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.

Sir Akoma Medical Services (NPI 1144702473)

Field	Value
Entity Type	Organization
Organization	Sir Akoma Medical Services
Address	543 Guma Yuos Ln
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Family Medicine Physician
NPI Enumerated	September 4, 2018

Payer Source	Total Paid
Medicaid	$884.3K
Medicare	$0

Key Findings

SIR AKOMA MEDICAL SERVICES is a Family Medicine Physician practice based in TAMUNING, GU with an NPI enumerated 2018-09-04 (~8 years ago). The provider reports no Medicare billing on file and $884.3K in lifetime Medicaid revenue, making its commercial/payer footprint effectively single-payer in the available data (Medicaid-focused).

Revenue is heavily concentrated in a small set of outpatient E/M and preventive codes: the top three Medicaid codes (99213, 99214, 99396) account for 90.4% of this provider’s total Medicaid revenue. The single largest line is 99213 at $429.8K (48.6% of Medicaid revenue), followed by 99214 at $321.6K (36.4%) and 99396 at $47.7K (5.4%).

The code mix points to a primary care, office-based operation focused on established-patient management and preventive adult visits: 99213 and 99214 are routine established-patient E/M visits with relatively high volumes, while 99396 is an established well-patient visit for ages 40–64. This combination is consistent with a traditional family medicine clinic whose revenue is driven by recurring office visits and age-based preventive care.

Competitive standing by code is middling to modestly above-average in-state rather than dominant. For 99213 the provider ranks #10 of 48 (81th percentile; typical, unremarkable volume), and for 99214 it ranks #9 of 35 (76th percentile; typical, unremarkable volume), indicating steady but not market-leading volume on its top E/M services. The 99396 entry is listed as #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), so there is no meaningful statewide benchmark for that preventive code.

The practice also generates nontrivial new-patient visit volume and pediatric/adolescent well visits alongside established-patient care. 99203 accounts for $45.4K (5.1%) and ranks #6 of 24 (78th percentile), while pediatric/adolescent preventive codes such as 99383 ($14.1K, 1.6%), 99384 ($7.7K, 0.9%), 99395 ($6.2K, 0.7% and listed #1 of 2 providers, 100th percentile), and 99393 ($3.1K, 0.3%) indicate a modest mixed-age preventive workflow. These figures suggest a full-spectrum family medicine panel with lower but meaningful well-child and adolescent activity.

Operational throughput is visible in claim counts and average paid per claim for the top E/M codes: 99213 shows 4.8K claims at $89 avg paid/claim and 99214 shows 3.1K claims at $104 avg paid/claim. Those volumes imply steady, recurring ambulatory visits as the backbone of Medicaid revenue, while lower-value codes such as 99211 ($2.1K revenue, 117 claims, $18 avg paid/claim) represent ancillary visit activity.

Several otherwise billable service codes appear reported but show $0 avg paid/claim and $0 revenue, which may reflect nonpayment, bundling, or reporting idiosyncrasies. Examples include 99406 (12 claims, $0 avg paid/claim, $0 revenue; ranks #3 of 3, 0th percentile) and 99490 (140 claims, $0 avg paid/claim, $0 revenue; ranks #2 of 4, 67th percentile). These patterns warrant attention if evaluating reimbursement completeness or care-management service adoption.

The provider’s heavy dependence on two outpatient E/M codes for the majority of Medicaid revenue (99213 and 99214 together represent 48.6% + 36.4% = the lion’s share of receipts as reported) creates concentration exposure: changes in E/M reimbursement, coding guidance, or patient panel composition would disproportionately affect total Medicaid revenue. Given the practice’s tenure since 2018-09-04 (~8 years), this appears to be an established local primary-care operation with steady visit volumes rather than a rapidly expanding specialty or hospital-affiliated practice.

Medicaid: Complete Services Breakdown

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

14 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…	4,830	$90	$429.8K
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…	3,090	$100	$321.6K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	340	$140	$47.7K
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…	410	$110	$45.4K
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.	110	$130	$14.1K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	50	$150	$7.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	50	$140	$6.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	30	$120	$3.1K
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,…	60	$40	$2.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	120	$20	$2.1K

Showing 1–10 of 14

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

Sir Akoma Medical Services — 1 of 12 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

14 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…	10	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…	9	40	630	$90	$172.1K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1	10	340	$140	$47.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9	10	130	$110	$42.8K
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…	6	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,…	13	20	120	$60	$35.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	11	10	780	$20	$30.2K
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…	19	20	60	$140	$20.8K
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.	4	10	40	$130	$14.6K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	10	20	450	$10	$11.3K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Sir Akoma Medical Services, 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

Sir Akoma Medical Services — Billing Profile & Reimbursement Data

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Sir Akoma Medical Services — 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