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.

Teofila Maria Cruz (NPI 1548500291)

Field	Value
Entity Type	Individual
Organization	Teofila Maria Cruz
Address	520 W Santa Monica Ave
City	Dededo
State	GU
ZIP	96929
Taxonomy	Nurse Practitioner
NPI Enumerated	February 18, 2013

Payer Source	Total Paid
Medicare	$32.2K
Medicaid	$0

Key Findings

TEOFILA MARIA CRUZ appears to operate primarily in an inpatient/observation setting: the top revenue-driving codes are 99232, 99233 and 99239, which are all hospital inpatient/observation subsequent visit or discharge E/M services. This code mix suggests the provider's work is focused on ongoing inpatient management and discharge-day care rather than outpatient clinic visits or procedures.

Revenue is highly concentrated in a very small set of services: the precomputed top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, with 99232 generating $16.4K (51.0% of this provider's total Medicare revenue), 99233 generating $11.6K (35.9% of this provider's total Medicare revenue), and 99239 generating $4.2K (13.2% of this provider's total Medicare revenue). This concentration means operational or reimbursement changes for inpatient E/M codes would materially impact the provider's billed Medicare revenue.

This provider is effectively single-payer at the claim level: total Medicare revenue is $32.2K and there is no Medicaid billing on file. The absence of any Medicaid billing suggests Medicare is the sole recorded public payer for this NPI in the dataset, which limits revenue diversification across public payers.

In national competitive terms the provider is a modest, typical participant for these inpatient E/M codes: 99232 ranks #30159 of 177383 providers nationally (83th percentile; typical, unremarkable volume for this code), 99233 ranks #43966 of 128818 providers nationally (66th percentile; typical, unremarkable volume for this code), and 99239 ranks #32402 of 62398 providers nationally (47th percentile; typical, unremarkable volume for this code). None of the code-level percentiles indicate dominant national market share; volumes are described as typical or unremarkable for each code.

Claim and payment detail reinforce the operational focus: 99232 accounts for 304 claims at $54 avg paid/claim, 99233 for 141 claims at $82 avg paid/claim, and 99239 for 53 claims at $80 avg paid/claim. The high claim count for 99232 combined with its lower average paid/claim explains why it produces the largest single share of Medicare revenue despite lower per-claim payments.

The provider's NPI was enumerated 2013-02-18 (~13 years ago), indicating a relatively long tenure on the Medicare file. This tenure supports the interpretation that the observed inpatient-focused billing profile is established rather than a short-term or new practice pattern.

The complete absence of Medicaid billing on file is notable in a dual-payer analysis: there are no Top 25 Medicaid codes and the record explicitly lists "none below — this provider has no Medicaid billing on file." For payer/market analyses in Guam, this means the provider's public-payer footprint is limited to Medicare in the available data and any assessment of Medicaid access or competition should account for potential unobserved billing arrangements (e.g., billing under a different NPI or group).

Concentration in a narrow set of inpatient E/M codes creates both operational exposure and clarity: policy or hospital privileging changes affecting 99232/99233/99239 would directly affect nearly all reported Medicare revenue, while the focused code set simplifies benchmarking against inpatient peers. Analysts seeking to evaluate expansion or diversification opportunities should note the current dependence on inpatient follow-up and discharge-day management services as the dominant revenue drivers.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	300	$50	$16.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	140	$80	$11.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	50	$80	$4.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Guam Distribution

Teofila Maria Cruz — 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. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	8	20	130	$90	$16.5K
99232	9	30	150	$60	$12.1K
99239	8	20	50	$90	$4.8K

Nearby Providers

Other providers in the same ZIP code as Teofila Maria Cruz, ranked by combined Medicare and Medicaid revenue.

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

Teofila Maria Cruz — Billing Profile & Reimbursement Data

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Teofila Maria Cruz — 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