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 Memorial Hospital (NPI 1366519027)

Key Findings

Field	Value
Entity Type	Organization
Organization	Guam Memorial Hospital
Address	850 Governor Carlos Camacho Road
City	Oka Tamuning
State	GU
ZIP	96913
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 29, 2006

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

GUAM MEMORIAL HOSPITAL is effectively a single-payer Medicaid provider in the claims data set: there is no Medicare billing on file and total Medicaid revenue is reported as $3.5M. This absence of Medicare activity makes Medicaid the sole documented public payer driving the facility’s reported revenue streams in the dataset.

Revenue is concentrated in a small set of evaluation-and-management codes: the precomputed top three Medicaid codes (99283, 99232, 99285) together account for 41.3% of this provider’s total Medicaid revenue. Individually those codes generate $556.4K (99283 – 16.0%), $513.5K (99232 – 14.7%), and $369.6K (99285 – 10.6%), indicating a heavy share of dollars tied to emergency department and inpatient E/M activity.

The clinical mix implied by the top codes points to a hospital focused on emergency and inpatient care with an active obstetrics service. High-revenue E/M codes in the ED and inpatient setting (99283, 99284, 99285, 99232, 99223, 99222) dominate the list, while obstetric delivery codes 59409 ($290.2K) and 59410 ($80.3K) plus newborn care 99460 ($39.5K) confirm on-site labor/delivery and postpartum services. Diagnostic and monitoring services are also material, with 93010 and 71045 among high-claim-volume codes.

Volume metrics reinforce a busy front-line service profile: 99283 shows 8.2K claims and 99284 and 99282 show 3.2K and 3.1K claims respectively, while routine ECG interpretation 93010 appears at 10.6K claims. These claim counts, combined with the dollar amounts reported, suggest frequent ED encounters and high throughput for basic cardiac and chest imaging services in the facility.

Competitive standing is mixed across code lines at the state level. The hospital ranks in the 75th percentile for 99283 and 99285 (both #2 of 5 providers in-state), indicating a visible but not dominant role in higher-acuity ED care, while 99232 ranks #3 of 5 (50th percentile), signaling middle-of-market inpatient follow-up volume. Conversely, the hospital is the sole reported state provider for some obstetric codes (59409 and 59410 are #1 of 1), and it ranks #1 of 5 for 93010 at the 100th percentile, which identifies localized dominance in ECG interpretation and an exclusive or near-exclusive role for some delivery services in the dataset.

Several codes are explicitly described as behaving like typical state volume rather than outliers; many ED and inpatient codes are labeled "typical, unremarkable volume" in their percentile notes (for example, 99232, 99284, 99223). The single notable statistical exception called out in the code list is 93010, described as "notably above typical state volume for this code," underscoring an unusually high ECG claim volume relative to peers.

The provider’s NPI tenure is long-standing: NPI enumerated 2006-11-29 (~20 years ago). This extended presence aligns with the breadth of inpatient, ED, and obstetric services reflected in the Medicaid claims mix and suggests established clinical operations rather than a newly opened facility.

Operationally, the combination of high claim counts for low- and mid-acuity ED E/M codes (e.g., 99283 with $68 avg paid/claim and 99284 with $113 avg paid/claim) together with concentrated revenue in higher-acuity E/M codes (99285) indicates revenue relies on volume-driven emergency throughput as well as episodic higher-acuity care. Given the dataset shows no Medicare revenue, this dependence on Medicaid volume and a few high-revenue E/M codes concentrates both activity and reimbursement risk around ED, inpatient, and obstetric service lines.

Medicaid: Complete Services Breakdown

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	8,180	$70	$556.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,080	$170	$513.5K
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.	2,200	$170	$369.6K
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.	3,240	$110	$366.6K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	370	$780	$290.2K
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…	1,050	$190	$196.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3,060	$40	$131.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,710	$70	$122.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,500	$80	$119.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	10,570	$10	$105.7K

Showing 1–10 of 47

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 Memorial Hospital — 2 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	2	10	1,880	$410	$2M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2	10	5,830	$330	$1.9M
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.	3	10	3,240	$290	$1.3M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3	10	3,080	$70	$295.4K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	1	10	370	$780	$290.1K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3	10	2,210	$120	$245.1K
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…	28	50	900	$80	$201.7K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	2	10	10,840	$20	$201.6K
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.	2	10	1,010	$140	$191.9K
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…	27	40	630	$90	$172.1K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peachy Mae Piana-pacheco	GU	Diagnostic Radiology Physician	$223.2K	$180
Alix Chenet	GU	Internal Medicine Physician	$64.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Lee	GU	Dentist	$0	$10.9M
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

Guam Memorial Hospital — Billing Profile & Reimbursement Data

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Guam Memorial Hospital — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References