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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Perinatal Associates Of New Mexico, Ltd (NPI 1376565952)

Key Findings

Field	Value
Entity Type	Organization
Organization	Perinatal Associates Of New Mexico, Ltd
Address	201 Cedar St Se Ste 405
City	Albuquerque
State	NM
ZIP	87106
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	July 24, 2006

Payer Source	Total Paid
Medicaid	$62.6M
Medicare	$0

PERINATAL ASSOCIATES OF NEW MEXICO, LTD is effectively a Medicaid-focused practice with no Medicare billing on file and $62.6M in lifetime Medicaid revenue; this makes the provider effectively single-payer from the available claims data and indicates business operations concentrated on low-income and publicly insured patient populations.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 40.3% of the provider's total Medicaid revenue, showing a heavy reliance on a small set of obstetric imaging and surveillance services to drive topline payments.

The provider’s top Medicaid revenue code is 76820 (Doppler ultrasonography of the umbilical artery), which generated $10.9M and represents 17.7% of the provider’s Medicaid revenue; this single-code dominance signals a service-line emphasis on fetal surveillance and high-volume prenatal monitoring.

Complementing 76820, codes 76818 and 76816 together add $8.8M (14.1%) and $5.3M (8.5%) respectively, reflecting large-scale provision of biophysical profiles and follow-up transabdominal ultrasounds; the code mix indicates the practice operates as a high-volume perinatal imaging and maternal–fetal medicine referral center.

Competitive standing within New Mexico is clearly dominant for many procedure lines: the practice ranks #1 in-state for multiple high-revenue ultrasound and fetal echocardiography codes (including 76820, 76818, 76816, 76819, 76817, 76825, 76801, 76811, and others), frequently at the 100th percentile and described as extreme outlier or notably above typical state volume, which supports characterization as the leading in-state provider for specialized prenatal imaging.

The provider also shows unusually large volumes in certain lower-paid services—e.g., 81002 has 57.2K claims and is a 100th-percentile extreme outlier—suggesting integrated or bundled outpatient workflows where routine urine testing and high-frequency ultrasound/imaging visits are processed at scale.

High-volume E/M codes such as 99215 ($4.1M, ranks #3 of 319, 99th percentile) and 99214 ($3.8M, 98th percentile) indicate that substantial clinical evaluation and management accompanies the imaging services; this mix is consistent with a practice that manages complex prenatal patients requiring significant decision-making and prolonged visits.

The NPI was enumerated ~20 years ago (2006-07-24), indicating long-standing presence in the market; combined with the provider’s dominant state rankings across many codes, this tenure likely underpins established referral relationships and sustained high-volume service lines.

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	121,600	$90	$10.9M
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	68,950	$130	$8.8M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	53,330	$100	$5.3M
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.	51,500	$100	$5.2M
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…	16,010	$260	$4.2M
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…	29,860	$140	$4.1M
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…	37,530	$100	$3.8M
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	35,710	$100	$3.6M
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	13,660	$200	$2.7M
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…	13,460	$140	$1.9M

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Perinatal Associates Of New Mexico, Ltd — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	1	10	80	$130	$1.8M
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	1	20	2,780	$90	$1.3M
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	30	380	$100	$796.5K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	1	10	1,440	$210	$777.9K
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…	1	20	1,230	$230	$753.6K
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.	6	140	130	$220	$568.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1	20	750	$90	$524.9K
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…	305	930	910	$80	$521.6K
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…	23	960	1,010	$90	$490K
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…	28	90	570	$80	$392.6K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unm Hospital	NM	General Acute Care Hospital	$0	$462.9M
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Unm Medical Group Inc	NM	Multi-Specialty Clinic/Center	$0	$113.5M
Dungarvin New Mexico LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$84.6M
Optumcare New Mexico LLC	NM	Family Medicine Physician	$0	$23.6M
Unm Hospital	NM	Psychiatric Hospital Unit	$228.5K	$17.6M
Family Eye Care/children's Eye Center Of New Mexico, P.C.	NM	Ophthalmology Physician	$0	$13.3M
Pediatrix Medical Group Of New Mexico, P.C.	NM	Neonatal-Perinatal Medicine Physician	$0	$11.9M
Guardian Flight LLC	NM	Air Ambulance	$372.6K	$6.9M
Climbing Tree Therapy, Inc.	NM	Occupational Therapist	$0	$6.6M

Perinatal Associates Of New Mexico, Ltd — Billing Profile & Reimbursement Data

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Perinatal Associates Of New Mexico, Ltd — 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