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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Mgmc, LLC (NPI 1891797148)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mgmc, LLC
Address	3800 Reservoir Rd Nw
City	Washington
State	DC
ZIP	20007
Taxonomy	General Practice Physician
NPI Enumerated	June 1, 2005

Payer Source	Total Paid
Medicaid	$18.1M
Medicare	$0

MGMC, LLC appears to be effectively a Medicaid-focused practice with no Medicare billing on file; lifetime Medicare revenue is listed as none while total Medicaid revenue is $18.1M, indicating the provider’s patient and payer mix is dominated by Medicaid payers rather than Medicare. This makes the entity effectively single-payer in publicly reported federal programs.

Revenue concentration within Medicaid is high: the precomputed top three Medicaid codes account for 48.4% of this provider’s total Medicaid revenue. That concentration indicates a relatively narrow set of services drives nearly half of Medicaid receipts and suggests operational focus on a few high-volume service lines.

Office/outpatient E/M codes are the largest individual revenue drivers. Code 99214 accounts for $4.1M (23.5% of Medicaid revenue) and 99213 accounts for $1.8M (10.5%), while high-complexity outpatient care 99215 contributes $1.6M (9.3%). Together these E/M codes show MGMC’s business is heavily weighted toward established-patient office visits across low, moderate, and high complexity levels.

MGMC is an extreme statewide outlier on several codes, demonstrating strong competitive standing in specific service lines. The provider ranks #5 of 305 for 99214 in the 99th percentile (labeled an extreme outlier), #2 of 48 for 99233 in the 98th percentile (extreme outlier), and #2 of 83 for 99204 also in the 99th percentile (extreme outlier), indicating volumes far above typical in-state peers for both outpatient and some hospital-related E/M services.

The provider also shows a large pathology/lab footprint within Medicaid billing: 88305 generates $1.4M (8.1% of Medicaid revenue) and 88307 adds $725K (4.2%), with both codes ranked at the state 100th percentile or notably above typical volumes. This mix suggests MGMC operates significant surgical pathology and ancillary lab interpretation services in addition to primary care E/M activity.

Inpatient and observation care comprise a meaningful portion of revenue, reflecting broader service settings beyond outpatient clinics. Codes 99233 ($2.5M, 14.4% and ranked #2 of 48, 98th percentile) and 99232 ($862.1K, 5.0%, 94th percentile) indicate substantial subsequent inpatient/observation visit volume, and discharge management 99239 ($238.7K, 1.4%, ranked #1 of 18) further supports significant hospital-associated work.

Several high-complexity and critical-care codes appear at materially elevated ranks, but with more modest dollar shares, signaling capability to manage sicker patients. For example, 99291 (critical care) yields $225.9K (1.3%) and ranks #7 of 27 (77th percentile), while initial inpatient high-complexity 99223 brings $560.7K (3.2%, 92nd percentile). These entries suggest MGMC provides some higher-acuity services in addition to volume-oriented outpatient care.

MGMC’s NPI has been enumerated since 2005-06-01 (~21 years), indicating long-standing presence in the market. The tenure combined with high statewide ranks on multiple codes implies an established operation that has scaled particular service lines (E/M, pathology, inpatient follow-ups) over time.

Medicaid: Complete Services Breakdown

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

144 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…	65,810	$60	$4.1M
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…	58,290	$40	$2.5M
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…	40,690	$50	$1.8M
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…	22,220	$70	$1.6M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	34,370	$40	$1.4M
99204	The provider sees a new 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 provider…	15,300	$90	$1.4M
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…	23,950	$40	$862.1K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	11,150	$70	$725K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	8,500	$70	$560.7K
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…	8,040	$50	$433.9K

Showing 1–10 of 144

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Mgmc, LLC — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

144 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	26	30	4,480	$140	$3.5M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	8	10	2,430	$230	$934.7K
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.	3	10	820	$310	$767.1K
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…	7	30	1,050	$120	$581.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	58	130	290	$140	$579.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	30	30	450	$130	$439.5K
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…	2	50	580	$60	$424.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	8	10	3,140	$110	$399.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	19	30	350	$110	$345.1K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	2	10	1,270	$140	$322.4K

Showing 1–10 of 144

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medstar - Georgetown Medical Center, Inc.	DC	General Acute Care Hospital	$0	$45.6M
Medstar Georgetown Medical Center, Inc	DC	Internal Medicine Physician	$0	$923.4K
Fred Mo	DC	Orthopaedic Surgery of the Spine Physician	$688.8K	$0
Andrea Singer	DC	Internal Medicine Physician	$608.6K	$0
Andrew Mo	MD	Orthopaedic Surgery of the Spine Physician	$540.7K	$0
Jean-marc Voyadzis	MD	Neurological Surgery Physician	$486.7K	$0
Sean Collins	DC	Radiation Oncology Physician	$444.1K	$0
Charles Mugera	MD	Internal Medicine Physician	$396.2K	$0
Allison Oldfield	MD	Diagnostic Radiology Physician	$372.8K	$0
Bruce Knolmayer	MD	Orthopaedic Surgery Physician	$364.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. John's Community Services-dc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$99M
Mina Akhlaghi	DC	Dentist	$0	$2.1M
Anisa Omar	DC	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$892K
Parham Farid	DC	Diagnostic Radiology Physician	$642.7K	$0
Siamak Majidi	DC	Pediatric Dentistry	$0	$618.1K
Ryan Hankins	DC	Urology Physician	$445K	$0
Fernando Pagan	DC	Neurology Physician	$436.9K	$0
Laxman Bahroo	DC	Neurology Physician	$353.8K	$0
Brendan Merchant	DC	Internal Medicine Physician	$346.7K	$0
Michael Fabrizio	DC	Urology Physician	$344.8K	$0

Mgmc, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References