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 Urology, LLC (NPI 1497281687)

Field	Value
Entity Type	Organization
Organization	Guam Urology, LLC
Address	633 Gov Carlos G Camacho Rd
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Urology Physician
NPI Enumerated	May 7, 2017

Payer Source	Total Paid
Medicaid	$63.8K
Medicare	$0

Key Findings

This provider files no Medicare claims on record (no Medicare billing on file) and reports a total lifetime Medicaid revenue of $63.8K, making its public-payer footprint effectively single-payer Medicaid based on the available data. The absence of Medicare billing suggests the practice’s publicly observed reimbursement activity is concentrated in the state Medicaid program rather than the Medicare market.

Revenue is highly concentrated in three codes: 99213, 99214, and 99222. Those top three Medicaid codes account for 83.9% of this provider’s total Medicaid revenue, with 99213 reported at $23.6K (37.0%), 99214 at $20.7K (32.4%), and 99222 at $9.2K (14.5%), indicating that a small set of evaluation-and-management services drives the majority of reimbursement.

The service mix is predominantly evaluation-and-management (E/M) visits: 99213 and 99214 are the largest revenue drivers and represent routine established-patient office care, while 99222 and 99232 show the practice also bills for initial and subsequent inpatient/observation E/M encounters. Procedural diagnostic billing is negligible by comparison (for example, 51798 is $112, 0.2% of Medicaid revenue), which points to an ambulatory/consultative urology model with limited procedure-driven revenue in the Medicaid population.

Claim volume and per-claim reimbursement confirm a clinic-oriented throughput: 99213 has 306 claims at a $77 avg paid/claim for $23.6K revenue, 99214 has 265 claims at a $78 avg paid/claim for $20.7K revenue, and 99222 has 79 claims at a $117 avg paid/claim for $9.2K revenue. These counts show steady office visit volume for established patients and a smaller but material number of higher-reimbursement inpatient initial visits.

Competitive standing within the state is modest for the top office E/M codes: 99213 ranks #32 of 48 providers in-state (34th percentile; typical, unremarkable volume for this code) and 99214 ranks #24 of 35 providers in-state (32th percentile; typical, unremarkable volume for this code), which together indicate the provider is neither a dominant nor an outlier performer on common outpatient visit codes. For hospital initial care, 99222 ranks #3 of 3 providers in-state (0th percentile; typical, unremarkable volume for this code), suggesting only a very small group of peers bills this code in-state and this provider’s inpatient billing is limited in scale.

A few codes show single-provider or very small-peer comparisons: 51798 is reported as rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available) but contributes only $112 to revenue, so while the provider may be the only Medicaid filer for that ultrasound measure in-state, the clinical and financial impact is negligible. Similarly, later inpatient/subsequent visit codes such as 99232 (58 claims, $89 avg paid/claim, $5.2K revenue) appear in very small provider pools (rank #5 of 5, 0th percentile), reinforcing a small-scale inpatient footprint.

Operationally, the combination of concentrated revenue in a few E/M codes and overall Medicaid revenue of $63.8K suggests limited scale; this pattern could produce sensitivity to changes in visit volume or reimbursement for those specific codes. Given the NPI was enumerated 2017-05-07 (~9 years ago), the practice has an established presence but has not grown a large Medicaid billing base in the observable data period, implying either a small practice size or a payer mix that relies on non-Medicare/Medicaid commercial or self-pay sources not captured here.

Medicaid: Complete Services Breakdown

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

6 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…	310	$80	$23.6K
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…	270	$80	$20.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	80	$120	$9.2K
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…	60	$90	$5.2K
99204	The provider sees a new 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 provider…	40	$130	$5K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	10	$10	$110

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 Urology, LLC — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	5	10	3,080	$70	$295.4K
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…	32	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…	24	40	630	$90	$172.1K
99222	The provider sees a patient for an initial 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	720	$120	$64.8K
99204	The provider sees a new 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 provider…	13	20	60	$140	$20.8K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	1	10	10	$10	$110

Nearby Providers

Other providers in the same ZIP code as Guam Urology, 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 Urology, LLC — Billing Profile & Reimbursement Data

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Guam Urology, 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