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.

One Love Pediatrics, LLC (NPI 1932568995)

Field	Value
Entity Type	Organization
Organization	One Love Pediatrics, LLC
Address	744 N Marine Corps Dr
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Pediatrics Physician
NPI Enumerated	February 19, 2016

Payer Source	Total Paid
Medicaid	$123.3K
Medicare	$0

Key Findings

ONE LOVE PEDIATRICS, LLC shows essentially exclusive Medicaid activity: there is no Medicare revenue on file while total Medicaid revenue is $123.4K, indicating the practice operates primarily within the Medicaid payer space rather than serving a Medicare patient population. This makes the provider effectively single-payer (Medicaid) in the available claims data.

Revenue concentration is very high: the precomputed top 3 Medicaid codes account for 96.5% of the provider's total Medicaid revenue, signaling that a very small set of pediatric outpatient and preventive visit codes drive nearly all billed Medicaid income. That level of concentration suggests limited service-line diversification in the claims observed.

The dominant Medicaid revenue driver is 99213 (established patient E/M), which generates $106.5K or 86.3% of this provider’s Medicaid revenue and represents 1.3K claims at $84 average paid per claim. While this code overwhelmingly dominates the practice’s Medicaid income, the provider ranks #21 of 48 in-state (57th percentile), implying the provider has typical, unremarkable volume for 99213 relative to peers rather than being a major outlier.

Preventive medicine visits are the second and third contributors: 99391 (well-child preventive services) accounts for $8.9K (7.2% of Medicaid revenue) across 82 claims at $109 average paid and ranks #3 of 5 in-state (50th percentile), and 99383 (new patient pediatric well visit) contributes $3.6K (3.0%) across 28 claims at $130 average paid and ranks #9 of 12 (27th percentile). Together these preventive codes confirm the practice delivers routine pediatric well-care in addition to problem-focused office visits.

Competitive standing within the state is modest across the listed codes: 99213 volume places the provider near the state median, 99391 sits at the mid-point within a very small peer group, and 99383 is lower in rank (27th percentile), indicating the provider is a typical, modest participant in pediatric ambulatory services statewide rather than a dominant player. Other listed codes such as 99203, 86580, G2211, and 96161 each contribute only small shares of revenue, reinforcing a business profile centered on standard office and preventive pediatrics.

The provider has been enumerated for about 10 years (NPI registered 2016-02-19), indicating an established presence in the market long enough to develop recurring Medicaid relationships; despite that tenure, the current billing mix remains concentrated in core E/M and well-visit codes rather than broader procedure or specialty lines.

Several low-revenue but frequent service codes appear in the Medicaid mix: 86580 (TB skin test) shows 106 claims but only $1.2K revenue, and G2211 appears on 130 claims for $910 revenue; these patterns indicate the practice performs routine screening and complexity add-on coding at low per-claim reimbursement levels, consistent with outpatient pediatric workflow.

Given the absence of Medicare billing on file, any competitive or growth analysis should focus on Medicaid reimbursement dynamics and pediatric ambulatory care in-state; strategic moves to diversify payer mix or broaden service lines would be necessary to shift revenue concentration away from the current triad of visit codes that comprise 96.5% of Medicaid 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
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…	1,270	$80	$106.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	80	$110	$8.9K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	30	$130	$3.6K
99203	The provider sees a new 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 provider…	20	$120	$2K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	110	$10	$1.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	130	$10	$910
96161	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient's caregiver, analyzes the results, assigns a score, and documents the findings. Use this code…	50	$1	$140

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

One Love Pediatrics, LLC — 0 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…	21	50	900	$80	$201.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3	10	80	$100	$44.8K
99203	The provider sees a new 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 provider…	20	20	140	$110	$35.4K
99383	The provider performs a well–patient visit for a child who is between the ages of 5 and 11 who meets the definition of new patient.	9	10	40	$130	$14.6K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	12	20	450	$10	$11.3K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	2	10	110	$10	$1.3K
96161	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient's caregiver, analyzes the results, assigns a score, and documents the findings. Use this code…	1	10	40	$1	$130

Nearby Providers

Other providers in the same ZIP code as One Love Pediatrics, LLC, 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

One Love Pediatrics, LLC — Billing Profile & Reimbursement Data

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One Love Pediatrics, LLC — 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