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.

Lisa Flores (NPI 1124104195)

Field	Value
Entity Type	Individual
Organization	Lisa Flores
Address	Guam Seventh-day Adventist Clinic
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Sports Medicine (Neuromusculoskeletal Medicine) Physician
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicare	$91.6K
Medicaid	$0

Key Findings

This provider’s billed Medicare activity is modest in scale with total Medicare revenue of $91.6K and no Medicaid billing on file, making the practice effectively single‑payer (Medicare) in the available data. The absence of any Medicaid claims suggests the provider’s patient mix, referral patterns, or payer contracting is concentrated on fee‑for‑service Medicare beneficiaries rather than state Medicaid populations.

Revenue is highly concentrated in office/outpatient evaluation and management and preventive visits: the three highest‑revenue Medicare codes are 99213, 99214 and G0439, and the precomputed top‑3 codes account for 55.5% of this provider’s total Medicare revenue. The two E/M codes 99213 and 99214 each generate $19.1K (21.0% each) while G0439 contributes $12.3K (13.5%), indicating that routine follow‑up visits and annual wellness visits are the primary revenue drivers.

Code mix and service lines point to a stable ambulatory sports/neuromusculoskeletal practice that also delivers basic primary care and prevention: 99213 (established patient visit) and 99214 (moderate complexity visit) lead revenue, G0439 (annual wellness visit) is a top contributor, and vaccine administration codes such as G0008 (122 claims, $4K) and 90662 (44 claims, $3.2K) appear repeatedly. The presence of point‑of‑care and lab codes—36415 (359 claims, $2.9K), 80061 (308 claims, $4K), and 83036 (191 claims, $1.7K)—supports an office workflow that includes phlebotomy, lipid panels, and A1C testing alongside routine visits.

Competitive standing is mixed across the top codes: 99213 (368 claims, $52 avg paid/claim, $19.1K revenue (21.0% of this provider's total Medicare revenue)) ranks #44415 of 457151 providers nationally (90th percentile) and is described as typical, unremarkable volume for this code, indicating relatively strong national volume for routine established‑patient visits; 99214 (208 claims, $92 avg paid/claim, $19.1K revenue (21.0% of this provider's total Medicare revenue)) ranks #146438 of 479517 providers nationally (69th percentile) and 99214 is described as typical, unremarkable volume for this code, while G0439 (89 claims, $138 avg paid/claim, $12.3K revenue (13.5% of this provider's total Medicare revenue)) ranks #37630 of 105855 providers nationally (64th percentile) and is also described as typical, unremarkable volume for this code. This pattern—one relatively higher percentile for basic E/M and otherwise mid‑range percentiles—suggests the provider is a modest but reliable participant in ambulatory primary/sports‑medicine services rather than a dominant national specialty center.

Ancillary imaging participation appears limited relative to national peers: screening mammography 77067 (79 claims, $108 avg paid/claim, $8.5K revenue (9.4% of this provider's total Medicare revenue)) ranks #10428 of 15198 providers nationally (31th percentile) and is described as typical, unremarkable volume for this code, while diagnostic mammography 77065 (19 claims, $69 avg paid/claim, $1.3K revenue (1.4% of this provider's total Medicare revenue)) ranks #7916 of 9312 providers nationally (14th percentile) and is described as typical, unremarkable volume for this code. Those lower percentiles indicate imaging is a smaller or secondary part of the practice compared with national imaging providers.

The profile of frequent low‑unit lab and immunization codes—80061 (308 claims, $13 avg paid/claim, $4K revenue), 36415 (359 claims, $8 avg paid/claim, $2.9K revenue), 90662 (44 claims, $72 avg paid/claim, $3.2K revenue), and G0008 (122 claims, $33 avg paid/claim, $4K revenue)—is consistent with an outpatient clinic model that provides routine preventive care, vaccination, and basic diagnostic testing on site to support ongoing chronic and sports‑related care. This operational mix aligns with the provider’s Sports Medicine (Neuromusculoskeletal Medicine) Physician taxonomy and the emphasis on recurring office visits and preventive services.

NPI tenure is long: the provider’s NPI was enumerated 2006-10-31 (~20 years ago), signaling an established presence in the local market. Combined with a modest total Medicare revenue base and a code mix centered on routine E/M, wellness visits, vaccinations, and basic labs, the data are consistent with a long‑standing, outpatient‑focused practice rather than a high‑volume specialty or hospital‑based operation.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

27 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…	370	$50	$19.1K
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…	210	$90	$19.1K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	90	$140	$12.3K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	80	$110	$8.5K
G0008	Administration of influenza virus vaccine	120	$30	$4K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	310	$10	$4K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	40	$70	$3.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	360	$10	$2.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	270	$10	$2.7K
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…	20	$150	$2.6K

Showing 1–10 of 27

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 27 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Guam Distribution

Lisa Flores — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. state median

27 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	34	90	140	$90	$25.7K
99215	15	20	40	$120	$14.6K
99213	13	100	100	$60	$10.6K
77067	4	10	20	$110	$9.4K
G0439	6	20	40	$130	$8.1K
76641	5	10	60	$80	$7.8K
99490	7	10	100	$50	$7.7K
90662	5	10	50	$70	$3.9K
77065	4	10	20	$70	$3.2K
G0008	7	40	30	$30	$2.1K

Showing 1–10 of 27

Nearby Providers

Other providers in the same ZIP code as Lisa Flores, 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

Lisa Flores — Billing Profile & Reimbursement Data

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Lisa Flores — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References