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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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's Healthcare Associates Of Oakland PLLC (NPI 1568653780)

Women's Healthcare Associates Of Oakland PLLC is a medical specialty clinic/center provider located in Lake Orion, Michigan. This profile covers 0 Medicare and 71 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	Women's Healthcare Associates Of Oakland PLLC
Address	1428 S Lapeer Rd
City	Lake Orion
State	MI
ZIP	48360
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	August 5, 2007

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

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

71 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	44,560	$50	$2.1M
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	2,200	$840	$1.8M
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…	23,430	$70	$1.5M
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…	1,820	$760	$1.4M
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	9,560	$70	$669.2K
J7297	Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg	790	$770	$611.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	6,890	$80	$557.7K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	9,210	$50	$488.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7,320	$70	$475.5K
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	1,040	$450	$461.6K

Showing 1–10 of 71

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Women's Healthcare Associates Of Oakland PLLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

71 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	430	480	1,350	$110	$1.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	349	450	1,540	$90	$1.3M
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…	23	130	200	$750	$636K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	26	50	230	$760	$523.3K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	9	160	260	$820	$506.6K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	6	20	90	$2,020	$489.9K
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…	131	4,380	1,000	$70	$289.9K
J7297	Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg	2	10	390	$620	$256.6K
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…	85	4,770	1,060	$50	$247.8K
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	21	40	80	$680	$226.1K

Showing 1–10 of 71

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jonathan Zaidan	MI	Obstetrics & Gynecology Physician	$120.1K	$0
Douglas Pugmire	MI	Gynecologic Oncology Physician	$26.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michigan Institute For Advanced Surgery Center, LLC	MI	Ambulatory Surgical Clinic/Center	$949.8K	$0
Madeline Turner	MI	Dermatology Physician	$111.5K	$0
Carl Sarnacki	MI	Family Medicine Physician	$47.2K	$0
Norman Salem	MI	Family Medicine Physician	$37K	$0
Erik Zuckerberg	MI	Family Medicine Physician	$29.4K	$0
Adrienne Wells	MI	Anesthesiology Physician	$20.6K	$0

Women's Healthcare Associates Of Oakland PLLC — Billing Profile & Reimbursement Data

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Women's Healthcare Associates Of Oakland PLLC — 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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