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.

Joel Marc Rubio (NPI 1639289499)

Field	Value
Entity Type	Individual
Organization	Joel Marc Rubio
Address	133 Route 3
City	Dededo
State	GU
ZIP	96929
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicare	$158.9K
Medicaid	$0

Key Findings

This provider bills almost exclusively to Medicare with total Medicare revenue of $158.9K and no Medicaid billing on file, indicating an effectively single-payer Medicare practice footprint rather than a mixed Medicaid/Medicare operation. Analysts should treat Medicaid as absent for competitive or network-contracting considerations.

Revenue is highly concentrated: the precomputed top three Medicare codes account for 75.3% of the provider's Medicare revenue, driven by 99215 ($58.6K, 36.9%), 99233 ($35.3K, 22.2%), and 99214 ($25.7K, 16.2%). This concentration means changes to utilization or reimbursement for these specific E/M services would materially affect overall revenue.

The code mix points to a high-acuity, hospital-integrated endocrinology practice rather than a purely outpatient clinic. High-volume, complex outpatient E/M (99215: 501 claims, $117 avg/claim, $58.6K) is paired with substantial subsequent inpatient care (99233: 375 claims, $94 avg/claim, $35.3K) and critical care billing (99291: 140 claims, $167 avg/claim, $23.4K, 14.7% of revenue), consistent with an endocrine clinician who manages complex, inpatient and acute consultations in addition to outpatient follow-up.

Competitive standing is mixed across codes: for 99215 the provider ranks #1906 of 145531 nationally (99th percentile) and is flagged as an "extreme outlier, far above typical national volume for this code," which signals unusually high national volume for complex established office visits. By contrast, 99233 (rank #14049 of 128818, 89th percentile) and 99214 (rank #89617 of 479517, 81th percentile) are described as "typical, unremarkable volume," indicating the provider is exceptional on one outpatient metric but otherwise within normal ranges for several other top codes.

There are operational implications from the service mix: 99291 (critical care) contributes $23.4K (14.7% of Medicare revenue) and 99233 contributes $35.3K (22.2%), so hospital access and on-call/consultation arrangements are likely key drivers of revenue. Conversely, 99223 (initial hospital care) is low-volume (16 claims, $118 avg/claim, $1.9K, ranks #116565 of 139583, 14th percentile) which suggests the practice provides more follow-up/subsequent inpatient management than initial inpatient admissions.

Ancillary services contribute only small shares of revenue, so the practice appears focused on evaluation-and-management rather than diversified ancillary billing. Examples include G0008 influenza vaccine (77 claims, $32 avg/claim, $2.5K, 1.6%), 90688 influenza vaccine (77 claims, $20 avg/claim, $1.5K, 1.0%), and 82947 glucose testing (477 claims, $4 avg/claim, $1.9K, 1.2%); these lines add clinical breadth but do not materially diversify revenue.

The provider has long tenure in the Medicare program, with NPI enumeration on 2006-08-30 (~20 years ago), signaling an established presence that may have embedded referral pathways and hospital privileges. That longevity combined with the concentrated, high-acuity code mix makes the practice sensitive to changes in hospital relationships or referral patterns.

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
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…	500	$120	$58.6K
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…	380	$90	$35.3K
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…	330	$80	$25.7K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	140	$170	$23.4K
99205	The provider sees a new 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 provider…	50	$150	$7.5K
G0008	Administration of influenza virus vaccine	80	$30	$2.5K
82947	The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip.	480	$1	$1.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	$120	$1.9K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	80	$20	$1.5K
36410	In this procedure, the provider inserts a needle into a vein to withdraw blood or infuse a drug for a patient who is three years old or older.	20	$10	$270

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Guam Distribution

Joel Marc Rubio — 1 of 11 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

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	23	90	140	$90	$25.7K
99233	3	20	130	$90	$16.5K
99215	2	20	40	$120	$14.6K
99291	4	10	60	$170	$13.1K
99223	16	20	30	$130	$7K
99205	1	10	40	$150	$5.4K
G0008	10	40	30	$30	$2.1K
82947	1	10	480	$1	$1.8K
90688	8	30	30	$20	$1.4K
99406	9	10	50	$10	$650

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Joel Marc Rubio, 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

Joel Marc Rubio — Billing Profile & Reimbursement Data

Sign up for Joel Marc Rubio — Billing Profile & Reimbursement Data policy alerts

Joel Marc Rubio — Billing Profile & Reimbursement Data

Sign up for Joel Marc Rubio — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References