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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Woman Care Clinic Inc (NPI 1811161524)

Woman Care Clinic Inc is a obstetrics & gynecology physician provider located in South Charleston, West Virginia. This profile covers 0 Medicare and 28 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	Woman Care Clinic Inc
Address	4501 Maccorkle Ave Sw
City	South Charleston
State	WV
ZIP	25309
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	April 15, 2008

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

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

28 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…	27,420	$60	$1.6M
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	4,360	$70	$318.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2,650	$70	$193.4K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	3,000	$60	$185.8K
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.	2,200	$70	$160.5K
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.	2,880	$50	$143.9K
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…	1,320	$100	$131.8K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	3,370	$40	$128K
93976	The provider performs a duplex scan of a single organ or a limited area of the abdominal, pelvic, scrotal, or retroperitoneal organs. He performs the procedure to examine the vascular supply to the…	1,510	$80	$126.8K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	13,150	$10	$105.2K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Woman Care Clinic Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	19	20	150	$700	$308.2K
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…	81	1,270	1,240	$30	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	100	190	660	$40	$226.4K
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…	615	1,030	890	$50	$221K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	2	10	320	$70	$132.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	12	50	730	$60	$126.6K
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…	47	340	140	$90	$97.5K
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.	12	80	390	$60	$69.4K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	4	20	740	$30	$69.3K
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…	23	30	90	$170	$64.7K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Urgent Care, Inc.- West Virginia	WV	Urgent Care Clinic/Center	$0	$66.9M
Herbert J. Thomas Memorial Hospital Association	WV	General Acute Care Hospital	$0	$26.1M
Mountaineer Family Medicine, Inc.	WV	Family Medicine Physician	$0	$19.5M
Ths Physician Partners Inc	WV	Internal Medicine Physician	$0	$9.2M
Appalachian Medical LLC	WV	Durable Medical Equipment & Medical Supplies	$0	$8M
Pulmonary Associates Of Char LLC	WV	Pulmonary Disease Physician	$0	$5.5M
Maccorkle Emergency Physicians PLLC	WV	Emergency Medicine Physician	$0	$4.4M
Patel & Patel Md Inc	WV	Obstetrics & Gynecology Physician	$0	$4M
Wecare Medical LLC	WV	Oxygen Equipment & Supplies (DME)	$0	$3.7M
Lincoln County Primary Care Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$2.7M

Woman Care Clinic Inc — Billing Profile & Reimbursement Data

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Woman Care Clinic 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

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