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.

Health Partners, L.L.C. (NPI 1780804146)

Field	Value
Entity Type	Organization
Organization	Health Partners, L.L.C.
Address	590 S Marine Corps Drive
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Preventive Medicine/Occupational Environmental Medicine Physician
NPI Enumerated	April 26, 2007

Payer Source	Total Paid
Medicaid	$71.9K
Medicare	$0

Key Findings

HEALTH PARTNERS, L.L.C. shows effectively single-payer activity: there is no Medicare billing on file and lifetime Medicaid revenue is $71.9K, indicating the provider’s billed services in the available dataset are concentrated in Medicaid rather than Medicare. This payer concentration suggests any analysis of utilization or contracting leverage should be focused on Medicaid relationships rather than Medicare performance.

Revenue concentration within Medicaid is extreme: the precomputed top three codes account for 95.6% of the provider’s total Medicaid revenue. Those three codes are 99214 ($30.2K, 335 claims, $90 avg paid/claim, 41.9% of Medicaid revenue), 99233 ($27.6K, 178 claims, $155 avg paid/claim, 38.3% of Medicaid revenue), and 99291 ($11K, 23 claims, $479 avg paid/claim, 15.3% of Medicaid revenue), which together dominate the revenue profile and leave little contribution from other codes.

The code mix suggests a blended service line that includes outpatient established visits, inpatient follow-up, and episodic critical care: 99214 is the single largest revenue driver and is an established-patient outpatient E/M code, while 99233 is for subsequent inpatient/observation care and 99291 is critical care for high-intensity, time-based services. This mix implies the provider is delivering both ambulatory evaluation-and-management and hospital-based acute care services rather than purely preventive/occupational exams, consistent with a Preventive Medicine/Occupational Environmental Medicine Physician who may also cover inpatient or emergent episodes.

Competitive standing by code is modest to limited within-state. For the largest code, 99214, the provider ranks #22 of 35 in-state (38th percentile; typical, unremarkable volume), indicating typical outpatient volume relative to peers; for 99233 the provider ranks #5 of 6 (20th percentile; typical, unremarkable volume), indicating a relatively small statewide presence for inpatient subsequent care; and for 99291 the provider ranks #4 of 4 (0th percentile; typical, unremarkable volume), showing that while critical care billing is present, the provider is not a leading statewide supplier of that service.

There are small ancillary or atypical items in the profile that merit note: 82947 (glucose by method other than reagent strip) appears 356 times for $712 total and ranks #1 of 2 in-state (100th percentile; typical, unremarkable volume), which indicates high relative standing for this low-revenue lab item among a very small peer set but that it contributes only 1.0% of Medicaid revenue. Conversely, 99215 shows 41 claims with $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue) yet ranks #4 of 7 in-state (50th percentile; typical, unremarkable volume), an unusual reporting pattern where billed services did not translate to paid Medicaid revenue in the dataset.

The provider’s tenure is long-standing: the NPI was enumerated on 2007-04-26 (~19 years ago), indicating nearly two decades of enrollment that could support established referral patterns or institutional relationships despite the modest Medicaid revenue total. This longevity suggests the current limited revenue footprint is not due to a newly entered provider but rather a long-enrolled practice with a small Medicaid billing footprint.

Operational risk and business implications center on high dependence on a narrow set of high-acuity and evaluation-and-management codes. With 95.6% of Medicaid revenue coming from 99214, 99233, and 99291, the practice’s financial stability in Medicaid is sensitive to changes in utilization, documentation requirements, or reimbursement for those specific E/M and critical-care services, so payers and network managers evaluating contracting or utilization review should prioritize those code lines.

The overall Medicaid footprint is modest in absolute terms ($71.9K lifetime) and uneven across service types; the provider appears to be a modest, typical-volume participant for commonly billed outpatient E/M (99214) and a relatively small contributor for inpatient subsequent care (99233) and critical care (99291). Analysts should treat HEALTH PARTNERS, L.L.C. as a small Medicaid provider with concentrated service lines rather than as a major statewide competitor across multiple service categories.

Medicaid: Complete Services Breakdown

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

6 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…	340	$90	$30.1K
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…	180	$160	$27.6K
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…	20	$480	$11K
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	$170	$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.	360	$1	$710
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…	40	$0	$0

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

Health Partners, L.L.C. — 1 of 5 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	22	40	630	$90	$172.1K
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…	5	10	1,090	$90	$137K
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…	6	10	750	$140	$118K
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…	4	10	180	$210	$53.7K
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…	4	10	40	$40	$7.2K
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.	1	10	190	$1	$480

Nearby Providers

Other providers in the same ZIP code as Health Partners, L.L.C., 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

Health Partners, L.L.C. — Billing Profile & Reimbursement Data

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Health Partners, L.L.C. — 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