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.

Blue Ocean Medical Group LLC (NPI 1235791203)

Key Findings

Field	Value
Entity Type	Organization
Organization	Blue Ocean Medical Group LLC
Address	655 Harmon Loop Rd Ste 108
City	Dededo
State	GU
ZIP	96929
Taxonomy	Family Medicine Physician
NPI Enumerated	July 1, 2019

Payer Source	Total Paid
Medicaid	$665.1K
Medicare	$0

BLUE OCEAN MEDICAL GROUP LLC has effectively a single-payer footprint in the available data: there is no Medicare billing on file while lifetime Medicaid revenue is $665.1K, indicating operations are focused on Medicaid-covered care rather than Medicare populations. This concentration suggests the practice’s patient mix is skewed toward Medicaid beneficiaries or that it contracts primarily with Medicaid rather than Medicare plans.

Revenue is highly concentrated in a few evaluation-and-management (E/M) office visit codes: the precomputed top 3 Medicaid codes account for 83.5% of the provider’s total Medicaid revenue, with 99214 alone representing $363.9K (54.7%). This concentration implies the practice’s primary service line is outpatient primary care visits with moderate-complexity management of established patients.

The provider shows unusually high state-level volume for some new-patient E/M services: 99204 generates $97.4K (14.6% of Medicaid revenue) and ranks #1 of 20 in-state, described as "notably above typical" volume. That ranking indicates BLUE OCEAN is a leading in-state provider for higher-complexity new patient visits, which could reflect strong new-patient intake or regional referral patterns for initial evaluations.

99203 also contributes materially ($94.3K, 14.2% of Medicaid revenue) and ranks #4 of 24 in-state (87th percentile), reinforcing that new-patient office visits are a significant part of the clinic’s business. Together with 99204, the mix of high-rank new-patient E/M codes suggests the practice handles a substantial share of initial evaluations in the state, not just routine follow-ups.

Established-patient visits at moderate and lower complexity are present but less dominant: 99214 is the largest single revenue source, while 99213 accounts for $54.5K (8.2%) and ranks in the middle of state peers (45th percentile). This pattern points to a practice that balances managing ongoing patients with a heavier-than-average emphasis on new patient evaluations.

The provider’s state competitive standing is mixed across codes: it is a top-ranked statewide provider for 99204 (100th percentile) and ranks highly for 99203 (87th percentile), but for common established-patient codes such as 99213 it sits near the median (45th percentile) and for 99214 it is in the 82th percentile and described as typical volume. This implies market leadership in new-patient intake while being a typical competitor for routine established-patient visits.

Clinical ancillary services are present but represent a small share of revenue: point-of-care immunoassays for strep and influenza (87880 and 87804) and basic lab or vaccine codes appear in the top-25 Medicaid mix but collectively account for under 3% of revenue. The presence of these codes indicates the clinic performs in-office testing and immunizations consistent with a family medicine practice, but these are minor revenue drivers relative to E/M visits.

Provider tenure is short-to-moderate: the NPI was enumerated on 2019-07-01 (~7 years ago). That timeframe is consistent with an established local practice that has built a significant new-patient volume in-state within a relatively recent operational window, which aligns with the high rankings on 99204 and 99203.

Medicaid: Complete Services Breakdown

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

19 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…	3,830	$100	$363.9K
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…	680	$140	$97.4K
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…	880	$110	$94.3K
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…	740	$70	$54.5K
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…	430	$80	$35K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	460	$20	$6.9K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	420	$20	$6.3K
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.	30	$120	$3.1K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	290	$10	$1.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	10	$70	$1K

Showing 1–10 of 19

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

Blue Ocean Medical Group LLC — 4 of 16 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

19 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…	27	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…	7	40	630	$90	$172.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	7	10	500	$50	$45.3K
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…	4	20	140	$110	$35.4K
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…	1	20	60	$140	$20.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	9	10	30	$80	$16.2K
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.	10	10	40	$130	$14.6K
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…	2	10	40	$40	$7.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1	10	460	$10	$6.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1	10	260	$10	$3.3K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guam Healthcare Development Incorporated	GU	Clinic/Center	$0	$30.8M
C V Alegria Dds Inc	GU	General Practice Dentistry	$0	$11.3M
Albert Huang	GU	Dentist	$0	$5.4M
Usrc Finegayan, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
Renal Centers Of Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Government Of Guam Department Of Administration	GU	Federally Qualified Health Center (FQHC)	$0	$2.4M
Maria Chela Mariano	GU	Family Medicine Physician	$0	$1.8M
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
Anthony Bekkerman	GU	Emergency Medicine Physician	$49.5K	$623.9K
Yolanda Carrera	GU	Pediatrics Physician	$0	$334.5K

Blue Ocean Medical Group LLC — 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