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

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

Effingham Obstetrics And Gynecology Associates PLLC (NPI 1649677063)

Field	Value
Entity Type	Organization
Organization	Effingham Obstetrics And Gynecology Associates PLLC
Address	912 N Henrietta St
City	Effingham
State	IL
ZIP	62401
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	December 1, 2014

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	45,300	$80	$3.8M
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…	60	$920	$54.5K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	870	$1	$3.5K
0500F	No Summary found for this code	2,160	$0	$0
0502F	No Summary found for this code	13,680	$0	$0
58300	In this procedure, the provider places a contraceptive intrauterine device (IUD) in the uterine cavity.	20	$0	$0
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	820	$0	$0
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	870	$0	$0
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	1,300	$0	$0
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	160	$0	$0

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Effingham Obstetrics And Gynecology Associates PLLC — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	154	850	7,490	$120	$3.9M
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…	77	170	50	$910	$144.1K
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…	928	14,680	300	$50	$48.7K
0502F	No Summary found for this code	23	1,170	550	$30	$48.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	45	320	290	$50	$48K
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…	335	14,190	280	$20	$38.9K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	80	140	190	$30	$33.7K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	24	320	100	$50	$17K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	120	160	50	$70	$16.6K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	201	480	110	$40	$15.4K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Effingham Obstetrics And Gynecology Associates PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sarah Bush Lincoln Health Center	IL	General Acute Care Hospital	$0	$3.3M

Nearby Providers

Other providers in the same ZIP code as Effingham Obstetrics And Gynecology Associates PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Anthonys Memorial Hospital Of The Hospital Sisters Of The Third	IL	Home Health Agency	$0	$9.4M
Family Care Associates Of Effingham, S.c.	IL	Rural Health Clinic/Center	$0	$7.8M
Heartland Human Services	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.2M
Lincare Inc.	IL	Durable Medical Equipment & Medical Supplies	$0	$5.3M
Philip Dy	IL	Medical Oncology Physician	$4.4M	$549.3K
Southern Illinois Healthcare Foundation Inc	IL	Federally Qualified Health Center (FQHC)	$0	$4.3M
Fatima Ahmad	IL	Ophthalmology Physician	$1.9M	$1.5M
Community Support Systems Cfc 20	IL	Early Intervention Provider Agency	$0	$3.1M
Hanna Saba	IL	Hematology & Oncology Physician	$2.2M	$334K
Casey Duncan	IL	Radiation Oncology Physician	$1.2M	$4.2K

Effingham Obstetrics And Gynecology Associates PLLC — Billing Profile & Reimbursement Data

Sign up for Effingham Obstetrics And Gynecology Associates PLLC — Billing Profile & Reimbursement Data policy alerts

Effingham Obstetrics And Gynecology Associates PLLC — Billing Profile & Reimbursement Data

Sign up for Effingham Obstetrics And Gynecology Associates PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References