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.

Takecare Insurance Company Inc. (NPI 1972565240)

Key Findings

Field	Value
Entity Type	Organization
Organization	Takecare Insurance Company Inc.
Address	548 S Marine Corps. Dr
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Health Service Clinic/Center
NPI Enumerated	April 3, 2006

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

TAKECARE INSURANCE COMPANY INC. reports no Medicare billing on file and $1.4M in lifetime Medicaid revenue, making its public payer footprint effectively single-payer (Medicaid) in available data. This narrow payer mix means analyses of its performance should focus on Medicaid reimbursement dynamics rather than Medicare trends for this entity.

Revenue is highly concentrated in three outpatient evaluation-and-management codes: the precomputed top three codes account for 82.2% of the provider's Medicaid revenue. Those top drivers are 99213 ($653.9K, 46.6% of Medicaid revenue), 99214 ($367.2K, 26.2%), and 99203 ($132.8K, 9.5%), indicating the bulk of dollars come from routine office visits.

The code mix—dominated by 99213, 99214, and 99203—indicates a primary-care or general ambulatory clinic workflow focused on established- and new-patient office visits rather than specialty procedures. Supporting services in the profile (pediatric well visits 99393/99383, vaccines 90460/90688, and basic imaging 71046/77067) suggest the clinic also delivers preventive and family-oriented outpatient care at smaller scale.

On competitive standing within the state, TAKECARE is a high-volume performer for several key codes: 99213 ranks #4 of 48 providers (94th percentile) and 99203 ranks #2 of 24 (96th percentile), both described as "notably above typical" state volume. By contrast, 99214 is more typical for the state (#8 of 35, 79th percentile); overall the provider is a prominent in-state participant for routine E/M visits, especially lower-complexity established visits and some new-patient visits.

Several specific codes show exceptional in-state positioning beyond the top three: 99202 ranks #1 of 11 providers (100th percentile) and 90688 (influenza vaccine) ranks #1 of 10 providers (100th percentile), both noted as "notably above typical" volume. These rankings imply strengths in new-patient intake and seasonal vaccination delivery, with 99202 generating $102K and 90688 generating $8.6K in Medicaid revenue.

Clinical testing and public-health services appear as supplemental lines: COVID-related specimen collection G2023 has 2.1K claims and $49.2K revenue (ranks #1 of 2, 100th percentile) while immunoassay 87811 has 563 claims and $21.4K revenue (ranks #2 of 2). These entries show the clinic provided in-house SARS–CoV–2 testing during the period captured, though peer comparisons are limited by very small state peer sets.

Operational throughput is high for routine visits: the provider submitted 8.8K claims for 99213 and 3.6K claims for 99214, reflecting sustained ambulatory visit volume that underpins the revenue concentration. Combined with an NPI enumeration date of 2006-04-03 (~20 years ago), the data portray an established clinic with consistent outpatient volume over time.

Because Medicaid accounts for all reported public-payer revenue and E/M codes dominate billing, the provider's financial and operational performance is sensitive to Medicaid policy or fee-schedule changes affecting office visits. Ancillary services (vaccines, imaging, TB testing) contribute modestly to revenue, suggesting limited diversification outside core ambulatory care services.

Medicaid: Complete Services Breakdown

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

30 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…	8,840	$70	$653.9K
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…	3,600	$100	$367.2K
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…	1,270	$110	$132.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,280	$80	$102K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	2,140	$20	$49.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	560	$40	$21.4K
99204	The provider sees a new 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 provider…	90	$150	$13.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	450	$20	$9.4K
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.	480	$20	$8.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	260	$30	$8.1K

Showing 1–10 of 30

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

Takecare Insurance Company Inc. — 4 of 25 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

30 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…	4	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…	8	40	630	$90	$172.1K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	3	10	180	$140	$121K
D0230	Intraoral - periapical each additional radiographic image	12	10	1,370	$20	$85.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	7	10	2,980	$20	$81.4K
D0120	Periodic oral evaluation - established patient	10	10	1,070	$40	$80K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5	10	500	$50	$45.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	9	10	150	$50	$42.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	8	10	130	$110	$42.8K
D0220	Intraoral - periapical first radiographic image	14	20	350	$10	$38K

Showing 1–10 of 30

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

Takecare Insurance Company Inc. — Billing Profile & Reimbursement Data

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Takecare Insurance Company 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

Related Providers

Nearby Providers

Frequently Asked Questions

References