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

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

Pacific Cardiology Consultants LLC (NPI 1013278936)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pacific Cardiology Consultants LLC
Address	633 Gov Carlos G Camacho Rd
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Interventional Cardiology Physician
NPI Enumerated	June 7, 2012

Payer Source	Total Paid
Medicaid	$429.4K
Medicare	$0

This provider has no Medicare billing on file and all recorded federal payer activity is through Medicaid, with total Medicaid revenue of $429.4K; in other words, PACIFIC CARDIOLOGY CONSULTANTS LLC is effectively a single-payer (Medicaid) operation in the available data rather than a mixed Medicare/Medicaid biller. The absence of Medicare claims should be treated as a material characteristic of the payer mix when comparing to typical interventional cardiology profiles.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three codes (99214, 93306, 99213) together account for 87.4% of the provider’s Medicaid revenue. The leading code 99214 alone represents $190.2K (44.3% of Medicaid revenue), followed by 93306 at $130.6K (30.4%) and 99213 at $54.7K (12.7%), indicating a narrow set of services drive almost all reimbursement.

The code mix (high volumes of 99214 and 99213 office/outpatient E/M visits plus large-volume 93306 transthoracic echocardiography) points to a clinic-focused cardiology practice that prioritizes diagnostic imaging and longitudinal outpatient care rather than high-revenue interventional procedures. Although the provider’s taxonomy is Interventional Cardiology Physician, the billed services on Medicaid emphasize E/M and noninvasive cardiac imaging.

99214 is the single biggest Medicaid revenue driver with 2.6K claims, $74 avg paid/claim, and $190.2K revenue; it ranks #11 of 35 providers in-state (71th percentile) and is described as "typical, unremarkable volume for this code," which frames the provider as a moderate-volume outpatient follow-up and management site for established patients. This ranking suggests they are neither a market leader nor a low-volume outlier for established-patient visits.

93306 (2.7K claims, $48 avg paid/claim, $130.6K revenue) is the second-largest revenue contributor and ranks #2 of 4 providers in-state (67th percentile) with the same characterization of "typical, unremarkable volume for this code." The relatively small peer pool for 93306 in-state combined with meaningful revenue share indicates echocardiography is a core operational capability, but the provider is not clearly dominant among echo providers statewide.

Several lower-revenue but relevant cardiac service codes appear in the mix and reinforce a diagnostic emphasis: 99204 ($24.7K, rank #5 of 20, "typical, unremarkable volume for this code"), 93010 ($17.5K, rank #3 of 5, "typical, unremarkable volume for this code"), and stress test codes 93016/93018 (small revenue shares). The presence of these codes alongside the echo and E/M volumes points to a workflow that combines outpatient evaluation, ECG interpretation, and stress testing as integrated service lines.

The provider reports 93227 (ambulatory ECG review/interpretation) with 568 claims and $7.4K revenue and is listed as rank #1 of 1 providers in-state with "no state peer volume comparison available," making this a service where PACIFIC CARDIOLOGY CONSULTANTS LLC is the sole Medicaid reporter in the state dataset. That sole-provider status could reflect a niche or limited peer reporting rather than obvious market dominance, but it does mark a unique footprint in the Medicaid claims record.

The NPI has been enumerated since 2012-06-07 (~14 years ago), indicating a stable multi-year presence; combined with the modest total Medicaid revenue ($429.4K) and the concentrated code mix (top three codes = 87.4% of Medicaid revenue), the profile is consistent with a long-standing, clinic-based cardiology practice that depends primarily on outpatient E/M and echocardiographic services rather than diversified procedural revenue streams.

Medicaid: Complete Services Breakdown

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

10 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…	2,570	$70	$190.2K
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…	2,720	$50	$130.6K
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…	980	$60	$54.7K
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…	190	$130	$24.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2,920	$10	$17.5K
93227	In this procedure, the provider reviews and interprets the data from an external electrocardiographic, or ECG recorder, worn by a patient for 48 hours to detect abnormal heart rates and rhythms. He…	570	$10	$7.4K
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…	40	$70	$2.5K
93018	The provider analyzes and interprets the recording of the electrical activity of the heart to examine for any abnormality in its functioning, including blood pressure and electrocardiograph readings…	110	$10	$1.1K
93016	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	50	$10	$740
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	180	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Guam Distribution

Pacific Cardiology Consultants LLC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. Guam median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	2	10	2,210	$120	$245.1K
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…	24	50	900	$80	$201.7K
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…	11	40	630	$90	$172.1K
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…	18	20	140	$110	$35.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	3	10	2,920	$10	$31.5K
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…	5	20	60	$140	$20.8K
93227	In this procedure, the provider reviews and interprets the data from an external electrocardiographic, or ECG recorder, worn by a patient for 48 hours to detect abnormal heart rates and rhythms. He…	1	10	570	$10	$7.5K
93016	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	3	10	90	$10	$4K
93018	The provider analyzes and interprets the recording of the electrical activity of the heart to examine for any abnormality in its functioning, including blood pressure and electrocardiograph readings…	2	10	410	$10	$3.7K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	2	10	180	$1	$10

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Lee	GU	Dentist	$0	$10.9M
Guam Memorial Hospital	GU	General Acute Care Hospital	$0	$3.5M
Rsa - Tumon, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.9M
Robert Yang	GU	Dentist	$0	$2.4M
Antonio Garcia	GU	Pediatrics Physician	$0	$2.2M
Ma Gladys Linsangan	GU	Pediatrics Physician	$0	$2.2M
Ari Katerelos	GU	Radiation Oncology Physician	$2.1M	$0
Guam X-ray	GU	Vascular & Interventional Radiology Physician	$0	$2.1M
Sarah Clegg	GU	General Practice Dentistry	$0	$1.7M
Peter Kh Go	GU	Surgery Physician	$152.8K	$1.5M

Pacific Cardiology Consultants LLC — Billing Profile & Reimbursement Data

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Pacific Cardiology Consultants 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