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.

Prime Care Inc (NPI 1386783629)

Field	Value
Entity Type	Organization
Organization	Prime Care Inc
Address	851 Governor Carlos Camacho Rd
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Pharmacy
NPI Enumerated	February 5, 2007

Payer Source	Total Paid
Medicaid	$3.6K
Medicare	$0

Key Findings

PRIME CARE INC shows effectively single-payer activity: there is no Medicare billing on file while total Medicaid revenue is $3.6K, indicating all reported public-program revenue for this NPI comes from Medicaid. This profile is consistent with a small, Medicaid-focused outpatient supplier rather than a mixed Medicare/Medicaid provider.

The provider has been enumerated (registered) since 2007-02-05, indicating roughly 19 years of active NPI status. This extended tenure suggests established operations in the market despite the low reported Medicaid revenue.

Revenue concentration is very high: the top 3 Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, meaning its Medicaid business is entirely dependent on a narrow set of supply codes rather than a diversified service mix.

Business/service-line implications from the top codes point to a pharmacy or durable medical equipment supplier focused on diabetes and injection supplies: A4211 (supplies for self-administered injections) and A4206 (syringe with needle, sterile, 1 cc or less) together make up the majority of revenue, with A4253 (blood glucose test strips) representing the remaining share. This mix suggests the operation predominantly dispenses self-injection supplies and diabetes testing consumables.

Competitive standing in-state is modest for these codes: A4211 ranks #4 of 10 providers in the state (67th percentile), which indicates a typical, unremarkable volume relative to peers rather than market dominance. A4206 ranks #6 of 8 (29th percentile) and A4253 ranks #11 of 11 (0th percentile), both reflecting low to very low positioning among in-state suppliers for those items.

Code-level payment characteristics show modest per-claim reimbursement: A4211 averaged $9 paid/claim and A4206 averaged $10 paid/claim, while A4253 averaged $20 paid/claim. Combined with the claim volumes (215, 142, and 14 claims respectively), these unit payments produce the small aggregate Medicaid revenue of $3.6K, consistent with a low-volume supplier operation.

Given the Medicaid rank percentiles and small total revenue, PRIME CARE INC is best characterized as a niche or minor supplier within the state market for injection and diabetes testing supplies; its operations do not register as a major statewide competitor for these codes. Analysts evaluating network or procurement relationships should treat this NPI as a limited-volume partner rather than a high-capacity supplier.

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
A4211	Supplies for self-administered injections	220	$10	$1.9K
A4206	Syringe with needle, sterile, 1 cc or less, each	140	$10	$1.4K
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	10	$20	$280

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

Prime Care 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
A4206	Syringe with needle, sterile, 1 cc or less, each	6	10	320	$10	$7.6K
A4253	Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips	11	10	130	$20	$5.8K
A4211	Supplies for self-administered injections	4	10	100	$10	$2.9K

Prime Care Inc — Billing Profile & Reimbursement Data

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Prime Care 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