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

Why is the Medicaid comparison limited to California 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. California (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 Mar Monte (NPI 1538351077)

Field	Value
Entity Type	Organization
Organization	Planned Parenthood Mar Monte
Address	1691 The Alameda
City	San Jose
State	CA
ZIP	95126
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	August 17, 2007

Payer Source	Total Paid
Medicaid	$26.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	498,460	$30	$13M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	496,110	$30	$12.9M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	35,390	$20	$778.6K
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.	530	$30	$13.1K
J3490	Unclassified drugs	570	$20	$13K
A4267	Contraceptive supply, condom, male, each	560	$20	$11.3K
87806	The lab analyst may conduct tests to identify the presence of HIV type 1 or type 2 strain in the patient’s blood.	200	$30	$5.6K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	220	$20	$4.6K
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,…	90	$50	$4.5K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	150	$20	$3.6K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Planned Parenthood Mar Monte — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S4993	Contraceptive pills for birth control	169	210	1,290	$110	$295.6K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	6	1,140	530	$20	$195.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	6	1,270	450	$20	$183.5K
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…	11,168	13,300	640	$40	$169.6K
87806	The lab analyst may conduct tests to identify the presence of HIV type 1 or type 2 strain in the patient’s blood.	176	240	2,510	$20	$168.2K
J3490	Unclassified drugs	733	1,390	670	$20	$159.5K
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…	12,545	14,520	760	$10	$122.8K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	11	310	500	$10	$101.4K
99201	Deleted code, effective Jan. 1, 2021	474	660	120	$90	$68.9K
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,…	4,015	5,600	440	$10	$44.4K

Showing 1–10 of 16

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Wong	CA	Internal Medicine Physician	$110.8K	$0
Elisha Jang	CA	Gerontology Nurse Practitioner	$54.4K	$0
Moneesha Pinto	CA	Internal Medicine Physician	$16K	$0

Planned Parenthood Mar Monte — Billing Profile & Reimbursement Data

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Planned Parenthood Mar Monte — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References