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.

West Grove Clinic, Sc (NPI 1518167477)

West Grove Clinic, Sc is a mental health clinic/center (including community mental health center) provider located in Wauwatosa, Wisconsin. This profile covers 0 Medicare and 19 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	West Grove Clinic, Sc
Address	10012 W. Capitol Dr. #101
City	Wauwatosa
State	WI
ZIP	53222
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 19, 2007

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0047	Alcohol and/or other drug abuse services, not otherwise specified	9,380	$140	$1.3M
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…	12,400	$80	$967.3K
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…	27,130	$30	$841.1K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	12,380	$30	$396.1K
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…	5,300	$20	$122K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,200	$40	$51.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	430	$60	$25.1K
90836	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…	390	$40	$14.1K
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…	300	$30	$9.3K
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…	360	$20	$7.5K

Showing 1–10 of 19

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

West Grove Clinic, Sc — 4 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	182	190	620	$40	$226.6K
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…	49	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…	806	1,760	250	$40	$173.2K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	1	10	400	$110	$136.9K
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…	20	900	410	$70	$130.4K
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…	107	790	400	$40	$109.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	77	350	210	$60	$95.8K
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,…	368	690	160	$60	$90.4K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	51	110	270	$50	$87.4K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	3	140	340	$30	$49.2K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yia Lor	WI	Family Nurse Practitioner	$36.4K	$0
David Schulz	WI	Psychiatry Physician	$16.9K	$0
Anne Ania Person	WI	Nurse Practitioner	$12.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Speciality Screening LLC	WI	Clinical Medical Laboratory	$0	$10.8M
Genetox, LLC	WI	Clinical Medical Laboratory	$0	$6.5M
Tracy Pritzl	WI	Clinical Psychologist	$0	$4.5M
Maria Amarante	WI	Professional Counselor	$0	$3.6M
Elizabeth Moberg-wolff	WI	Pediatric Rehabilitation Medicine Physician	$49.2K	$2.7M
Fresenius Medical Care Midwest Dialysis, LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.5M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.1M
Milwaukee Internal Medicine Associates Inc	WI	Multi-Specialty Clinic/Center	$0	$2M
Wellpoint Care Network	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2M
Midwest Nephrology Associates, Sc	WI	Ambulatory Surgical Clinic/Center	$1.1M	$676.7K

West Grove Clinic, Sc — Billing Profile & Reimbursement Data

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West Grove Clinic, Sc — 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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