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.

Unm Medical Group Inc (NPI 1831218627)

Key Findings

Field	Value
Entity Type	Organization
Organization	Unm Medical Group Inc
Address	2211 Lomas Ne
City	Albuquerque
State	NM
ZIP	87106
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	March 29, 2007

Payer Source	Total Paid
Medicaid	$113.5M
Medicare	$0

This provider is effectively single‑payer in the available dataset: Medicare shows none (no Medicare billing on file) while Medicaid billing totals $113.5M, indicating the provider's publicly reported revenue base is concentrated in Medicaid. Analysts should treat Medicaid as the primary payer when evaluating this entity's scale and utilization patterns.

Revenue is highly concentrated in a few evaluation-and-management lines: the precomputed top 3 Medicaid codes account for 43.3% of the provider's total Medicaid revenue, driven by 99284 ($16.7M, 19.4%), 99214 ($12.5M, 14.5%), and 99233 ($8M, 9.3%). This concentration implies that a minority of service types generate the bulk of Medicaid dollars for the organization.

The code mix signals a broad acute-care and outpatient footprint: top codes include emergency department visits (99284, 99285), high-volume outpatient E/M (99214, 99213), and inpatient subsequent care (99233, 99232). Coupled with high-volume critical care reporting (99291) and frequent hospital admission/discharge codes (e.g., 99223, 99238), the pattern is consistent with a multispecialty operation that manages emergency, inpatient, and ambulatory care flows.

The provider is a dominant statewide participant on many high‑revenue Medicaid codes: 99233 ranks #1 of 93 providers in-state (100th percentile), 99214 ranks #2 of 963 (100th percentile), and 99291 ranks #1 of 48 (100th percentile). Multiple advanced imaging and high-complexity E/M codes also sit at or near #1/#2 with 100th or near-100th percentiles, supporting characterization as a major hub rather than a modest competitor within New Mexico.

Volume metrics reinforce scale of operations: extremely large claim counts include 201.8K claims for 99214, 165.7K claims for 99284, and 153K claims for 71045, along with tens of thousands of claims for inpatient and ED E/M codes. Those absolute claim volumes suggest high throughput across emergency, outpatient, and diagnostic services and would materially affect network capacity and utilization analyses.

The provider reports substantial neonatal and pediatric critical-care activity: 99469 ($2.2M, rank #2 of 4), 99480 ($1.3M, rank #2 of 5), and 99472 ($995.8K, rank #1 of 3). These entries, together with high pediatric and newborn follow-up payments, indicate organized newborn/neonatal service lines (including critical-care follow‑up) that contribute meaningfully to Medicaid revenue.

Advanced diagnostic and procedural capacity is evident from top imaging and pathology codes: CT abdomen/pelvis 74177 ($3.5M, rank #2 of 56, 98th percentile), CT head 70450 ($2.3M, rank #2 of 56, 98th percentile), MRI brain 70553 ($903.2K, rank #1 of 27, 100th percentile), CT thorax 71260 ($877.7K, rank #1 of 38, 100th percentile), and surgical pathology 88305 ($1.5M, rank #3 of 48, 96th percentile). The combination of high-volume imaging and pathology suggests substantial in-house diagnostic capabilities supporting acute and inpatient care.

The organization is long‑standing in the NPI registry, enumerated 2007-03-29 (~19 years ago), which supports an interpretation of operational maturity; combined with the high-volume and high-rank service mix, this tenure is consistent with an established multispecialty center with integrated acute, diagnostic, and neonatal services.

Medicaid: Complete Services Breakdown

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

364 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	165,710	$100	$16.7M
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…	201,800	$60	$12.5M
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…	100,400	$80	$8M
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…	158,910	$40	$6.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	86,510	$60	$5.3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	36,360	$140	$5.1M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	35,580	$140	$4.9M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	46,690	$80	$3.5M
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…	33,960	$80	$2.9M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	65,570	$40	$2.3M

Showing 1–10 of 364

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

Unm Medical Group Inc — 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

364 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.	3	80	12,050	$160	$3.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	9	70	6,920	$210	$3.5M
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.	24	80	10,650	$130	$2.4M
90945	The provider evaluates the patient and chooses one of several methods to perform dialysis, except hemodialysis.	3	10	32,970	$60	$2M
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	10	4,270	$400	$1.7M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2	60	3,070	$210	$1.4M
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…	9	20	2,780	$90	$1.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	10	290	$320	$1.3M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	2	10	6,420	$120	$1.1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	10	5,500	$120	$1M

Showing 1–10 of 364

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unm Hospital	NM	General Acute Care Hospital	$0	$462.9M
Unm Sandoval Regional Medical Center, Inc	NM	General Acute Care Hospital	$0	$27.4M
Unm Hospital	NM	Psychiatric Hospital Unit	$228.5K	$17.6M
Unm Medically Fragile Case Management Program	NM	Case Management Registered Nurse	$0	$10.2M
Unm Focus Program	NM	Case Manager/Care Coordinator	$0	$4.9M
University Of New Mexico Dental Services	NM	General Practice Dentistry	$0	$3.3M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Cecilia Arana Yi	AZ	Hematology & Oncology Physician	$1.8M	$0
Mehraboon Irani	IL	Blood Banking & Transfusion Medicine Physician	$4.6K	$677.4K
Anthony Martinez	FL	Anatomic Pathology & Clinical Pathology Physician	$511.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Dungarvin New Mexico LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$84.6M
Perinatal Associates Of New Mexico, Ltd	NM	Maternal & Fetal Medicine Physician	$0	$62.6M
Optumcare New Mexico LLC	NM	Family Medicine Physician	$0	$23.6M
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
Albuquerque Indian Health Center	NM	Clinic/Center	$0	$6.6M
Presbyterian Hospital Asc	NM	Ambulatory Surgical Clinic/Center	$38.2K	$6.2M

Unm Medical Group 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