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

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

Capital Women's Care, L.L.C. (NPI 1679534069)

Field	Value
Entity Type	Organization
Organization	Capital Women's Care, L.L.C.
Address	8110 Maple Lawn Blvd Ste 235
City	Fulton
State	MD
ZIP	20759
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	March 28, 2006

Payer Source	Total Paid
Medicaid	$28.7M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and $28.7M in lifetime Medicaid revenue, making its public-payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid practice. The absence of Medicare activity should be considered when comparing its scale and service mix to multi-payer peers.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 77.8% of the provider's total Medicaid revenue, driven by 99213 (121.9K claims, $97 avg paid/claim, $11.8M revenue, 41.8%), 99214 (71.1K claims, $133 avg paid/claim, $9.5M revenue, 33.4%), and 76816 (7.3K claims, $102 avg paid/claim, $746.8K revenue, 2.6%). This concentration indicates the vast majority of Medicaid dollars flow through routine outpatient evaluation-and-management and follow-up fetal ultrasound services.

The code mix indicates an ambulatory obstetrics and gynecology practice focused on high-volume established-patient visits and prenatal care: 99213 and 99214 dominate revenue, while prenatal-specific codes and obstetric imaging (for example H1003 with 71.1K claims and $710.8K revenue, and multiple ultrasound codes such as 76816, 76819, 76820, 76830) and well-woman visits (99395, $574.3K revenue) appear throughout the top codes. High volumes of STI and HPV testing codes (87491, 87591, 87661, 87624) and urine testing (81002) further emphasize routine women’s health screening as a core operational function.

On competitive standing for routine office visits, the practice is a dominant statewide player: 99213 ranks #8 of 3275 providers in-state (100th percentile; extreme outlier) with 121.9K claims, and 99214 ranks #16 of 3673 providers in-state (100th percentile; extreme outlier) with 71.1K claims. These percentile and rank positions signal volumes far above typical state peers for core E/M services and imply significant market share for ambulatory visits in the provider’s service area.

Several lab and screening codes are also extreme outliers in-state: 81002 (100.6K claims, $301.9K revenue) ranks #1 of 213 providers (100th percentile; extreme outlier) and H1003 ranks #1 of 49 providers (100th percentile; extreme outlier). 99459 (pelvic exam in conjunction with E/M) similarly ranks #1 of 23 providers (100th percentile; extreme outlier). Those rankings highlight unusually large throughput for basic clinic testing and prenatal education relative to peers.

By contrast, the practice’s imaging and some specialized obstetric services appear more typical for in-state peers: 76816 (7.3K claims, $746.8K revenue) ranks #9 of 61 providers (87th percentile; typical, unremarkable volume), and related ultrasound codes (76819, 76820, 76830) fall in mid-to-high percentiles described as typical or unremarkable. This pattern suggests the clinic’s scale advantage is concentrated in visit and screening volume rather than a disproportionate lead in specialty imaging.

The provider has been NPI-enumerated since 2006-03-28 (~20 years ago), indicating a long-tenured presence in the market. When coupled with $28.7M in Medicaid revenue and repeated extreme outlier rankings on high-frequency codes, this tenure supports the interpretation of an established, high-volume outpatient women’s health operation.

For payers and network managers, the combination of extreme-volume E/M billing (99213/99214), dominant screening throughput (81002, H1003, STI panels), and near-exclusive Medicaid billing suggests both negotiation focus and utilization-management implications will be concentrated on ambulatory visit rates, prenatal program reimbursements, and high-volume laboratory/point-of-care testing streams. The data also indicate strong alignment with preventive and prenatal services given the notable volumes in 99395 and prenatal education H1003.

Medicaid: Complete Services Breakdown

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

63 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…	121,870	$100	$11.8M
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…	71,090	$130	$9.5M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7,320	$100	$746.8K
H1003	Prenatal care, at-risk enhanced service; education	71,080	$10	$710.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	4,100	$140	$574.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	16,340	$30	$522.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	16,320	$30	$506K
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.	5,550	$90	$482.4K
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,…	8,020	$60	$457.3K
87481	The lab analyst performs a test for Candida species using amplified nucleic acid probe technique.	7,560	$50	$355.5K

Showing 1–10 of 63

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Capital Women's Care, L.L.C. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	44	50	590	$90	$493.6K
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…	16	3,670	680	$90	$310K
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…	8	3,280	610	$80	$296.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	5	50	660	$30	$289.2K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	5	50	640	$30	$284.4K
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…	10	20	60	$810	$256.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	288	300	420	$50	$213.2K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	3	10	1,340	$30	$204.3K
81513	The lab analyst performs the technical lab test on a vaginal fluid specimen for quantitative real–time amplification of RNA markers for three bacterial species listed in the code descriptor, and…	3	10	950	$30	$201K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9	60	370	$70	$195.6K

Showing 1–10 of 63

Related Providers

Other providers that share a Tax Identification Number (TIN) with Capital Women's Care, L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keerthi Prasad	TX	Vascular & Interventional Radiology Physician	$666.7K	$0
Jamie Shutter	NV	Anatomic Pathology & Clinical Pathology Physician	$582.7K	$0
Arthur Kane	ME	Diagnostic Radiology Physician	$459.4K	$0
Monish Merchant	FL	Vascular & Interventional Radiology Physician	$306.8K	$120
Annette Bicher	VA	Gynecologic Oncology Physician	$211.6K	$0
Gaylord Rose	VA	Gynecologic Oncology Physician	$188.1K	$0
Peter O'hare	MD	Obstetrics & Gynecology Physician	$159.6K	$0
John Elkas	VA	Gynecologic Oncology Physician	$114.6K	$0
Patricia Dehof	MD	Obstetrics & Gynecology Nurse Practitioner	$104.1K	$0
Gerrit Schipper	MD	Obstetrics & Gynecology Physician	$95K	$0

Nearby Providers

Other providers in the same ZIP code as Capital Women's Care, L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apnt, Inc.	MD	Pediatric Skilled Nursing Facility	$0	$22M
Maple Lawn Surgery Center	MD	Ambulatory Surgical Clinic/Center	$533K	$0
Ruwani Gunawardane	MD	Neurology Physician	$249.4K	$0
Vajira Gunawardane	MD	Specialist	$227.1K	$0
Victoria Staiman	MD	Urology Physician	$220.2K	$0
Keivan Gazy	MD	Psychiatric/Mental Health Nurse Practitioner	$118.2K	$0
Kuldeep Singh	MD	Specialist	$21.9K	$0
Meghan Lynch	MD	Gynecology Physician	$14.9K	$0
Patrick Lee	MD	Anesthesiology Physician	$13.4K	$0

Capital Women's Care, L.L.C. — Billing Profile & Reimbursement Data

Sign up for Capital Women's Care, L.L.C. — Billing Profile & Reimbursement Data policy alerts

Capital Women's Care, L.L.C. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References