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.

Virgilio Petero Jr (NPI 1528228798)

Key Findings

Field	Value
Entity Type	Individual
Organization	Virgilio Petero Jr
Address	Guam Regional Medical City
City	Dededo
State	GU
ZIP	96929
Taxonomy	Urology Physician
NPI Enumerated	June 11, 2008

Payer Source	Total Paid
Medicare	$75.4K
Medicaid	$0

This provider’s Medicare footprint is small in absolute dollars: total Medicare revenue is $75.4K and there is no Medicaid billing on file, indicating the provider operates with effectively single-payer (Medicare) claims activity. The lack of any Medicaid billing suggests limited exposure to state programs and a revenue base concentrated exclusively in Medicare.

Revenue is highly concentrated in a few office E/M and procedural codes: the precomputed top-3 Medicare codes account for 63.7% of the provider’s Medicare revenue, with 99214 generating $28.5K (37.7%), 99213 generating $11.5K (15.3%), and 52000 generating $8.1K (10.7%). These three codes together represent the bulk of reported Medicare payments and drive the overall business profile.

The code mix points to an outpatient-focused urology practice that performs routine office visits plus diagnostic/therapeutic bladder procedures. High-volume E/M codes 99214 and 99213 dominate by revenue, while 52000 (cystoscopy) and related bladder codes (51710, 51700, 51798) show that the practice also delivers procedural bladder care and catheter management on-site.

Procedural activity is meaningful but secondary to E/M revenue: 52000 (41 claims, $198 avg paid/claim, $8.1K revenue) is the largest procedure by revenue, and catheter/instillation codes 51710 (38 claims, $3.5K) and 51700 (35 claims, $1.1K) plus bladder ultrasound 51798 (132 claims, $1.1K) indicate a steady stream of lower-reimbursement urologic procedures supporting the office practice. These procedure volumes suggest hands-on urologic management rather than a purely consultative role.

Competitive standing versus national Medicare peers is modest: 99214 ranks #82471 of 479517 providers nationally (83th percentile; typical, unremarkable volume for this code) and 99213 ranks #110246 of 457151 (76th percentile; typical, unremarkable volume for this code), indicating routine but not dominant E/M presence. Procedural ranking for 52000 is lower (rank #6291 of 8548 providers nationally, 26th percentile; typical, unremarkable volume), so the provider is more typical than a high-volume national procedural center.

Hospital-based E/M codes show some inpatient/observation activity: 99232 (104 claims, $6.1K revenue) and 99222 (61 claims, $5.2K revenue) appear in the top code list, which implies the provider delivers follow-up and initial inpatient care in addition to outpatient visits. Both codes carry percentile ranks in the mid-range (99232 at 56th percentile; 99222 at 80th percentile) and therefore reflect occasional hospital service rather than a primary inpatient focus.

The lifetime pattern of claims and revenue shows no Medicaid billing on file and a modest Medicare total, which has implications for payer contracting and network strategy: with $75.4K in Medicare revenue and no Medicaid activity, the provider would be classified operationally as Medicare-dependent for public-payor volume. Analysts should treat this entity as a small-scale Medicare-serving urology practice when benchmarking payer negotiations or capacity planning.

The provider has an established billing history with an NPI enumerated on 2008-06-11 (~18 years ago), signaling long-term presence in the market. Despite tenure, the reported Medicare revenue levels and national percentile ranks suggest a steady, locally oriented practice rather than a high-volume or regionally dominant urology group.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	350	$80	$28.5K
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…	180	$60	$11.5K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	40	$200	$8.1K
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…	70	$110	$7.7K
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…	100	$60	$6.1K
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…	60	$90	$5.2K
51710	In this procedure, the provider removes a tube that he previously places into a patient’s bladder and replaces it with a new tube through the same incision. This procedure is complicated because of…	40	$90	$3.5K
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…	20	$120	$2.4K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	130	$10	$1.1K
51700	Bladder irrigation and instillation are used to deliver medication directly to the bladder via a catheter. These medications are usually anti–inflammatory agents used to treat infection or…	40	$30	$1.1K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guam Healthcare Development Incorporated	GU	Clinic/Center	$0	$30.8M
C V Alegria Dds Inc	GU	General Practice Dentistry	$0	$11.3M
Albert Huang	GU	Dentist	$0	$5.4M
Usrc Finegayan, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
Renal Centers Of Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Government Of Guam Department Of Administration	GU	Federally Qualified Health Center (FQHC)	$0	$2.4M
Maria Chela Mariano	GU	Family Medicine Physician	$0	$1.8M
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
Anthony Bekkerman	GU	Emergency Medicine Physician	$49.5K	$623.9K
Blue Ocean Medical Group LLC	GU	Family Medicine Physician	$0	$665.1K

Virgilio Petero Jr — Billing Profile & Reimbursement Data

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Virgilio Petero Jr — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	20	90	140	$90	$25.7K
99215	13	20	40	$120	$14.6K
99232	21	30	150	$60	$12.1K
99213	30	100	100	$60	$10.6K
52000	2	10	40	$210	$10.2K
99204	13	50	30	$110	$6.7K
51710	1	10	40	$90	$3.5K
99222	1	20	30	$100	$2.8K
51798	1	10	120	$10	$1K
51700	1	10	20	$40	$900