is #1 of 43 and also an extreme outlier (100th percentile), and J7304 is #1 of 6 (100th percentile, notably above typical state volume), together indicating market leadership in dispensing contraceptive supplies.

While contraceptive supplies dominate revenue, the organization still performs clinic visits and procedures at modest relative scale: E/M codes 99213 and 99214 collectively account for small shares of Medicaid revenue (0.9% and 0.6% respectively) and sit in mid‑to‑high state percentiles (86th and 78th). This suggests the business model emphasizes product distribution and family planning services over higher‑margin, higher‑volume traditional office E/M revenue streams.

The provider shows measurable LARC procedural activity beyond supply dispensing: 58300 (IUD placement) records 1.3K claims and ranks #1 of 16 providers in‑state (notably above typical state volume), and J7307 (implant system) has 521 claims and ranks #2 of 17 (94th percentile). These data confirm the organization is a substantive statewide provider of insertion procedures in addition to supply distribution.

Operational scale is evident from claim volumes on supply codes: S4993 has 212.1K claims and A4267 has 118.7K claims, while T5999 (supply, NOS) shows 24.2K claims. The combination of very high claim counts and the presence of both dispensing and procedure codes suggests a hybrid clinic-and-dispensing model serving large numbers of Medicaid patients.

The NPI was enumerated on 2008-04-25 (~18 years ago), indicating an established presence in the market; combined with the Medicaid concentration and statewide leadership on multiple contraceptive codes, this tenure supports a sustained operational focus on reproductive and family‑planning services for Medicaid populations.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S4993	Contraceptive pills for birth control	212,110	$60	$13.2M
J7304	Contraceptive supply, hormone containing patch, each	11,770	$190	$2.3M
H1010	Non-medical family planning education, per session	20,420	$100	$2M
T5999	Supply, not otherwise specified	24,240	$70	$1.8M
A4267	Contraceptive supply, condom, male, each	118,680	$10	$1.5M
J7303	Contraceptive supply, hormone containing vaginal ring, each	5,210	$70	$343.9K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	520	$380	$195.9K
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…	4,600	$40	$193.2K
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…	2,190	$60	$129.1K
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…	1,730	$70	$114K

Showing 1–10 of 25

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 — 8 of 25 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H1010	Non-medical family planning education, per session	7	50	3,770	$90	$744.2K
S4993	Contraceptive pills for birth control	1	50	3,210	$70	$732.6K
T5999	Supply, not otherwise specified	1	10	2,310	$70	$649.2K
J7304	Contraceptive supply, hormone containing patch, each	1	10	240	$200	$433.5K
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…	365	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…	250	1,760	250	$40	$173.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	201	690	160	$60	$90.4K
A4267	Contraceptive supply, condom, male, each	1	40	2,160	$10	$89.7K
J7303	Contraceptive supply, hormone containing vaginal ring, each	1	10	80	$80	$69.2K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	2	20	70	$370	$65.9K

Showing 1–10 of 25

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, 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
Planned Parenthood Of Wi, Inc	WI	Ambulatory Family Planning Facility	$0	$2.3M

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
M. L. Tharps & Associates LLC	WI	Supports Brokerage Agency	$0	$9.9M
Dva Renal Healthcare Inc	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.9M
City Of Milwaukee Health Dept	WI	Clinic/Center	$0	$3.5M
Murtaza Sajan	WI	Dentist	$0	$3.1M
Abbey Ford	WI	Family Nurse Practitioner	$806K	$0
William Maloney	WI	Emergency Medicine Physician	$96.4K	$655.9K
Aleksandar Rosich	WI	Internal Medicine Physician	$219.4K	$311.8K
Kelly Ann Cullen	WI	Emergency Medicine Physician	$106K	$266.7K
Fleming Dermatopathology, LLC	WI	Dermatopathology Physician	$298.5K	$0
David Lieberman	WI	Emergency Medicine Physician	$29K	$223.2K

Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data

Sign up for Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data policy alerts

Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data

Sign up for Planned Parenthood Of Wisconsin — Billing Profile & Reimbursement Data policy alerts

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