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.

Kathryn Guffrey (NPI 1144512252)

Field	Value
Entity Type	Individual
Organization	Kathryn Guffrey
Address	113 Route 3
City	Dededo
State	GU
ZIP	96912
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 8, 2011

Payer Source	Total Paid
Medicare	$67.3K
Medicaid	$0

Key Findings

Practice profile and service line: Billing is concentrated in emergency medicine service lines—high-acuity emergency department E/M codes dominate the profile, with 99285 and 99284 together representing the vast majority of visits and revenue and 99291 appearing as the only clearly critical-care code in the top earners. The presence of 93010 indicates routine ECG interpretation is performed but contributes only a small share of revenue relative to ED E/M services.

Revenue concentration and risk: This provider's Medicare revenue is highly concentrated — the precomputed top 3 Medicare codes account for 92.5% of total Medicare revenue — indicating financial dependence on a narrow set of ED/critical-care services (99285, 99284, 99291). Such concentration creates sensitivity to coding, payer policy changes, or shifts in ED case mix that affect those specific codes.

Top revenue drivers (Medicare): 99285 is the principal revenue driver with $43.4K (64.2% of Medicare revenue) across 291 claims at $149 avg paid/claim, followed by 99284 with $14.1K (21.0%) across 140 claims at $101 avg paid/claim, and 99291 with $5K (7.3%) across 28 claims at $177 avg paid/claim. Together these three codes dominate billing and indicate a practice handling a substantial share of higher-complexity ED visits.

Payer mix: This provider is effectively single-payer in the available data — Total Medicare revenue is $67.3K while Medicaid shows none (no Medicaid billing on file). Analysts should treat comparisons or Medicaid-based benchmarking as not applicable because there is no Medicaid billing to evaluate.

Competitive standing for core ED codes: For 99285 the provider ranks #6802 of 61347 (89th percentile; typical, unremarkable volume for this code) and for 99284 ranks #7403 of 64306 (88th percentile; typical, unremarkable volume for this code), which places the clinician above many peers on volume for high-complexity ED visits but still within the data platform’s “typical” characterization rather than as an extreme outlier. By contrast, 99291 (critical care) ranks #48399 of 71290 (31th percentile; typical, unremarkable volume for this code), indicating relatively modest use of billed critical-care time compared with national peers.

Additional utilization signals: Lower-acuity ED codes such as 99283 and 99282 appear in the dataset but contribute relatively little revenue—99283 accounts for $3.8K (5.7% of Medicare revenue) and ranks #2243 of 31069 (93th percentile; typical, unremarkable volume for this code), while 99282 accounts for $352 (0.5%) and ranks #2688 of 3059 (0th percentile; typical, unremarkable volume for this code). This mix further emphasizes an orientation toward higher-acuity ED encounters rather than a predominance of low-acuity visits.

Scale and market position: With Total Medicare revenue of $67.3K over this record and no recorded Medicaid revenue, the provider represents a modest-scale Medicare biller rather than a major institutional or high-volume group practice. National rank percentiles for the main ED codes place the clinician above many individual peers on 99285/99284 volume but the absolute revenue scale remains limited.

Tenure and administrative footprint: The provider NPI was enumerated 2011-05-08 (~15 years ago), indicating an established billing presence over a multi-year period; combined with the narrow code concentration, this suggests a stable, focused emergency-medicine practice pattern rather than recent, broad diversification of payer relationships or service lines.

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	290	$150	$43.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	140	$100	$14.1K
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…	30	$180	$5K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	60	$60	$3.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	120	$10	$840
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	10	$30	$350

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Guam Distribution

Kathryn Guffrey — 1 of 6 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

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	1	20	80	$140	$15.2K
99291	11	10	60	$170	$13.1K
99284	5	20	90	$90	$9.4K
99283	3	10	30	$50	$2.1K
93010	6	20	80	$10	$1K
99282	4	10	20	$30	$530

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kathryn Guffrey, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Florida Emergency Management LLC	FL	Emergency Medicine Physician	$0	$7.5M
Suzette Fink Bryan	AZ	Diagnostic Radiology Physician	$258K	$0
Timur Kouliev	IL	Emergency Medicine Physician	$180K	$0
Dominic Williams	MD	Emergency Medicine Physician	$139.1K	$0
Stanley Koontz	NC	Emergency Medicine Physician	$138.2K	$0
Bernard Jones	SC	Emergency Medicine Physician	$137.9K	$0
Yong Lee	FL	Emergency Medicine Physician	$131.6K	$0
Robert Fumento	DE	Emergency Medicine Physician	$129.3K	$0
Gordon Bobbett	SC	Emergency Medicine Physician	$126K	$1.2K
Bryan Carney	OH	Emergency Medicine Physician	$126.7K	$0

Kathryn Guffrey — Billing Profile & Reimbursement Data

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Kathryn Guffrey — 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

Related Providers

Frequently Asked Questions

References