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.

Guam Dermatology Institute LLC (NPI 1306404413)

Field	Value
Entity Type	Organization
Organization	Guam Dermatology Institute LLC
Address	633 Gov Carlos G Camacho Rd Ste 102
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Dermatology Physician
NPI Enumerated	June 4, 2019

Payer Source	Total Paid
Medicaid	$189K
Medicare	$0

Key Findings

GUAM DERMATOLOGY INSTITUTE LLC reports no Medicare billing on file and $189K in lifetime Medicaid revenue, making its public payer footprint effectively single-payer Medicaid rather than a mixed Medicare/Medicaid practice. The absence of any Medicare claims on file is a defining feature of this provider’s billing profile and should be treated as an operational reality when assessing payer risk and network coverage.

Revenue is highly concentrated: the top three Medicaid codes account for 95.8% of the provider’s total Medicaid revenue, indicating a narrow set of services drives nearly all billed Medicaid income. This concentration suggests that shifts in coverage, utilization, or reimbursement for those specific codes would materially affect the provider’s Medicaid revenue.

The code mix indicates a clinic-level dermatology practice with a strong procedural orientation toward phototherapy and routine office visits: 96910 (phototherapy) contributes $77.1K (40.8% of Medicaid revenue) and 99213/99203 (established and new patient E/M visits) together contribute $104K+ in revenue. Taken together, these top codes point to a service model centered on in-clinic phototherapy treatments supported by regular new and established patient evaluation visits.

96910 is reported as $77.1K and ranks #1 of 1 providers in-state, but the record notes "no state peer volume comparison available," so while the provider appears to be the only in-state reporter for this code, peer-context interpretation is limited. This pattern could reflect a genuine local specialization in UVB phototherapy, or it could reflect limited state-level reporting for this CPT; either way, the provider is the sole in-state Medicaid reporter for 96910 in the available dataset.

99213 is the single largest individual Medicaid claim line at $80.7K (42.7% of the provider’s Medicaid revenue), with 823 claims and a rank of #25 of 48 in-state (49th percentile), which the file labels as "typical, unremarkable volume." That ranking positions the provider as a modest, middle-of-market participant for routine established-patient dermatology visits within Guam.

99203 (new patient E/M) accounts for $23.3K (12.3% of Medicaid revenue) across 188 claims and ranks #11 of 24 in-state (57th percentile), also described as "typical, unremarkable volume," indicating steady but not dominant new-patient evaluation activity relative to state peers. This supports an interpretation of ongoing new patient throughput sufficient to sustain phototherapy and follow-up services rather than high-volume referral center status.

Higher-complexity E/M and add-on codes contribute marginally to Medicaid revenue: 99214 is $6.6K (3.5%) and G2211 is $1.2K (0.6%), both characterized as "typical, unremarkable volume" or limited by small peer sets in-state. The small share from 99214 suggests fewer visits billed at moderate-complexity levels, reinforcing that most clinical encounters are lower-complexity follow-ups and procedure sessions rather than complex medical management.

The provider’s NPI was enumerated on 2019-06-04 (~7 years ago), giving it several years of presence in the local market; combined with the concentrated code mix and in-state ranking pattern, this suggests a stable, niche dermatology practice focused on phototherapy and routine outpatient dermatology visits rather than broad multispecialty or high-complexity dermatologic services.

Medicaid: Complete Services Breakdown

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

5 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…	820	$100	$80.7K
96910	The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis.	750	$100	$77.1K
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…	190	$120	$23.3K
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…	70	$90	$6.6K
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…	70	$20	$1.2K

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

Guam Dermatology Institute LLC — 0 of 5 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

5 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…	25	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…	28	40	630	$90	$172.1K
96910	The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis.	1	10	750	$100	$77K
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…	11	20	140	$110	$35.4K
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…	4	10	110	$10	$1.3K

Nearby Providers

Other providers in the same ZIP code as Guam Dermatology Institute LLC, 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

Guam Dermatology Institute LLC — Billing Profile & Reimbursement Data

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Guam Dermatology Institute 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