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.

Planned Parenthood Of Wisconsin, Inc (NPI 1780859280)

Field	Value
Entity Type	Organization
Organization	Planned Parenthood Of Wisconsin, Inc
Address	5380 W Fond Du Lac Ave
City	Milwaukee
State	WI
ZIP	53216
Taxonomy	Ambulatory Family Planning Facility
NPI Enumerated	April 25, 2008

Payer Source	Total Paid
Medicaid	$10.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H1010	Non-medical family planning education, per session	49,010	$90	$4.5M
S4993	Contraceptive pills for birth control	40,140	$70	$2.9M
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…	11,400	$60	$672.3K
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…	14,110	$40	$508K
J8499	Prescription drug, oral, non chemotherapeutic, nos	14,820	$20	$340.8K
A4267	Contraceptive supply, condom, male, each	25,910	$10	$311K
99204	The provider sees a new 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 provider…	1,800	$100	$176.7K
99203	The provider sees a new 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 provider…	2,610	$60	$167.3K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	220	$730	$157.8K
J1050	Injection, medroxyprogesterone acetate, 1 mg	8,580	$20	$154.5K

Showing 1–10 of 29

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

Planned Parenthood Of Wisconsin, Inc — 6 of 25 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H1010	Non-medical family planning education, per session	2	50	3,770	$90	$744.2K
S4993	Contraceptive pills for birth control	3	50	3,210	$70	$732.6K
J7304	Contraceptive supply, hormone containing patch, each	4	10	240	$200	$433.5K
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…	112	1,630	270	$40	$205.3K
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…	94	1,760	250	$40	$173.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	33	350	300	$50	$157.9K
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,…	103	690	160	$60	$90.4K
A4267	Contraceptive supply, condom, male, each	4	40	2,160	$10	$89.7K
J7303	Contraceptive supply, hormone containing vaginal ring, each	6	10	80	$80	$69.2K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	5	20	70	$370	$65.9K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Planned Parenthood Of Wisconsin, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$22M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$10.4M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$5.6M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$5.2M
Planned Parenthood Of Wi, Inc	WI	Ambulatory Family Planning Facility	$0	$4.8M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$3.5M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$3.3M
Planned Parenthood Of Wi, Inc.	WI	Ambulatory Family Planning Facility	$0	$3.1M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$2.5M
Planned Parenthood Of Wi, Inc	WI	Ambulatory Family Planning Facility	$0	$2.3M

Nearby Providers

Other providers in the same ZIP code as Planned Parenthood Of Wisconsin, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samir Mullick Md Sc	WI	Pediatrics Physician	$0	$11.4M
Trinity Home Health Care Inc.	WI	Home Health Agency	$0	$10.5M
Familia Dental Mkemidtown LLC	WI	General Practice Dentistry	$0	$7.4M
Milwaukee Dental Group Sc	WI	General Practice Dentistry	$0	$7.3M
Independent Physicians Of Wisconsin, LLC	WI	Internal Medicine Physician	$0	$6.9M
Ahmed Elhamady	WI	Dentist	$0	$5.4M
Children's Medical Group	WI	Pediatrics Physician	$0	$4.6M
Fresenius Medical Care Midwest Dialysis, LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.5M
Blake Dialysis LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.3M
Children's Medical Group	WI	Dentist	$0	$3M

Planned Parenthood Of Wisconsin, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References