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

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

The Women's Health Group PC (NPI 1720103484)

The Women's Health Group PC is a obstetrics & gynecology physician provider located in Thornton, Colorado. This profile covers 0 Medicare and 51 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	The Women's Health Group PC
Address	9195 Grant Street
City	Thornton
State	CO
ZIP	80229
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	March 20, 2007

Payer Source	Total Paid
Medicaid	$4M
Medicare	$0

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

51 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…	910	$1,220	$1.1M
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…	4,440	$90	$386.4K
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…	1,680	$190	$312.5K
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.	4,250	$70	$305.7K
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…	3,230	$60	$197.2K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	800	$170	$134.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,130	$120	$129.7K
76813	The provider uses either a transabdominal or transvaginal ultrasound to measure the fetal nuchal translucency, or the clear, fluid–filled space at the back of the neck, of the first or a single…	1,200	$100	$118.7K
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…	1,100	$110	$117.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	2,910	$40	$110.7K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

The Women's Health Group PC — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	450	2,520	330	$100	$352K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	40	40	110	$160	$326K
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	10	60	$1,250	$286.5K
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…	378	2,630	430	$90	$268.2K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	14	60	360	$30	$183.5K
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…	2	10	110	$1,410	$153.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	14	70	350	$30	$150K
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,…	477	690	140	$90	$118.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	104	720	130	$100	$110K
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…	6	40	170	$150	$99.9K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allegiance Home Care Inc	CO	In Home Supportive Care Agency	$0	$33.7M
A Better Life Experience Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$30.7M
Hca Healthone LLC	CO	General Acute Care Hospital	$0	$30.6M
Clinica Campesina Family Health Services	CO	Federally Qualified Health Center (FQHC)	$0	$25.5M
Oliver Behavioral Consultants LLC	CO	Behavior Analyst	$0	$16.6M
Rocky Mountain Youth Medical & Nursing Consultants Inc	CO	Pediatrics Physician	$0	$16.2M
Carepoint Emergency Medicine, PLLC	CO	Emergency Medicine Physician	$0	$7.6M
Physician's Choice Medical, LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$7.5M
Thornton Youth Dentistry, PC	CO	General Practice Dentistry	$0	$7.1M
H.e.a.r.t Counseling Center, LLC	CO	Community/Behavioral Health Agency	$0	$5.4M

The Women's Health Group PC — Billing Profile & Reimbursement Data

Sign up for The Women's Health Group PC — Billing Profile & Reimbursement Data policy alerts

The Women's Health Group PC — Billing Profile & Reimbursement Data

Sign up for The Women's Health Group PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References