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

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

Momdoc, LLC (NPI 1184780355)

Key Findings

Field	Value
Entity Type	Organization
Organization	Momdoc, LLC
Address	2055 W Frye Rd Ste 9
City	Chandler
State	AZ
ZIP	85224
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$63.3M
Medicare	$0

MOMDOC, LLC operates as an obstetrics & gynecology physician practice with a heavy procedural and prenatal care focus: the top Medicaid codes include 59400 (global obstetric delivery), multiple obstetric ultrasound codes (76816, 76815, 76819, 76830, 76801, 76856, 76811, 76817, 76805, 76813) and contraceptive/gynecologic services (J7298, Q0091). This mix indicates a service line built around high-volume prenatal imaging, delivery services, and routine gynecologic care rather than specialty non-obstetric procedures.

Revenue concentration on Medicaid is highly concentrated in a small set of codes: the top 3 Medicaid codes by revenue (99214, 59400, 99215) account for 54.3% of the provider’s total Medicaid revenue. Notably, 99214 alone generates $22.1M (35.3% of Medicaid revenue), showing that a few high-volume evaluation/management and delivery codes dominate revenue.

MOMDOC is effectively a Medicaid-centric provider: there is no Medicare billing on file while lifetime Medicaid revenue totals $63.3M, which makes Medicaid the sole documented payer revenue stream and implies payer mix is concentrated entirely in Medicaid. This single-payer footprint suggests operational focus and revenue dependency on Medicaid beneficiaries.

For several high-revenue codes, MOMDOC is a statewide outlier and market leader: it ranks #1 in Arizona for 59400 (global delivery), 76816, 76815, 76819, 76801, J1050, 99051, 76376, Q0091 and J7298, with many of these labeled as "extreme outlier, far above typical state volume." These rankings indicate dominant share of in-state Medicaid volume for core obstetric and imaging services.

Evaluation/management intensity at MOMDOC is unusually high compared with in-state peers: 99214 shows 302.4K claims and $22.1M revenue (35.3% of Medicaid revenue) and ranks #4 of 3041 providers in-state (100th percentile; extreme outlier), while 99215 accounts for $5.6M (8.9%) and ranks #3 of 927 providers (100th percentile). This suggests very high volumes of established-patient office visits with moderate-to-high complexity under Medicaid.

Service mix and unit economics reflect both high volume and relatively low per-claim payments for many items: examples include 81025 (101.5K claims, $7 avg paid/claim, $710.6K revenue) and 76376 (66K claims, $5 avg paid/claim, $329.9K revenue), showing that substantial claim counts for low-priced services contribute meaningfully to total revenue. Coupled with high-value items like 59400 ($2045 avg paid/claim, $6.3M), the practice captures revenue across a wide per-claim spectrum.

MOMDOC’s positioning on contraceptive and injection products is notable: it ranks #1 in-state for J7298 (Mirena) with $890.5K revenue and for J1050 (medroxyprogesterone acetate) with $1.4M, both marked as extreme outliers. This indicates a substantial volume of contraceptive management and related onsite dispensing or administration under Medicaid.

Tenure data show MOMDOC has been NPI-enumerated since 2006-12-29 (~20 years ago), indicating long-established presence in the market. Combined with current Medicaid dominance and top-state rankings, the provider appears to be a mature, high-capacity OB/GYN practice with sustained Medicaid-facing operations.

Medicaid: Complete Services Breakdown

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	302,350	$70	$22.1M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	3,070	$2,050	$6.3M
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…	56,460	$100	$5.6M
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…	75,380	$50	$3.9M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	37,350	$80	$3M
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.	43,430	$70	$2.8M
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.	36,660	$70	$2.5M
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.	22,980	$90	$2M
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	19,890	$90	$1.9M
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	21,880	$80	$1.8M

Showing 1–10 of 53

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Momdoc, LLC — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	234	260	3,030	$190	$3.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	209	260	2,600	$170	$2.6M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1	50	70	$1,810	$436K
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.	3	400	200	$120	$403K
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	3,040	750	$50	$343.9K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2	40	320	$160	$279.9K
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…	32	2,780	600	$50	$267K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1	110	440	$90	$208.3K
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	70	610	$70	$183.9K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	15	110	540	$50	$167.5K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arion Care Solutions, LLC	AZ	In Home Supportive Care Agency	$0	$608.8M
Dignity Community Care	AZ	General Acute Care Hospital	$0	$71M
Valley Perinatal Services, LLC	AZ	Maternal & Fetal Medicine Physician	$0	$23.6M
Amy Grulke, PLLC	AZ	Speech-Language Pathologist	$0	$21M
Phoenix Neurological Institute, Inc	AZ	Neurology Physician	$0	$18M
360 Physical Therapy LLC	AZ	Multi-Specialty Clinic/Center	$0	$16.8M
Phoenician Medical Center, Inc	AZ	Family Medicine Physician	$0	$15.7M
Twelfth One, LLC	AZ	Home Infusion Therapy Pharmacy	$0	$14.3M
Chandler Emergency Medical Group, LLC	AZ	Emergency Medicine Physician	$0	$14.3M
Emeritus Properties Ngh, LLC	AZ	Assisted Living Facility	$0	$13.3M

Momdoc, LLC — 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

Nearby Providers

Frequently Asked Questions

References