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NPI 1235271693 · Tamuning, GU · Obstetrics Physician
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Kimberly Walton is a obstetrics physician provider located in Tamuning, Guam. This profile covers 4 Medicare and 1 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 | Kimberly Walton |
| Address | 425 Chalan San Antonio |
| City | Tamuning |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Obstetrics Physician |
| NPI Enumerated | February 13, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.4K |
| Medicaid | $4K |
This provider reports modest public-payer volume overall: Total Medicare revenue is $6.4K while Total Medicaid revenue is $4K, making Medicare the larger single public payer but both payer pools are small in absolute terms. The presence of revenue on both Medicare and Medicaid indicates a dual-payer practice footprint rather than a single-payer reliance.
Medicare revenue is highly concentrated: the precomputed top three Medicare codes account for 85.5% of this provider's total Medicare revenue, with 77067, G0101, and 99213 identified as the primary drivers. Those top codes are screening mammography (77067), cervical/vaginal cancer screening with pelvic and breast exam (G0101), and routine established patient office visits (99213), which together point to a narrow set of services producing most Medicare dollars.
Medicaid revenue is effectively single-code dependent: the precomputed top three Medicaid codes account for 100.0% of Medicaid revenue, and that Medicaid revenue is entirely attributed to 99213 (43 claims, $92 avg paid/claim, $4K revenue). This creates operational sensitivity to outpatient office-visit volume in the state Medicaid population.
Service-line implications align with a women’s health/preventive outpatient focus: top Medicare codes include 77067 and 77063 (mammography and tomosynthesis) and G0101 (cervical cancer screening), together with 99213 office visits, suggesting the practice primarily generates revenue from screening imaging and routine ambulatory gynecologic care rather than inpatient deliveries or complex obstetric procedures. The provider’s taxonomy of Obstetrics Physician combined with an outpatient screening-heavy mix suggests their local role may emphasize preventive and follow-up clinic services.
Competitive standing on Medicare is modest and mixed by code: 77067 ranks #14090 of 15198 nationally (6th percentile; typical, unremarkable volume), 77063 ranks #13294 of 14277 (6th percentile; typical, unremarkable volume), G0101 ranks #5021 of 15420 (67th percentile; typical, unremarkable volume), and 99213 ranks #389026 of 457151 (14th percentile; typical, unremarkable volume). These percentiles indicate the provider is not a dominant national processor for these services and generally operates at low-to-typical volumes.
Competitive standing in Medicaid is low in-state: Medicaid 99213 ranks #42 of 48 providers in-state (13th percentile; typical, unremarkable volume), signaling below-peer visit volumes for the same established-patient office-visit code among local Medicaid providers. This suggests constrained market share for routine outpatient visits within the state Medicaid population.
Tenure is long but does not translate to high public-payer volume: the NPI was enumerated on 2007-02-13 (~19 years ago), indicating a longstanding presence in the market, yet reported Medicare and Medicaid revenues remain limited. Longevity may reflect a stable local practice or part-time/public-payer-focused billing rather than recent high-volume expansion.
Operational detail: two imaging codes appear among the Medicare top codes with relatively low national volume indicators. 77067 shows 17 claims at $136 avg paid/claim ($2.3K revenue) and 77063 shows 17 claims at $55 avg paid/claim ($935 revenue), both labeled as typical, unremarkable volume (6th percentile for each), which suggests the provider’s mammography-related revenue stems from routine screening-level activity rather than high-volume imaging operations.
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 |
|---|---|---|---|---|
| 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… | 20 | $140 | $2.3K |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | 40 | $40 | $1.6K |
| 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… | 20 | $70 | $1.5K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 20 | $60 | $940 |
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.
1 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… | 40 | $90 | $4K |
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
1 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… | 42 | 50 | 900 | $80 | $201.7K |
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