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.

Wellpoint Care Network (NPI 1639343320)

Field	Value
Entity Type	Organization
Organization	Wellpoint Care Network
Address	8901 W. Capitol Dr
City	Milwaukee
State	WI
ZIP	53222
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	April 15, 2008

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	11,670	$90	$1M
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…	12,850	$50	$680.8K
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…	1,730	$40	$74.5K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	6,640	$10	$66.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	1,350	$40	$59.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	300	$80	$22.9K
H0046	Mental health services, not otherwise specified	490	$40	$19.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	390	$30	$12K
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…	30	$40	$1.2K

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

Wellpoint Care Network — 2 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1,294	1,630	270	$40	$205.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	482	630	2,500	$20	$135.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	113	260	690	$40	$133.8K
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…	24	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…	43	790	400	$40	$109.6K
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…	34	260	200	$30	$27.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	94	370	60	$60	$21.5K
H0046	Mental health services, not otherwise specified	5	20	160	$20	$15.6K
90785	This add–on code represents increased work intensity of psychotherapy services that adds difficulty to delivery of service.	3	90	190	$10	$7.3K

Nearby Providers

Other providers in the same ZIP code as Wellpoint Care Network, ranked by combined Medicare and Medicaid revenue.

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
West Grove Clinic, Sc	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.8M
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
Midwest Nephrology Associates, Sc	WI	Ambulatory Surgical Clinic/Center	$1.1M	$676.7K

Wellpoint Care Network — Billing Profile & Reimbursement Data

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Wellpoint Care Network — 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