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.

Guahan Physicians And Consultants (NPI 1760760060)

Field	Value
Entity Type	Organization
Organization	Guahan Physicians And Consultants
Address	744 N Marine Corps Dr Ste C110
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Oncology Clinic/Center
NPI Enumerated	August 3, 2011

Payer Source	Total Paid
Medicaid	$81.6K
Medicare	$0

Key Findings

This provider is effectively single‑payer within the available claims data: there is no Medicare billing on file while lifetime Medicaid revenue totals $81.6K, indicating that Medicaid accounts for the entire reported federal payer footprint for this NPI. The absence of Medicare activity means analysts should treat comparisons to national Medicare peers as not applicable for this entity.

Revenue is highly concentrated in a very small set of services: the precomputed top‑3 Medicaid codes account for 95.7% of this provider’s total Medicaid revenue. Specifically, 99214 generates $61.2K (75.0% of Medicaid revenue), 99213 generates $13.7K (16.8%), and 96372 generates $3.1K (3.8%), underscoring that a tiny number of codes drive nearly all billing value.

The provider’s taxonomy as an Oncology Clinic/Center aligns with the observed code mix, which is dominated by evaluation & management visits (99214, 99213) plus infusion/injection procedures (96372, 96365 and multiple J‑codes). This pattern is consistent with an outpatient oncology/infusion practice model where established patient visits and administration of therapies or supportive injections are the core operational activities.

Competitive standing for the highest‑value code 99214 is modest within the state: the provider ranks #17 of 35 providers in‑state (53th percentile; typical, unremarkable volume for this code), indicating neither dominance nor unusually low activity for the primary revenue driver. Because 99214 accounts for 75.0% of Medicaid revenue, that middling statewide rank implies the practice captures a modest share of higher‑complexity outpatient oncology visits locally.

Lower‑level E/M and infusion volumes are weaker relative to peers: 99213 is #36 of 48 (26th percentile; typical, unremarkable volume for this code), suggesting below‑average statewide activity for lower‑complexity established visits, while 96372 is #3 of 6 (60th percentile; typical, unremarkable volume for this code), indicating a moderate position among the small set of providers who bill that injection code. These ranks imply the practice attracts more higher‑complexity visits (99214) than higher counts of lower‑level E/M encounters.

Several infusion and supply J‑codes appear, but state peer comparisons are limited by very small denominators. J3420 is reported at #1 of 2 providers in‑state (100th percentile; typical, unremarkable volume for this code), while J3475 and J3480 each rank #1 of 1 with 0th percentile and no state peer volume comparison available; these rankings reflect that the provider administers supportive injections but that the competitive context for those specific supplies is sparse. Analysts should interpret percentile signals for these J‑codes cautiously given the tiny peer pools.

Operationally, the dependence on 99214 for three‑quarters of Medicaid revenue creates concentrated revenue risk: changes in visitation patterns, payer policy for E/M coding, or patient volume could have outsized effects on total Medicaid receipts. The remainder of billed services (96372, 96365 and a handful of J‑codes) provides supplementary revenue but represents only a small fraction of the overall Medicaid earnings.

This NPI has been enumerated since 2011‑08‑03 (~15 years ago), indicating an established presence; however, the lifetime Medicaid revenue of $81.6K signals a relatively small Medicaid footprint despite long tenure. For payers and competitors assessing market positioning, the practice appears established but limited in scale within the state Medicaid pool, with a narrow set of high‑value service lines driving most reported revenue.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	640	$100	$61.2K
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…	210	$70	$13.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	210	$20	$3.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	50	$60	$3K
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	120	$1	$240
J3475	Injection, magnesium sulfate, per 500 mg	60	$1	$190
J3480	Injection, potassium chloride, per 2 meq	60	$1	$60

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

Guahan Physicians And Consultants — 1 of 7 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

7 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…	36	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…	17	40	630	$90	$172.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	2	10	170	$410	$67.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	3	10	210	$70	$23.4K
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	1	10	70	$1	$230
J3475	Injection, magnesium sulfate, per 500 mg	1	10	60	$1	$180
J3480	Injection, potassium chloride, per 2 meq	1	10	60	$1	$40

Nearby Providers

Other providers in the same ZIP code as Guahan Physicians And Consultants, 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

Guahan Physicians And Consultants — Billing Profile & Reimbursement Data

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Guahan Physicians And Consultants — 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

Nearby Providers

Frequently Asked Questions

References