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.

Dennis Antonio Sarmiento (NPI 1114988821)

Field	Value
Entity Type	Individual
Organization	Dennis Antonio Sarmiento
Address	548 South Marine Corps Drive
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Pediatrics Physician
NPI Enumerated	March 31, 2006

Payer Source	Total Paid
Medicaid	$50.9K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer (Medicaid) biller for the available claims set, with total Medicaid lifetime revenue of $50.9K. The absence of Medicare revenue indicates the provider’s Medicare-facing activity is negligible or nonexistent in this dataset, concentrating financial exposure to Medicaid payers only.

Medicaid revenue is highly concentrated: the precomputed top three Medicaid codes account for 73.5% of the provider’s total Medicaid revenue, indicating that a small set of services (office visits and vaccine administrations) drives most of receipts. Specifically, 99213, 99212, and 90460 are the primary revenue drivers by dollar share of the Medicaid portfolio.

The code mix — led by 99213 ($22.9K, 257 claims, $89 avg paid/claim) and 99212 ($7.3K, 118 claims, $62 avg paid/claim) — points to a pediatric primary-care practice that performs a high volume of established outpatient E/M visits. These two evaluation-and-management codes together represent routine sick and follow-up visits typical of office-based pediatrics rather than specialty procedural work.

Vaccine administration is a material part of operations: 90460 has 400 claims for $7.2K revenue ($18 avg paid/claim) and 90461 has 156 claims for $6.9K revenue ($44 avg paid/claim). The combined presence of multiple vaccine administration codes at substantial claim counts suggests regular immunization workflows and throughput consistent with pediatric preventive care.

Preventive/well-child services appear in the mix as well: 99383 generated $4.3K across 32 claims ($133 avg paid/claim) and 99393 contributed $1.4K across 12 claims. These well‑patient visit codes for children ages 5–11 reinforce the interpretation that routine preventive care and school‑age physicals are part of the service line.

Competitive standing within Guam’s Medicaid market is modest to below-average across the top codes: 99213 ranks #34 of 48 providers in-state (30th percentile; typical, unremarkable volume for this code), 99212 ranks #11 of 21 (50th percentile; typical), and 90460 ranks #8 of 8 (0th percentile; typical). Across these rankings the provider is not a dominant statewide player for these services and more closely resembles a small or mid-level local practice.

Despite a long tenure — NPI enumerated 2006-03-31 (~20 years ago) — the lifetime Medicaid revenue of $50.9K and the modest rank positions imply limited billing volume over time. The combination of long enumeration date and small total revenue suggests part‑time clinical activity, low patient volume, or limited participation in Medicaid billing relative to peers.

No code in the reported top list is flagged as an extreme statistical outlier; the dataset’s descriptors label volumes as "typical, unremarkable" across the listed codes (including 99213, 99212, 90460, and 90461). This pattern indicates steady, routine pediatric ambulatory care rather than concentrated or anomalous billing behavior.

Medicaid: Complete Services Breakdown

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

7 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…	260	$90	$22.9K
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,…	120	$60	$7.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	400	$20	$7.2K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	160	$40	$6.9K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	30	$130	$4.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10	$120	$1.4K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	90	$10	$940

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

Dennis Antonio Sarmiento — 0 of 7 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	34	50	900	$80	$201.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	7	10	2,360	$30	$101.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	8	10	2,980	$20	$81.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11	10	130	$110	$42.8K
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,…	11	20	120	$60	$35.1K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	7	10	40	$130	$14.6K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	13	20	450	$10	$11.3K

Nearby Providers

Other providers in the same ZIP code as Dennis Antonio Sarmiento, ranked by combined Medicare and Medicaid revenue.

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

Dennis Antonio Sarmiento — Billing Profile & Reimbursement Data

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Dennis Antonio Sarmiento — 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