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.

American Medical Center, LLC (NPI 1457329849)

Key Findings

Field	Value
Entity Type	Organization
Organization	American Medical Center, LLC
Address	1244 North Marine Corps Drive
City	Upper Tumon
State	GU
ZIP	96913
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	March 10, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

This provider has no Medicare billing on file and reports $1.2M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer with Medicaid as the dominant source of recorded fee‑for‑service revenue. Analysts should treat any Medicare comparisons as not applicable when assessing this entity’s payer mix or national competitiveness.

Revenue is extremely concentrated in a very small set of outpatient E/M codes: the top three Medicaid codes account for 96.4% of total Medicaid revenue, driven by 99213 ($635.3K, 52.7% of Medicaid revenue), 99214 ($481.7K, 40.0%), and 99203 ($45.6K, 3.8%). This concentration indicates the practice’s financial performance depends heavily on routine office/urgent visits rather than procedural or specialty billings.

The code mix and the provider’s taxonomy (Urgent Care Clinic/Center) align: dominant codes 99213 and 99214 are established‑patient E/M visits that reflect high-volume, episodic outpatient care consistent with urgent care or general outpatient clinic operations. The notable presence of 99203 (new patient office visit) further supports a flow of both returning and newly presenting patients rather than procedure‑driven specialty care.

On state competitive standing for the top revenue drivers, the provider ranks strongly: 99213 ranks #5 of 48 providers in‑state (91th percentile; notably above typical state volume for this code) and 99214 ranks #4 of 35 providers in‑state (91th percentile; notably above typical state volume for this code). These positions indicate the provider is a major in‑state volume participant for routine E/M visits, even if total Medicaid revenue is modest in absolute terms.

There are notable billing/payment patterns for several codes where claim volume does not translate into commensurate paid revenue: for example, 99490 shows 2.8K claims with $0 avg paid/claim ($0 revenue) and 99215 shows 719 claims with a $2 avg paid/claim ($1.4K revenue). Such disconnects suggest differences in Medicaid coverage, bundled payments, or reporting artifacts for certain chronic care management and higher‑level E/M codes rather than a uniform fee schedule across all services.

The practice offers on‑site point‑of‑care testing and preventive services alongside E/M visits, as shown by 87811 (719 claims, $20.1K revenue) for SARS–CoV–2 immunoassay testing (87811 ranks #1 of 2 providers in‑state, 100th percentile; typical, unremarkable volume for this code), and multiple influenza/TB vaccine and testing codes (e.g., 86580, 87804, 90658, 90688, G0008) with smaller revenue contributions. This mix is typical for urgent care centers that combine episodic visits with rapid testing and immunizations.

The provider has a long tenure in the NPI registry (NPI enumerated 2006-03-10, ~20 years ago), which together with the concentrated but substantial Medicaid visit volume suggests an established local practice with sustained patient flow for routine outpatient care. Longevity increases the likelihood that observed patterns reflect stable service offerings rather than a short‑term reporting anomaly.

Beyond the two dominant E/M codes, revenue diversification is limited: pediatric well visit 99393 ($1.6K) and various vaccine administration codes (multiple entries with $0–$1.5K each) contribute only small fractions of Medicaid revenue. This indicates a breadth of offered services typical of an urgent care setting but with financial dependence on routine established‑patient E/M visits for the business model.

Medicaid: Complete Services Breakdown

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

22 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…	8,820	$70	$635.3K
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…	5,410	$90	$481.7K
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…	370	$120	$45.6K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	720	$30	$20.1K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	610	$10	$6.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	180	$30	$4.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	260	$10	$2.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	30	$70	$1.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	$110	$1.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	70	$20	$1.5K

Showing 1–10 of 22

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

American Medical Center, LLC — 2 of 14 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

22 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…	5	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…	4	40	630	$90	$172.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10	10	130	$110	$42.8K
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…	8	20	140	$110	$35.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	18	20	120	$60	$35.1K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	10	10	780	$20	$30.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1	10	640	$30	$20.9K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	7	20	450	$10	$11.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	11	20	180	$20	$10.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1	10	40	$40	$7.2K

Showing 1–10 of 22

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

American Medical Center, LLC — Billing Profile & Reimbursement Data

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American Medical Center, 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