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.

Payless Markets Inc (NPI 1285746107)

Field	Value
Entity Type	Organization
Organization	Payless Markets Inc
Address	275 Farenholt Ave Ste 208
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Community/Retail Pharmacy
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$9K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports only $9K in lifetime Medicaid revenue, making it effectively a single‑payer (Medicaid) operation in the available data. The absence of Medicare claims means analysts should evaluate competitive and operational posture solely against Medicaid activity for this entity.

Taxonomy and top services align: listed as a Community/Retail Pharmacy and the top billed codes are diabetes self‑care supplies and related DME, indicating the operation primarily dispenses outpatient diabetes testing supplies rather than clinical services. The three highest‑revenue Medicaid codes (A4253, E0607, A4259) correspond to blood glucose test strips, a home blood glucose monitor, and lancets, which is consistent with retail pharmacy dispensing and device supply workflows.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue. In particular, A4253 represents 82.1% of Medicaid revenue ($7.4K), E0607 represents 10.7% ($960), and A4259 represents 7.2% ($646), so changes in coverage or pricing for diabetes supplies would materially affect overall revenue.

Claims and average payments show scale and unit economics: the provider reported 335 claims for A4253 at $22 avg paid/claim, 323 claims for A4259 at $2 avg paid/claim, and 12 claims for E0607 at $80 avg paid/claim. These counts and per‑claim payments underline a business model driven by high‑volume, lower‑cost strip and lancet dispensing supplemented by occasional higher‑unit‑price monitor sales.

Competitive standing by code is modest within the state: A4253 ranks #4 of 11 providers in‑state (70th percentile) and A4259 ranks #3 of 9 providers (75th percentile), both characterized as typical or unremarkable volumes for those codes. E0607 ranks #1 of 1 providers in‑state, but the documentation notes there is no state peer volume comparison available for that code, so that #1 ranking reflects sole billing rather than demonstrable dominance.

Tenure is long but scale remains small: the NPI was enumerated on 2006-08-31 (~20 years ago), indicating sustained registration over time despite reporting only modest Medicaid revenue ($9K) across its recorded lifetime. Long enumeration with low reported Medicaid revenue suggests a small, steady retail pharmacy presence rather than recent entrant expansion or major Medicaid contracting.

Strategic implications: because 100.0% of Medicaid revenue is tied to diabetes testing supplies (A4253/A4259) and a single monitor code (E0607), the provider has limited service diversification and is exposed to reimbursement or formulary shifts for those items. Analysts reviewing network, contracting, or utilization should treat PAYLESS MARKETS INC as a focused diabetes‑supply dispenser with modest statewide market share rather than a broad DME or clinical services provider.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	340	$20	$7.4K
E0607	Home blood glucose monitor	10	$80	$960
A4259	Lancets, per box of 100	320	$1	$650

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

Payless Markets Inc — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	4	10	130	$20	$5.8K
E0607	Home blood glucose monitor	1	10	10	$80	$960
A4259	Lancets, per box of 100	3	10	140	$1	$530

Payless Markets Inc — Billing Profile & Reimbursement Data

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Payless Markets Inc — 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

Frequently Asked Questions

References