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

Why is the Medicaid comparison limited to Tennessee 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. Tennessee (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.

Womens Health Services Of The Cumberlands, PLLC (NPI 1609965771)

Womens Health Services Of The Cumberlands, PLLC is a obstetrics & gynecology physician provider located in Cookeville, Tennessee. This profile covers 0 Medicare and 44 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	Womens Health Services Of The Cumberlands, PLLC
Address	1080 Neal St.
City	Cookeville
State	TN
ZIP	38501
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	October 12, 2006

Payer Source	Total Paid
Medicaid	$5.6M
Medicare	$0

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,880	$1,260	$2.4M
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	2,410	$190	$451.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	8,580	$50	$446.1K
93976	The provider performs a duplex scan of a single organ or a limited area of the abdominal, pelvic, scrotal, or retroperitoneal organs. He performs the procedure to examine the vascular supply to the…	3,360	$130	$433.1K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2,990	$130	$373.6K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	3,290	$70	$233.6K
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…	5,690	$40	$199K
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…	4,160	$50	$191.4K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	2,910	$50	$154K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,710	$70	$123.2K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Womens Health Services Of The Cumberlands, PLLC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0016	Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)	33	130	620	$200	$655.5K
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…	2	80	100	$1,260	$405.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	13	60	320	$140	$346.9K
H0033	Oral medication administration, direct observation	46	100	340	$150	$306.9K
90832	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…	162	300	480	$30	$221.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	14	150	390	$60	$220.9K
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…	665	3,760	610	$40	$202.3K
H2010	Comprehensive medication services, per 15 minutes	61	70	530	$130	$187.7K
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…	630	4,050	620	$30	$183.9K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	9	30	50	$1,230	$164.2K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Home Caregivers Of Cookeville	TN	Home Health Agency	$0	$49.6M
Cookeville Regional Medical Center	TN	General Acute Care Hospital	$0	$17.1M
Senior Life Management LLC	TN	In Home Supportive Care Agency	$0	$13.3M
Putnam County Pediatrics	TN	Pediatrics Physician	$0	$8.4M
Cavity Commando's Dentistry For Kids PLLC	TN	Pediatric Dentistry	$0	$7.6M
Tennessee Pediatric & Adolescent Center	TN	Legal Medicine	$0	$7M
County Of Putnam	TN	Land Ambulance	$1.7M	$4M
Cookeville Regional Dental Inc	TN	Dentist	$0	$5.4M
Cookeville Pediatric Associates, PLLC	TN	Pediatrics Physician	$0	$5M
Upper Cumberland Rural Health Clinic PLLC	TN	Rural Health Clinic/Center	$0	$3.6M

Womens Health Services Of The Cumberlands, PLLC — Billing Profile & Reimbursement Data

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Womens Health Services Of The Cumberlands, 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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