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NPI 1144364753 · Mangilao, GU · Internal Medicine Physician
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Leopoldo Arcilla is a internal medicine physician provider located in Mangilao, Guam. This profile covers 4 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Leopoldo Arcilla |
| Address | 123 Chalan Kareta |
| City | Mangilao |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | February 16, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.5M |
| Medicare | $81.3K |
LEOPOLDO ARCILLA is primarily practicing outpatient internal medicine focused on evaluation-and-management visits: the Medicare top code is 99214 and the Medicaid top codes are 99213 and 99214, which are routine established-patient office visits. The code mix (dominant E/M codes plus occasional new-patient codes and vaccine administration) suggests a general primary-care style practice that predominantly delivers face-to-face ambulatory care rather than procedure-heavy specialties.
Revenue concentration differs sharply by payer. For Medicare, the platform precomputed that the top 3 Medicare codes by revenue account for 99.5% of Medicare revenue, with 99214 alone generating $78.1K (95.6% of Medicare revenue). For Medicaid, the top 3 Medicaid codes account for 98.6% of Medicaid revenue, and two E/M codes — 99213 ($928.2K, 60.8%) and 99214 ($545.9K, 35.7%) — together make up the vast majority of Medicaid receipts, indicating heavy dependence on a small set of office-visit codes.
The provider’s payer mix is heavily weighted toward Medicaid in scale: total Medicaid revenue is $1.5M versus total Medicare revenue of $81.3K, indicating this clinician functions effectively as a Medicaid-focused provider. This profile is not a balanced Medicare–Medicaid mix but instead shows dominant Medicaid volume and revenue.
Competitive standing by payer shows contrasting footprints. On Medicare, 99214 ranks #9999 of 479517 providers nationally (98th percentile) and is described as "notably above typical national volume for this code," which signals that the provider’s Medicare 99214 billing volume is high relative to the national pool even though absolute Medicare revenue is small. In the Medicaid market, 99213 ranks #3 of 48 providers in-state (96th percentile) and 99214 ranks #2 of 35 providers in-state (97th percentile), indicating the provider is a top in-state performer for common office-visit codes and is a major Medicaid outpatient player locally.
Claim-level patterns reinforce a high-volume, routine care practice. Medicaid claims for 99213 number 9.5K and 99214 number 7.8K, with average paid/claim around $98 and $70 respectively; these large claim counts align with the revenue concentration metrics and imply steady ambulatory throughput rather than episodic high-cost procedures. Medicare claim counts are far lower (e.g., 1.1K claims for Medicare 99214) consistent with the much smaller Medicare revenue base.
Tenure and continuity are long-standing: the NPI was enumerated on 2007-02-16 (~19 years ago), indicating nearly two decades of presence in the billing system. That longevity supports interpretation of the high Medicaid volumes as an established practice rather than a temporary spike.
Vaccination and limited ancillary testing appear as minor revenue contributors. Codes for influenza vaccine administration (G0008 and 90686) appear on both payers but represent a negligible share of total revenue (Medicare vaccine codes together under 1.5% of Medicare revenue; Medicaid vaccine/administration entries are essentially de minimis), suggesting immunization services are provided opportunistically within the office workflow rather than as a distinct revenue center.
The provider shows no broad procedural mix or specialty-specific billings in the top codes beyond E/M and basic preventive care. Absent significant procedure codes in the top 25 lists, the business model appears to center on high-volume primary internal medicine visits, with care capture focused on established-patient management rather than specialty interventions.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 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… | 1,060 | $70 | $78.1K |
| 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… | 20 | $110 | $2.6K |
| G0008 | Administration of influenza virus vaccine | 20 | $30 | $540 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 20 | $20 | $440 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
8 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… | 9,470 | $100 | $928.2K |
| 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… | 7,800 | $70 | $545.9K |
| 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… | 260 | $120 | $32K |
| 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… | 80 | $150 | $11.6K |
| 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,… | 180 | $50 | $8.8K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 100 | $10 | $800 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 100 | $1 | $100 |
| G0008 | Administration of influenza virus vaccine | 10 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Guam median
8 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… | 3 | 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… | 2 | 40 | 630 | $90 | $172.1K |
| 93005 | The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to… | 5 | 10 | 150 | $100 | $142.1K |
| 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… | 10 | 20 | 140 | $110 | $35.4K |
| 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,… | 9 | 20 | 120 | $60 | $35.1K |
| 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… | 9 | 20 | 60 | $140 | $20.8K |
| G0008 | Administration of influenza virus vaccine | 10 | 10 | 100 | $10 | $830 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 5 | 10 | 100 | $1 | $580 |
Other providers in the same ZIP code as Leopoldo Arcilla, 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 |
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