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 Lee (NPI 1356483259)

Field	Value
Entity Type	Individual
Organization	Thomas Lee
Address	761 S Marine Corps Dr
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Dentist
NPI Enumerated	February 14, 2007

Payer Source	Total Paid
Medicaid	$10.9M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused practice: there is no Medicare billing on file and all reported lifetime federal revenue is $10.9M in Medicaid, indicating a single-payer footprint concentrated in Medicaid populations rather than a mixed Medicare/Medicaid practice. The absence of Medicare activity suggests the provider’s commercial and Medicaid relationships drive its scale.\n

Revenue is highly concentrated in a small set of procedures: the precomputed top three Medicaid codes account for 37.3% of total Medicaid revenue, led by D4220 at $2.2M (21.0%), followed by D2150 at $949.2K (9.0%) and D3220 at $778.8K (7.4%). These three codes alone represent more than one-third of reported Medicaid receipts, signaling dependence on a narrow set of high-throughput services.\n

The code mix points to a high-volume general dental practice with heavy restorative and preventive pediatric activity: D2150 (Amalgam - two surfaces) is a top revenue driver, while D1120 (Prophylaxis–child) and D1351 (Sealant - per tooth) appear in the top codes list, and D0150 (Comprehensive oral evaluation) is a sizable contributor. This combination of amalgam restorations, routine prophylaxis, sealants and comprehensive exams is consistent with a full-scope dental clinic serving both routine and restorative needs.\n

Imaging and diagnostic services are an outlier area of volume: D0230 shows 36.6K claims and $512.4K revenue and is labeled an "extreme outlier" in-state, and D0220 ranks #1 of 15 providers (100th percentile; "notably above typical state volume"). The provider’s very high claim counts for periapical imaging suggest workflows or care models that generate substantial radiographic utilization relative to peers.\n

The practice is a dominant statewide supplier for several restorative codes: D2150 ranks #1 of 8 providers in-state at the 100th percentile and is described as "notably above typical state volume," and multiple other restorative/pulp-related codes (e.g., D3120, D2335, D2160) also rank #1 of their peer sets at the 100th percentile. These rank/percentile signals indicate the provider is a major competitor in core restorative procedures within the state Medicaid market.\n

The mix includes both routine preventive and problem-focused/urgent care activity: substantial counts for D0140 (3.2K claims, limited oral evaluation) and extraction codes such as D7140 (3.4K claims, $547K) and D7210 (764 claims, $118.4K) show the practice delivers both scheduled preventive visits and active treatment for acute dental issues. That operational breadth supports billing across diagnostics, preventive, restorative and surgical codes.\n

Many high-revenue codes are flagged in-state as "notably above typical state volume" (for example D2150, D3120, D0150, D2335, D2160, D0220, D2950, D9230, D2161, D1110, D0274), reflecting repeated outperformance of peers across multiple service categories rather than a single-service anomaly. For payers and network analysts, this pattern suggests concentrated provider expertise or referral capture in these specific service lines, and it warrants targeted capacity and utilization review at the procedure level.\n

The provider has long tenure in the NPI file (enumerated 2007-02-14, ~19 years), which helps explain sustained high volumes and top in-state rankings; this longevity likely supports an established referral base and operational scale that reinforce its dominant position for several Medicaid dental codes.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D4220	N/A	12,340	$180	$2.2M
D2150	Amalgam - two surfaces, primary or permanent	10,320	$90	$949.2K
D3220	N/A	6,890	$110	$778.8K
D2930	N/A	3,870	$190	$735.7K
D3120	N/A	15,350	$40	$644.7K
D0150	Comprehensive oral evaluation – new or established patient	7,730	$70	$571.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3,360	$160	$547K
D0230	Intraoral - periapical each additional radiographic image	36,600	$10	$512.4K
D1120	Prophylaxis–child	8,400	$60	$495.6K
D2335	N/A	2,470	$170	$425.5K

Showing 1–10 of 34

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

Thomas Lee — 10 of 25 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D4220	N/A	2	10	940	$200	$845.2K
D2930	N/A	2	10	570	$180	$587.4K
D3220	N/A	2	10	560	$110	$406.3K
D2940	N/A	4	10	1,230	$220	$377.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2	10	490	$160	$322.3K
D2150	Amalgam - two surfaces, primary or permanent	1	10	1,360	$100	$315.6K
D1120	Prophylaxis–child	2	10	2,140	$60	$195.3K
D0150	Comprehensive oral evaluation – new or established patient	2	10	1,460	$70	$192.7K
D2160	Amalgam - three surfaces, primary or permanent	1	10	530	$110	$139.3K
D3120	N/A	1	10	850	$40	$136.9K

Showing 1–10 of 34

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Leopoldo Arcilla	GU	Internal Medicine Physician	$81.3K	$1.5M

Thomas Lee — Billing Profile & Reimbursement Data

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Thomas Lee — 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