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

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

Magella Medical Associates Billing, Inc. (NPI 1083631071)

Key Findings

Field	Value
Entity Type	Organization
Organization	Magella Medical Associates Billing, Inc.
Address	2400 Round Rock Ave
City	Round Rock
State	TX
ZIP	78681
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$69.1M
Medicare	$0

MAGELLA MEDICAL ASSOCIATES BILLING, INC. is effectively a single‑payer Medicaid operation: total Medicare revenue is none (no Medicare billing on file) while total Medicaid revenue is $69.1M, indicating the organization’s scale and financial exposure are concentrated entirely in Medicaid reimbursements. This payer concentration means trends in state Medicaid policy, neonatal reimbursement, or managed‑care contracting will directly affect the provider’s entire revenue base.

Revenue concentration is high within a narrow set of neonatal codes: the top three Medicaid codes (99469, 99480, 99479) account for 44.3% of the provider’s Medicaid revenue, with 99469 contributing $12.8M (20.1%), 99480 $8.4M (13.2%), and 99479 $7M (11.0%). That degree of concentration around a few neonatal critical‑care and low birth‑weight direction codes highlights dependence on a small number of high‑volume service lines.

The code mix is strongly neonatal and inpatient‑focused: 99469 (neonatal critical care subsequent evaluations), 99480/99479 (direction of recovering low birth weight infants), and 99460 (normal newborn evaluation) lead revenue and claims, while high volumes of echocardiography codes (93303, 93306, 93320) and fetal/obstetric ultrasound codes (76816, 76818, 76811) indicate integrated cardiac imaging and perinatal imaging capabilities. Together these codes suggest the practice operates at scale within a NICU/tertiary newborn care environment and provides both bedside critical care and diagnostic imaging for infants and newborns.

State competitive standing is dominant for key neonatal and imaging services: 99480 ranks #2 of 40 in‑state (97th percentile; extreme outlier), 99469 ranks #2 of 33 (97th percentile; notably above typical state volume), 99460 ranks #2 of 217 (100th percentile; extreme outlier), and 93303 ranks #1 of 73 (100th percentile; extreme outlier). Those high ranks and top percentiles indicate MAGELLA is a major statewide player for neonatal critical care, low birth‑weight management, and pediatric echocardiography rather than a modest participant.

Operational throughput is substantial across multiple high‑volume codes: examples include 71.8K claims for 99480, 72.6K claims for 99238, 69.6K claims for 99460, 34.8K claims for 99469, and 32.6K claims for 93320. These claim counts reflect sustained, high patient volumes that are consistent with coverage of one or more large birth centers or NICU programs and support the hypothesis of a large, centralized neonatal service footprint.

The provider offers a broad service mix beyond acute neonatal care, including developmental testing (96112: 12.7K claims, $1.3M; ranks #1 of 55 in‑state, 100th percentile; extreme outlier) and surgical newborn procedures such as circumcision (54150: 6.4K claims, $522.8K; ranks #2 of 67, 98th percentile; extreme outlier). Combined outpatient E/M activity (99214, 99215, 99213) alongside consult codes (99243, 99244) and imaging/biophysical profile codes (76815–76819) indicate the organization delivers both longitudinal outpatient follow‑up and procedural/diagnostic services for infants and mothers.

The provider’s long tenure (NPI enumerated 2006-07-16 (~20 years ago)) coupled with consistently extreme or notably above‑typical volumes on multiple state codes suggests established referral relationships and institutional scale. That longevity, plus dominant statewide rankings on several specialty neonatal and imaging codes, positions MAGELLA to be operationally resilient in execution but also materially exposed if reimbursement policies or demand for its top codes change, given that 44.3% of Medicaid revenue flows from the top three codes.

Medicaid: Complete Services Breakdown

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

118 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	34,830	$370	$12.8M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	71,850	$120	$8.4M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	56,240	$130	$7M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	69,560	$70	$5M
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	72,580	$60	$4.1M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	32,090	$110	$3.6M
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…	53,340	$50	$2.4M
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…	26,730	$70	$1.9M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	23,690	$80	$1.9M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	4,550	$370	$1.7M

Showing 1–10 of 118

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Magella Medical Associates Billing, Inc. — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

118 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	30	1,410	$340	$2.5M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	30	3,360	$120	$1.2M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	7	30	1,140	$370	$1.2M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	2	40	1,860	$110	$997.5K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	70	850	$180	$621.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	35	110	80	$1,260	$398.1K
93304	The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a…	8	20	200	$110	$278.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	12	370	550	$80	$249.6K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	8	30	100	$780	$242.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	18	130	150	$370	$240.6K

Showing 1–10 of 118

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acclaim Physician Group, Inc	TX	Internal Medicine Physician	$0	$30.9M
Obstetrix Medical Group Of Texas Billing, Inc.	TX	Maternal & Fetal Medicine Physician	$0	$25.7M
Behavior Health & Wellness Center, LLC	VA	Behavior Analyst	$0	$15.8M
Ira Schachar	CA	Retina Specialist (Ophthalmology) Physician	$3.9M	$4.1M
Theodore Leng	CA	Retina Specialist (Ophthalmology) Physician	$287.8K	$0
Nathan Hales	TX	Otolaryngology Physician	$149.2K	$0
Gregory Johnson	TX	Pediatric Cardiology Physician	$3.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kenmar Residential Hcs Services Inc.	TX	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$37.7M
Sedadent Anesthesia Services	TX	Dental Anesthesiology	$0	$11.1M
Darren Kocs	TX	Hematology & Oncology Physician	$2.5M	$0
Oakwood Surgery Center, Ltd., LLP	TX	Ambulatory Surgical Clinic/Center	$2.3M	$85.4K
Beth Hellerstedt	TX	Hematology & Oncology Physician	$2.1M	$0
Michael Herman	TX	Radiation Oncology Physician	$1.6M	$0
Usa Goodman	TX	Family Nurse Practitioner	$1.5M	$0
Darush Rahmani	TX	Rheumatology Physician	$1.4M	$0
Amanda Cantu	TX	Family Nurse Practitioner	$1.3M	$0
Nihar Patel	TX	Hematology & Oncology Physician	$1.2M	$0

Magella Medical Associates Billing, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References