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NPI 1659458248 · Tamuning, GU · Ophthalmology Physician
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Marjorie Debenedictis is a ophthalmology physician provider located in Tamuning, Guam. This profile covers 16 Medicare and 10 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 | Marjorie Debenedictis |
| Address | 633 Gov Carlos Camacho Rd. |
| City | Tamuning |
| State | GU |
| ZIP | 96913 |
| Taxonomy | Ophthalmology Physician |
| NPI Enumerated | November 1, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $255K |
| Medicare | $115.6K |
Practice orientation is clinically focused on cataract surgery plus high-volume office ophthalmology: Medicare top procedural code is 66984 (87 claims, $37.1K revenue) and Medicare also shows substantial office visits (92014, 92012) and retinal imaging (92134), while Medicaid volumes emphasize the same mix with large counts for 92014 (1.1K claims, $81.5K) and 92134 (1.1K claims, $30.6K). The code mix (66984, 66982, 92014, 92012, 92134, 92136) points to an operation that performs both surgical cataract care and ongoing outpatient medical eye care supported by diagnostic imaging and biometry.
Revenue concentration is high within each payer: the top three Medicare codes account for 62.0% of this provider's total Medicare revenue (with 66984, 92014, and 66982 leading Medicare revenue), and the top three Medicaid codes account for 71.5% of total Medicaid revenue (driven by 92014, 92012, and 92004). These precomputed shares indicate the provider’s billing is heavily weighted toward a small set of office and surgical ophthalmology services for each payer.
Payer mix is Medicaid-tilted in scale: lifetime Medicaid revenue is $255K compared with total Medicare revenue of $115.6K, so this provider generates more revenue from Medicaid than Medicare and appears more active in the state Medicaid market than in national Medicare volumes. The data suggest this is not a Medicare-focused high-revenue surgical center but rather a Medicaid-serving ophthalmology practice with meaningful surgical capacity.
National competitive standing for Medicare services is modest: 66984 ranks in the 46th percentile nationally and is described as typical, 92014 ranks in the 71th percentile (typical), and 66982 sits near the 49th percentile (typical). Those percentiles and rank positions indicate this provider has unremarkable national volume for its headline Medicare services rather than being a dominant national surgical center.
State-level competitive standing for Medicaid is prominent for routine ophthalmology and imaging: the provider ranks #1 in-state for 92012, 92004, 92134, and 92136 (100th percentile in-state volumes for each), while 92014 ranks #2 of 4 providers in-state (67th percentile). This pattern indicates the provider is a leading in-state source of comprehensive exams and retinal imaging for Medicaid beneficiaries, making it an important local provider for managed care networks.
Surgical and perioperative workflow is supported by perioperative diagnostics and measurements: Medicare shows biometry and IOL-related codes such as 92136 (115 claims, $3.3K) and 76519 (12 claims, $336), and Medicaid shows 92136 with 482 claims ($19.8K) and 76519 with 24 claims ($1.2K). The presence of both operative codes (66984, 66982) and preoperative measurement codes (92136, 76519) indicates the practice performs the full cataract care pathway from pre-op evaluation to intraocular lens selection and implantation.
Several services appear at very low national percentiles for Medicare, indicating limited national footprint for those procedures: 67028 ranks at the 3th percentile nationally, 76519 at the 2th percentile, and J7999 at the 5th percentile (all described as typical or unremarkable volume for their rank). These low percentiles suggest the provider performs some specialized or lower-volume procedures infrequently compared with national peers, even while certain routine exams and imaging are high-volume in-state.
Provider tenure is long-standing: the NPI was enumerated on 2006-11-01 (~20 years ago), which supports an established presence in TAMUNING, GU and aligns with the provider’s leading in-state Medicaid volumes and sustained mix of surgical and outpatient services. The combination of long tenure and concentrated Medicaid volume suggests stable local referral relationships for cataract care and routine ophthalmology follow-up.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 90 | $430 | $37.1K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 270 | $70 | $19.3K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 30 | $570 | $15.3K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 180 | $70 | $11.9K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 130 | $80 | $10.8K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 240 | $30 | $7K |
| 66821 | The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract. | 20 | $230 | $4.1K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 120 | $30 | $3.3K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 30 | $80 | $2.5K |
| J7999 | Compounded drug, not otherwise classified | 20 | $50 | $1.2K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
10 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 1,090 | $80 | $81.5K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 730 | $70 | $53.8K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 410 | $120 | $46.8K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1,130 | $30 | $30.6K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 480 | $40 | $19.8K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 50 | $370 | $16.6K |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 30 | $90 | $2.3K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 10 | $100 | $1.4K |
| 76519 | The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery. | 20 | $50 | $1.2K |
| J7999 | Compounded drug, not otherwise classified | 10 | $50 | $740 |
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
10 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 2 | 10 | 460 | $650 | $297.7K |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 2 | 10 | 1,030 | $80 | $92.4K |
| 67028 | The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye. | 3 | 10 | 40 | $90 | $32.7K |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 1 | 10 | 350 | $70 | $28.2K |
| 92004 | The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits. | 1 | 10 | 230 | $120 | $27.3K |
| 92134 | The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes. | 1 | 10 | 290 | $30 | $13.1K |
| 92136 | The provider uses a noninvasive method to measure the patient’s eye or eyes to get information that the provider then uses to calculate the appropriate power for an intraocular lens (IOL). Selecting… | 1 | 10 | 250 | $40 | $10.2K |
| J7999 | Compounded drug, not otherwise classified | 2 | 10 | 40 | $70 | $2.9K |
| 92002 | The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program. | 1 | 10 | 30 | $90 | $2.3K |
| 76519 | The provider uses A scan ultrasound echography to measure the axial length of the eye and determine the intraocular lens, or IOL calculation prior to cataract surgery. | 1 | 10 | 20 | $50 | $1.2K |
Other providers in the same ZIP code as Marjorie Debenedictis, 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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