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NPI 1558338509 · Tamuning, GU · Foot Surgery Podiatrist
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Teresa Borja is a foot surgery podiatrist provider located in Tamuning, Guam. This profile covers 3 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Teresa Borja |
| Address | 122 Tun Jose Toves Way |
| City | Tamuning |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Foot Surgery Podiatrist |
| NPI Enumerated | March 8, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $224.7K |
| Medicare | $6.1K |
The provider’s NPI was enumerated on 2006-03-08 (~20 years ago), indicating long-standing enrollment in federal programs and an established billing history across Medicare and Medicaid. Tenure on file supports interpretation of stable service delivery rather than a recent market entrant.
This practice is effectively Medicaid-dominant: lifetime Medicaid revenue totals $224.7K versus total Medicare revenue of $6.1K, so most of the reported billing and dollars come from Medicaid rather than Medicare. The provider should be treated operationally as a Medicaid-focused outpatient practice based on current revenue scale.
Medicare revenue is highly concentrated among three E/M codes: 99232 (38 claims, $64 avg paid/claim, $2.4K revenue; 39.9% of this provider's total Medicare revenue), 99222 (19 claims, $104 avg paid/claim, $2K revenue; 32.5%), and 99213 (60 claims, $28 avg paid/claim, $1.7K revenue; 27.6%). Precomputed figures show the top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, so Medicare activity is narrowly focused on a small set of hospital and outpatient E/M services.
The provider’s Medicare code volumes are described as typical and unremarkable at the national level: 99232 ranks #130544 of 177383 providers nationally (26th percentile; typical, unremarkable volume for this code), 99222 ranks #78715 of 117621 (30th percentile; typical, unremarkable volume), and 99213 ranks #258751 of 457151 (43th percentile; typical, unremarkable volume). These rankings suggest a modest national footprint on Medicare E/M codes rather than a dominant or specialized national presence.
Medicaid billing is heavily concentrated in outpatient office visits, dominated by 99213 (4.3K claims, $48 avg paid/claim, $206.1K revenue), which represents 91.7% of this provider's total Medicaid revenue. The precomputed summary confirms the top 3 Medicaid codes account for 100.0% of Medicaid revenue, and the single-code concentration around 99213 indicates the practice’s day-to-day operations generate high volume of routine established-patient outpatient visits.
Within the state Medicaid market the provider shows relatively strong placement for core outpatient codes: 99213 ranks #11 of 48 providers in-state (79th percentile; typical, unremarkable volume for this code) and 99203 (274 claims, $68 avg paid/claim, $18.6K revenue; 8.3% of Medicaid revenue) ranks #9 of 24 in-state (65th percentile; typical, unremarkable volume). These in-state rankings signal the provider is a credible regional competitor for routine office E/M visits in podiatry-focused care, especially for Medicaid patients.
Operational and financial sensitivity is concentrated in Medicaid outpatient visits: with $206.1K of Medicaid revenue tied to 99213 (91.7% of Medicaid revenue) and only $6.1K reported to Medicare overall, the practice’s revenue stream is exposed to changes in Medicaid policy, reimbursement, or patient volume for routine E/M visits. The small Medicare footprint—comprised primarily of a few inpatient/observation and office E/M claims—suggests limited diversification into higher-paying Medicare services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
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… | 40 | $60 | $2.4K |
| 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… | 20 | $100 | $2K |
| 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… | 60 | $30 | $1.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 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… | 4,290 | $50 | $206.1K |
| 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… | 270 | $70 | $18.6K |
How this provider's Medicaid billing volume and revenue compare to other Guam providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Guam median
2 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… | 11 | 50 | 900 | $80 | $201.7K |
| 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… | 9 | 20 | 140 | $110 | $35.4K |
Other providers in the same ZIP code as Teresa Borja, 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 |
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