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.

Edison Manaloto (NPI 1801327341)

Field	Value
Entity Type	Individual
Organization	Edison Manaloto
Address	133 Route 3
City	Dededo
State	GU
ZIP	96929
Taxonomy	Hospitalist Physician
NPI Enumerated	March 26, 2017

Payer Source	Total Paid
Medicare	$73.4K
Medicaid	$0

Key Findings

This provider’s billed activity is effectively single‑payer: total Medicare revenue is $73.4K while there is no Medicaid billing on file, so Medicare accounts for virtually all recorded public-payor reimbursement. That concentration means payer-level reviews will primarily focus on Medicare inpatient encounters rather than cross‑payer comparisons.

Revenue is highly concentrated in three inpatient E/M codes: 99233 (43.9% of Medicare revenue), 99232 (39.6%), and 99239 (13.7%), and those three codes together are precomputed to account for 97.3% of this provider’s total Medicare revenue. The profile indicates reliance on a narrow set of hospitalist services rather than a broad mix of outpatient or procedure-based billing.

The specific CPT mix (99233, 99232, 99239, with a small amount of 99223) is consistent with a hospitalist practice model focused on subsequent inpatient/observation care and discharge-day management. Code descriptions on file show these are subsequent inpatient visits and discharge management encounters, implying the provider’s day-to-day work is inpatient evaluation-and-management rather than initial high-volume admissions or outpatient procedural care.

Claim volumes and average payments for the top codes underline the operational footprint: 99233 appears on 335 claims at $96 avg paid/claim for $32.2K revenue, 99232 on 453 claims at $64 avg paid/claim for $29K revenue, and 99239 on 107 claims at $94 avg paid/claim for $10.1K revenue. Those counts and per‑claim payments drive the $73.4K Medicare total and show most Medicare encounters are follow-up inpatient visits rather than a large number of high‑paid procedures.

National competitive standing for the provider is modest: 99233 ranks #16719 of 128818 (87th percentile), 99232 ranks #17461 of 177383 (90th percentile), and 99239 ranks #17123 of 62398 (72th percentile), with the dataset characterizing each as a "typical, unremarkable volume for this code." These percentiles indicate the provider is not a dominant national outlier but does report above‑average activity on 99232 and 99233 relative to many peers.

High‑complexity initial inpatient visits (99223) are uncommon for this provider: only 14 claims at $141 avg paid/claim produced $2K in revenue (2.7% of Medicare revenue), and the code ranks #123465 of 139583 (9th percentile) with volume labeled "typical, unremarkable." This suggests the practice bills far more for subsequent and discharge management than for initial high‑complexity admissions.

Tenure is moderate: NPI enumerated 2017-03-26 (~9 years ago), indicating several years of Medicare billing history to assess consistency of the inpatient-focused pattern. Analysts can treat observed year‑to‑year variability as less likely to be a one‑off given this multi‑year enumeration.

For payer and contracting implications, the inpatient E/M concentration (top three codes = 97.3% of Medicare revenue) means utilization management, DRG alignment, and hospitalist staffing patterns will be the most relevant levers for cost and care reviews. Given the lack of Medicaid billing, state Medicaid program comparisons are not applicable and any network negotiations or utilization audits should be structured around Medicare inpatient follow‑up and discharge workflows.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	340	$100	$32.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	450	$60	$29K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	110	$90	$10.1K
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…	10	$140	$2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Guam Distribution

Edison Manaloto — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Guam

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	4	20	130	$90	$16.5K
99232	3	30	150	$60	$12.1K
99223	18	20	30	$130	$7K
99239	1	20	50	$90	$4.8K

Nearby Providers

Other providers in the same ZIP code as Edison Manaloto, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guam Healthcare Development Incorporated	GU	Clinic/Center	$0	$30.8M
C V Alegria Dds Inc	GU	General Practice Dentistry	$0	$11.3M
Albert Huang	GU	Dentist	$0	$5.4M
Usrc Finegayan, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.5M
Renal Centers Of Guam, LLC	GU	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Government Of Guam Department Of Administration	GU	Federally Qualified Health Center (FQHC)	$0	$2.4M
Maria Chela Mariano	GU	Family Medicine Physician	$0	$1.8M
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0
Anthony Bekkerman	GU	Emergency Medicine Physician	$49.5K	$623.9K
Blue Ocean Medical Group LLC	GU	Family Medicine Physician	$0	$665.1K

Edison Manaloto — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References