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

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

Valley Ob Gyn Clinic PC (NPI 1891803904)

Valley Ob Gyn Clinic PC is a specialist provider located in Saginaw, Michigan. This profile covers 0 Medicare and 43 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	Valley Ob Gyn Clinic PC
Address	926 N Michigan Ave
City	Saginaw
State	MI
ZIP	48602
Taxonomy	Specialist
NPI Enumerated	August 28, 2006

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	3,310	$850	$2.8M
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…	2,690	$750	$2M
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…	15,940	$50	$717.3K
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…	3,370	$210	$690.2K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	790	$810	$639.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	6,390	$70	$415.5K
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…	4,970	$70	$322.7K
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…	3,660	$80	$292.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	3,480	$80	$282.2K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	10,430	$20	$250.4K

Showing 1–10 of 43

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Valley Ob Gyn Clinic PC — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

43 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…	14	130	200	$750	$636K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	17	50	230	$760	$523.3K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	5	160	260	$820	$506.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	281	950	610	$80	$328.2K
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…	827	4,380	1,000	$70	$289.9K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	20	30	140	$680	$283.7K
J7297	Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg	5	10	390	$620	$256.6K
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…	373	4,770	1,060	$50	$247.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	322	780	140	$190	$192.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	18	240	1,040	$50	$133.3K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saginaw County Community Mental Health Authority	MI	Community/Behavioral Health Agency	$0	$172.1M
Covenant Medical Center, Inc.	MI	General Acute Care Hospital	$0	$96.6M
Covenant Medical Center, Inc	MI	Family Medicine Physician	$0	$19.3M
Covenant Medical Center, Inc.	MI	Emergency Medicine Physician	$0	$14.7M
Aps Employment Services, Inc.	MI	Home Health Agency	$0	$13.2M
Great Lakes Bay Health Centers	MI	Federally Qualified Health Center (FQHC)	$0	$8M
Covenant Medical Center, Inc.	MI	Family Medicine Physician	$0	$6M
Saginaw Cooperative Hospitals, Inc	MI	Obstetrics & Gynecology Physician	$0	$5.8M
Parthiv Amin	MI	Cardiovascular Disease Physician	$267.7K	$0
Bhikam Mehta	MI	Internal Medicine Physician	$212.4K	$21.3K

Valley Ob Gyn Clinic PC — Billing Profile & Reimbursement Data

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Valley Ob Gyn Clinic PC — 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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References