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

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

Sanders Clinic For Women PA (NPI 1962423046)

Sanders Clinic For Women PA is a obstetrics & gynecology physician provider located in Tupelo, Mississippi. This profile covers 0 Medicare and 37 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	Sanders Clinic For Women PA
Address	1041 S Madison St
City	Tupelo
State	MS
ZIP	38801
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	July 22, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

37 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…	12,240	$90	$1.1M
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…	15,920	$50	$827.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9,670	$60	$609.3K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	6,620	$90	$576K
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.	2,160	$70	$148.8K
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…	1,650	$80	$130.6K
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.	1,760	$40	$73.9K
59410	In this global service, the provider admits the patient to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal…	110	$620	$68.1K
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…	790	$70	$53.1K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	7,740	$10	$38.7K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Sanders Clinic For Women PA — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

37 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…	145	1,910	930	$60	$278.7K
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…	6	120	1,480	$90	$263.1K
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…	920	1,670	720	$50	$196.4K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	5	120	890	$90	$145.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	4	80	520	$60	$100.8K
59410	In this global service, the provider admits the patient to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal…	18	50	70	$630	$99.1K
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.	13	60	320	$50	$93.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	351	750	400	$20	$52.5K
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…	18	130	280	$60	$47.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	19	80	90	$110	$44.7K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Mississippi Medical Center, Inc.	MS	General Acute Care Hospital	$0	$117.7M
North Mississippi Medical Clinics Inc	MS	Internal Medicine Physician	$0	$16.9M
Happy Smiles Dentistry - Tupelo LLC	MS	General Practice Dentistry	$0	$16.2M
North Mississippi Ambulatory Surgery Center LLC	MS	Ambulatory Surgical Clinic/Center	$1.5M	$7.1M
Relias Emergency Medicine Specialists Of Tupelo LLC	MS	Emergency Medicine Physician	$0	$8.4M
Sog Surgery Center LLC	MS	Ambulatory Surgical Clinic/Center	$7.5M	$480
Prescribed Pediatric Extended Care, Inc	MS	Medically Fragile Infants and Children Day Care	$0	$7.2M
Kare-in-home Hospice Of North Mississippi, LLC	MS	Community Based Hospice Care Agency	$0	$5M
North Mississippi Allergy And Asthma Center PLLC	MS	Allergy & Immunology Physician	$0	$4.3M
Magnolia Manor Of Tupelo	MS	Preferred Provider Organization	$0	$3.4M

Sanders Clinic For Women PA — 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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