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.

Edgar M. Magcalas M.d. PC (NPI 1871862300)

Field	Value
Entity Type	Organization
Organization	Edgar M. Magcalas M.d. PC
Address	590 S Marine Corps Dr
City	Tamuning
State	GU
ZIP	96913
Taxonomy	Specialist
NPI Enumerated	December 29, 2011

Payer Source	Total Paid
Medicaid	$292.4K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer Medicaid billing entity, with Total Medicaid revenue of $292.4K reported. The absence of Medicare activity suggests its scope of reimbursed services (in the available data) is concentrated in state Medicaid programs rather than federal Medicare contracts.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes (99233, 99223, 99291) account for 93.6% of this provider's total Medicaid revenue. That concentration indicates a narrow service mix where a few high-acuity inpatient and critical care codes drive nearly all reported Medicaid dollars.

The top revenue-driving code is 99233, generating $157.6K (53.9% of Medicaid revenue) from 1.8K claims at an average paid/claim of $87; the provider ranks #2 of 6 in-state for this code and sits at the 80th percentile. This combination of high absolute revenue and an 80th percentile rank suggests the provider is a meaningful, above-average regional participant for subsequent inpatient/observation care visits.

99223 is the second-largest Medicaid revenue source at $65K (22.2% of Medicaid revenue) from 445 claims with an average paid/claim of $146, where the provider ranks #4 of 6 (40th percentile). Despite being the second-largest revenue contributor, the percentile and rank indicate this provider's volume for initial high-complexity inpatient visits is typical and not a market-leading position within the state.

99291 (critical care) accounts for $51.2K (17.5% of Medicaid revenue) from 310 claims at an average paid/claim of $165, and the provider ranks #2 of 4 in-state (67th percentile). The presence of substantial critical care billing alongside inpatient E/M codes reinforces that this practice operates in hospital inpatient and acute-care settings rather than a predominantly outpatient clinic model.

A fourth code, 99232, contributes $18.7K (6.4% of Medicaid revenue) from 306 claims at $61 avg paid/claim and ranks #4 of 5 (25th percentile). This smaller share and lower statewide rank for moderate-complexity subsequent inpatient visits further emphasize that most Medicaid revenue is concentrated in a few higher-acuity code lines.

Competitive standing across the three top codes is mixed: the provider is above-average regionally for 99233 (80th percentile) and modestly above typical for 99291 (67th percentile), but only at a typical or below-peak position for 99223 (40th percentile) and 99232 (25th percentile). Together these ranks portray the provider as a meaningful but not dominant inpatient/critical-care participant in the state Medicaid market.

Operational tenure is long enough to be established: the NPI was enumerated on 2011-12-29 (~15 years ago), which aligns with sustained Medicaid billing patterns concentrated in hospital inpatient and critical care services over time. The combination of long tenure plus concentrated code mix suggests the provider has an established role delivering acute inpatient care to Medicaid beneficiaries rather than a diversified ambulatory practice.

Medicaid: Complete Services Breakdown

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

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…	1,810	$90	$157.6K
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…	450	$150	$65K
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…	310	$170	$51.1K
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…	310	$60	$18.7K

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

Edgar M. Magcalas M.d. PC — 0 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. Guam median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	4	10	3,080	$70	$295.4K
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…	2	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…	4	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…	2	10	180	$210	$53.7K

Nearby Providers

Other providers in the same ZIP code as Edgar M. Magcalas M.d. PC, 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

Edgar M. Magcalas M.d. PC — Billing Profile & Reimbursement Data

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Edgar M. Magcalas M.d. PC — 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