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.

Thomas Baugh (NPI 1255302485)

Field	Value
Entity Type	Individual
Organization	Thomas Baugh
Address	U.s. Naval Hospital Guam
City	Agana Heights
State	GU
ZIP	96919
Taxonomy	Emergency Medicine Physician
NPI Enumerated	January 27, 2006

Payer Source	Total Paid
Medicare	$66.2K
Medicaid	$0

Key Findings

THOMAS BAUGH is an Emergency Medicine Physician in AGANA HEIGHTS, GU whose NPI was enumerated 2006-01-27 (~20 years ago). Lifetime Medicare revenue on file is $66.2K and there is no Medicaid billing on file, so this profile is effectively single-payer (Medicare) in scope for the dataset provided.

Revenue is highly concentrated in three codes: the precomputed top-3 Medicare codes account for 91.8% of this provider's total Medicare revenue. Individually, 99285 accounts for $36.4K (55.1%), 99284 for $12.8K (19.3%), and 99291 for $11.4K (17.3%), which together form the core of the billing mix.

The code mix (99285, 99284, 99291) is consistent with an emergency-department practice model that handles a meaningful share of high-acuity encounters. 99285 (high-level ED E/M) is the single largest revenue driver and 99291 (critical care) contributes a substantial portion of revenue, indicating frequent management of seriously ill or unstable patients within the emergency setting.

99285 is the dominant line item by revenue with 268 claims, $136 avg paid/claim, and $36.4K revenue (55.1% of Medicare revenue); it ranks #8296 of 61347 nationally (86th percentile) and is characterized in the dataset as "typical, unremarkable volume," which points to solid but not outsized national presence for that code. This suggests the provider’s high-acuity emergency visits are materially above many peers in absolute rank but remain within expected variation for ED physicians.

99284 (139 claims, $92 avg paid/claim, $12.8K revenue) and 99291 (65 claims, $176 avg paid/claim, $11.4K revenue) together make up 36.6% of Medicare revenue; 99284 ranks #7538 of 64306 (88th percentile) and 99291 ranks #24718 of 71290 (65th percentile), both described as typical or unremarkable volumes. The presence of 99291 at 17.3% of revenue highlights that critical care time is a significant component of billed services rather than an occasional add-on.

Secondary codes (99223, 93010, 99283) contribute only small shares of revenue (e.g., 99223 $3.2K or 4.8%; 93010 $1.4K or 2.1%; 99283 $918 or 1.4%) and are reported at modest national ranks and percentiles. 93010 shows many low-paid claims (227 claims at $6 avg paid/claim) that add little revenue but reflect routine ECG interpretation volume accompanying ED care.

From a business and risk perspective, the combination of a small absolute lifetime Medicare total ($66.2K) and a heavy concentration in three ED/critical-care codes suggests limited diversification: reimbursement exposure is concentrated in emergency services and entirely within Medicare. The absence of any Medicaid billing on file means payer-mix changes or policy shifts affecting Medicare reimbursement would disproportionately affect this provider's documented revenue stream.

Operationally, the provider’s ~20 years of NPI tenure combined with modest lifetime Medicare revenue suggests an established clinician who likely provides episodic or part-time emergency coverage rather than operating a high-volume, independent emergency practice. The billing pattern is consistent with a clinician who regularly manages high-acuity ED cases but does not generate large aggregated Medicare revenue compared with higher-volume national peers.

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.	270	$140	$36.4K
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	$90	$12.8K
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…	70	$180	$11.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	$140	$3.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	230	$10	$1.4K
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.	20	$50	$920

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

Thomas Baugh — 0 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	2	20	80	$140	$15.2K
99291	6	10	60	$170	$13.1K
99284	6	20	90	$90	$9.4K
99223	13	20	30	$130	$7K
99283	12	10	30	$50	$2.1K
93010	2	20	80	$10	$1K

Nearby Providers

Other providers in the same ZIP code as Thomas Baugh, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tracy Mcmonigle	GU	Physician Assistant	$8.7K	$0

Thomas Baugh — Billing Profile & Reimbursement Data

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Thomas Baugh — 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

Nearby Providers

Frequently Asked Questions

References