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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Mogic Ob-gyn Psc (NPI 1285928770)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mogic Ob-gyn Psc
Address	Mmc Professional Plaza
City	Manati
State	PR
ZIP	00674
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	June 2, 2011

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

MOGIC OB-GYN PSC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and all reported lifetime revenue is Medicaid‑based at $4.9M. This concentration means analyses of utilization and financial performance should be interpreted in the context of Medicaid payment rates and state program rules rather than Medicare benchmarks.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes (99213, 59515, 76816) account for 61.7% of this provider's total Medicaid revenue. The largest single code is 99213 ($2M revenue, 40.2% of Medicaid revenue), followed by 59515 ($612.5K, 12.6%) and 76816 ($438.9K, 9.0%).

The code mix points to a high‑volume obstetrics and gynecology practice with integrated prenatal imaging and delivery services. High counts for ultrasound codes 76816 (6.5K claims), 76805 (4.1K claims), and 76801 (2.4K claims) alongside major delivery codes 59515 (938 claims) and 59410 (501 claims) indicate the provider manages a large maternity caseload from outpatient prenatal care through delivery and postpartum follow‑up.

For several Medicaid services the provider is a statewide leader: 76816 ranks #1 of 20 providers in-state (100th percentile; extreme outlier) and 59410 ranks #1 of 15 providers in-state (100th percentile; extreme outlier), signaling dominant volume in follow‑up fetal ultrasound and vaginal delivery services. 59515 ranks #4 of 33 providers in-state (91th percentile), indicating it is also a major participant for cesarean delivery in Puerto Rico. These rankings suggest clinical capacity and referral relationships that support high obstetric throughput.

Operationally, MOGIC’s revenue profile mixes very high outpatient visit volumes with higher‑value procedural payments. Routine E/M 99213 shows 43.6K claims at $45 avg paid/claim (driving $2M), while delivery codes pay substantially more per claim (59515 $653 avg paid/claim and 59410 $617 avg paid/claim), indicating financial reliance on large visit volumes supplemented by episodic higher‑reimbursement delivery events.

Several codes are labeled as statistical outliers or notably above typical state volume, which has benchmarking implications rather than implying clinical issues. In addition to the extreme outlier status for 76816 and 59410, codes such as 76805 (rank #3 of 117; 98th percentile; extreme outlier) and 76801 (rank #1 of 20; 100th percentile; extreme outlier) underscore unusually concentrated ultrasound activity relative to in‑state peers and should be incorporated into peer comparisons and capacity planning.

The provider shows service breadth beyond routine office care, with meaningful use of emergency and consult codes and fetal monitoring interpretation. Emergency visit codes (99283 at 5.5K claims, 99284 at 1.6K claims) and consult/interpretation codes such as 59051 (2.4K claims, ranks #1 of 2 in-state; 100th percentile) indicate hospital or acute‑care involvement and that MOGIC provides both hands‑on obstetric services and consultative interpretations.

MOGIC’s registration history indicates established tenure in the market: the NPI was enumerated on 2011-06-02 (~15 years ago). This longevity, combined with the provider’s concentrated code dominance and high claim volumes, supports classification as a long‑standing, high‑volume obstetrics practice within Puerto Rico’s Medicaid ecosystem.

Medicaid: Complete Services Breakdown

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

41 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…	43,570	$50	$2M
59515	In this global service, the provider provides admission to the hospital for cesarean delivery of the fetus and placenta via an abdominal incision, and inpatient and outpatient postpartum care.…	940	$650	$612.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	6,460	$70	$438.9K
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…	500	$620	$309.1K
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…	4,080	$80	$306.1K
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…	4,730	$50	$236.4K
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.	5,470	$40	$191.6K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	4,670	$30	$154.1K
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…	2,410	$50	$122.8K
59051	A provider performs the interpretation of this fetal monitoring service that is other than the attending provider. The consulting provider evaluates the data from fetal monitors taken while the…	2,440	$50	$112.2K

Showing 1–10 of 41

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

Mogic Ob-gyn Psc — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	23	30	910	$40	$638.8K
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…	14	20	910	$110	$303K
59515	In this global service, the provider provides admission to the hospital for cesarean delivery of the fetus and placenta via an abdominal incision, and inpatient and outpatient postpartum care.…	4	30	100	$310	$109.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	294	390	290	$80	$96.8K
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.	7	10	910	$70	$93.9K
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.	54	340	210	$70	$81.7K
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.	22	500	220	$40	$79.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1	20	80	$70	$75.4K
99234	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	138	220	320	$80	$66.7K
59051	A provider performs the interpretation of this fetal monitoring service that is other than the attending provider. The consulting provider evaluates the data from fetal monitors taken while the…	1	10	1,230	$50	$56.6K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Pathology Csp	PR	Clinical Medical Laboratory	$0	$16.9M
Pci Group LLC	PR	Interventional Cardiology Physician	$0	$9.6M
Centro Cardiovascular De Manati Iii Csp	PR	Cardiovascular Disease Physician	$0	$5.7M
Anestesia Del Norte P.s.c.	PR	Specialist	$0	$5M
Dorado Health Inc	PR	General Acute Care Hospital	$0	$3.7M
Dentistas Asociados Del Norte	PR	General Practice Dentistry	$0	$3M
Crilomil Corp.	PR	Pediatric Dentistry	$0	$2.8M
Hospitalist Medical Services, Psc	PR	Anesthesiology Physician	$0	$2.7M
Atlantic Pathology	PR	Clinical Medical Laboratory	$0	$2.5M
Centro Imagenes Manati Yvf Psc	PR	Diagnostic Radiology Physician	$0	$2.3M

Mogic Ob-gyn Psc — Billing Profile & Reimbursement Data

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Mogic Ob-gyn Psc — 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