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.

Government Of Guam Department Of Administration (NPI 1629041546)

Field	Value
Entity Type	Organization
Organization	Government Of Guam Department Of Administration
Address	162 Abman Drive
City	Inarajan
State	GU
ZIP	96915
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 10, 2006

Payer Source	Total Paid
Medicaid	$614.8K
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid billing entity: there is no Medicare revenue on file and total lifetime Medicaid revenue is $614.8K. That concentration means analyses of financial performance and service mix should be interpreted entirely through the Medicaid lens rather than a mixed-payer model.

Revenue is highly concentrated in a small set of codes: the precomputed top three Medicaid codes account for 61.6% of the provider's total Medicaid revenue. Those top three are 99213 ($224.7K, 36.6%), 90461 ($85K, 13.8%), and 90460 ($69K, 11.2%), indicating a small number of services drive the bulk of revenue.

The code mix and volumes point to an FQHC-style primary care and immunization operation: high-volume established-patient E/M visits (99213 with 2.3K claims) coexist with large volumes of vaccine administration claims (90460 with 3.4K claims and 90461 with 2.4K claims). This pattern suggests routine outpatient primary care plus a significant focus on pediatric and population immunization services rather than specialty procedures.

Competitive standing within the state is modest-to-typical across top codes rather than dominant. For example, 99213 ranks #15 of 48 providers in-state (70th percentile; typical, unremarkable volume), 90461 ranks #4 of 7 (50th percentile; typical, unremarkable volume), and 90460 ranks #4 of 8 (57th percentile; typical, unremarkable volume), indicating the provider is a steady participant but not a leading statewide revenue generator for these services.

Preventive pediatric services are present but not a primary revenue driver: 99393 generates $23.7K (3.9% of Medicaid revenue) and ranks #5 of 11 in-state (60th percentile), while other pediatric preventive codes such as 99392 ($15.7K, 2.5%) and 99394 ($6.1K, 1.0%) appear at modest volumes. These entries support a role in child health maintenance and well visits consistent with FQHC responsibilities, but they do not dominate the clinic's Medicaid revenue.

The provider’s billing profile shows many low-paid, high-frequency procedures typical of public health and primary care service delivery: for example, 90460 averages $20 paid/claim across 3.4K claims and 90461 averages $36 paid/claim across 2.4K claims. Those high claim counts with modest per-claim payments explain how vaccine administration contributes materially ($85K and $69K) to overall Medicaid revenue despite low unit reimbursement.

Ancillary public-health screening and preventive services are notable in the mix: 86580 (tuberculosis skin test) appears with 1.2K claims and $12.8K revenue (2.1% of Medicaid revenue), and 82962 (blood glucose monitoring) appears with 228 claims and $684 revenue. These items reinforce an operational emphasis on community screening and basic primary-care services typical of a federally qualified health center.

The provider has long tenure in the NPI registry, enumerated 2006-02-10 (~20 years ago), which indicates an established presence in the market. Combined with the modest $614.8K Medicaid lifetime revenue and the code mix concentrated in routine primary care and vaccinations, the profile is consistent with a stable, safety-net FQHC clinic rather than a high-revenue specialty or hospital outpatient center.

Medicaid: Complete Services Breakdown

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

25 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…	2,320	$100	$224.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	2,360	$40	$85K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	3,450	$20	$69K
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…	490	$140	$67.7K
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.	1,370	$30	$35.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	210	$110	$23.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	170	$100	$15.7K
0002A	N/A	360	$40	$14.5K
0001A	N/A	360	$40	$14.2K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	1,160	$10	$12.8K

Showing 1–10 of 25

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

Government Of Guam Department Of Administration — 0 of 25 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

25 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…	15	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…	21	40	630	$90	$172.1K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	4	10	2,360	$30	$101.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	4	10	2,980	$20	$81.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5	10	470	$110	$69.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4	10	80	$100	$44.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5	10	130	$110	$42.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5	10	60	$120	$39K
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,…	8	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.	5	10	780	$20	$30.2K

Showing 1–10 of 25

Government Of Guam Department Of Administration — 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

Frequently Asked Questions

References