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.

Guam Medical Health Care Center, Inc. (NPI 1902160211)

Field	Value
Entity Type	Organization
Organization	Guam Medical Health Care Center, Inc.
Address	1757 Army Dr
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 2, 2012

Payer Source	Total Paid
Medicaid	$46.4K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports total Medicaid revenue of $46.4K, making its public payer footprint effectively single-payer (Medicaid) in the available data. The absence of Medicare activity suggests the practice either does not participate in Medicare or has not billed Medicare during the reporting window, so analyses of Medicare competitiveness are not applicable for this NPI.

Medicaid revenue is highly concentrated in a very small set of evaluation-and-management (E/M) visit codes: 99213, 99214, and 90471 together account for 97.7% of the provider's Medicaid revenue. The two established-patient office-visit codes (99213 at $29.4K or 63.4% and 99214 at $14.6K or 31.5%) dominate the revenue mix, indicating that routine outpatient visits are the primary revenue driver.

The code mix points to a primary-care, office-based operation focused on established patient management and vaccination services. 99213 and 99214 are the highest-revenue codes and describe low- to moderate-complexity outpatient evaluation-and-management visits; smaller but visible vaccination activity appears through 90471 (1.3K revenue, 2.9%), 90688 ($990 revenue, 2.1%), and G0008 (16 claims, $0 paid reported).

Competitive standing within the state is modest for the provider’s top E/M codes: 99213 ranks #29 of 48 (40th percentile) and 99214 ranks #20 of 35 (44th percentile), both labeled as typical, unremarkable volumes. These rank/percentile placements indicate the practice is neither a statewide leader nor an outlier in delivering these services, but rather a routine-volume participant among in-state peers.

Vaccination services are present but limited in revenue scale; 90471 generated $1.3K (2.9% of Medicaid revenue) and ranks #10 of 15 (36th percentile, typical), while 90688 generated $990 (2.1% of revenue) and ranks #4 of 10 (67th percentile, typical). The presence of multiple vaccine codes alongside E/M visits suggests the practice integrates preventive care (seasonal influenza vaccination) into its outpatient workflows even though vaccine revenue is a small share of the total.

Activity volumes and payment rates reflect a small-scale outpatient operation: 99213 and 99214 show 545 and 541 claims respectively with average paid/claim of $54 and $27 as reported. Other codes show much lower counts and average payments (for example, 90471 average paid/claim $19, 90688 $11, 81002 $3), reinforcing that most clinical throughput is focused on routine office visits rather than high-volume ancillary procedures.

Despite being enumerated on 2012-07-02 (~14 years ago), the provider’s Medicaid revenue ($46.4K) and claim counts indicate limited billing scale relative to many peers; the long tenure on file suggests an established presence but not necessarily a large Medicaid panel. Analysts should treat the NPI as a stable, small outpatient practice in the local market rather than a high-volume provider.

A few low-volume code signals are worth noting as payment or coverage nuances rather than operational scale: 81002 is only 19 claims ($57 revenue) and ranks #2 of 2 (0th percentile, typical), while G0008 shows 16 claims with $0 reported paid and ranks #8 of 10 (22th percentile, typical). These entries likely reflect small numbers of diagnostic or preventive actions tied to the office visit mix and do not materially change the overall picture of strong revenue concentration in 99213/99214.

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
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…	550	$50	$29.4K
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…	540	$30	$14.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	70	$20	$1.3K
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.	90	$10	$990
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	20	$1	$60
G0008	Administration of influenza virus vaccine	20	$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

Guam Medical Health Care Center, Inc. — 0 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
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…	29	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…	20	40	630	$90	$172.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10	20	180	$20	$10.1K
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.	4	10	70	$10	$1.2K
G0008	Administration of influenza virus vaccine	8	10	100	$10	$830
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	2	10	40	$1	$140

Nearby Providers

Other providers in the same ZIP code as Guam Medical Health Care Center, Inc., 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

Guam Medical Health Care Center, Inc. — Billing Profile & Reimbursement Data

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Guam Medical Health Care Center, Inc. — 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