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NPI 1013379460 · Wailuku, HI · General Acute Care Hospital
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Maui Health System A Kaiser Foundation Hospitals LLC is a general acute care hospital provider located in Wailuku, Hawaii. This profile covers 0 Medicare and 239 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Maui Health System A Kaiser Foundation Hospitals LLC |
| Address | 221 Mahalani St |
| City | Wailuku |
| State | HI |
| ZIP | 96793 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | March 24, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $60.3M |
| Medicare | $0 |
This provider is effectively a Medicaid-centered facility: there is no Medicare billing on file and total Medicaid revenue on record is $60.3M, so analyses of its payer performance must be interpreted as Medicaid-dominant rather than mixed-payer. The absence of Medicare claims prevents benchmarking against national Medicare volumes and revenue patterns for this entity.
Revenue is highly concentrated in a small set of services: the precomputed top three Medicaid codes (99283, 99284, 74177) account for 68.8% of this provider's total Medicaid revenue. The single largest contributor is 99283 (35.3% of Medicaid revenue), followed by 99284 (23.5%) and 74177 (10.0%), indicating that a few high-use episodic services drive most of the dollars.
The code mix points to an emergency-department–centric operating profile with substantial imaging capacity: 99283 (40.7K claims, $520 avg paid/claim, $21.1M), 99284 (23.5K claims, $599 avg paid/claim, $14.1M), and 74177 (5.7K claims, $1044 avg paid/claim, $6M) together show heavy ED throughput supported by high-cost CT imaging. High claim counts for ED E/M levels and CT studies imply the hospital manages a steady stream of acute presentations and relies on advanced imaging to support diagnosis.
Statewide competitive standing is solid for key ED and imaging codes but characterized in the data as typical for several high-volume items: 99283 ranks #6 of 45 (89th percentile, labeled "typical, unremarkable volume"), 99284 ranks #8 of 47 (85th percentile, labeled "typical, unremarkable volume"), and 74177 ranks #5 of 36 (89th percentile, labeled "typical, unremarkable volume"). These ranks place the provider among higher-volume in-state peers for core ED visits and abdominal/pelvic CTs, without being described as an extreme outlier.
There are a few notable above-typical volume signals that suggest service strengths beyond overall ED volume: 99282 ranks #4 of 31 (90th percentile) and is labeled "notably above typical state volume," indicating a high share of straightforward ED E/M visits; infusion-related codes 96365 and 96361 both rank #2 in-state (95th percentile) and are labeled "notably above typical state volume," which points to frequent IV medication and fluid administration in the outpatient/ED setting. These markers suggest operational capacity for repeated infusion workflows.
Imaging drives a meaningful share of non-E/M revenue and carries high per-claim payments: 74177 has a $1044 avg paid/claim and 74176 has a $933 avg paid/claim (74176 contributes $2M, 3.4% of Medicaid revenue), and 70450 appears with 6.4K claims ($32 avg paid/claim, $206.1K). This mix indicates that advanced CT scanning (especially abdomen/pelvis with contrast) is a material revenue center for the facility and likely a routine part of its ED diagnostic pathway.
Observation and critical-care billing are present but not dominant: hospital observation services G0378 account for $3.4M (5.7% of Medicaid revenue) with 3.2K claims and rank #7 of 13 (50th percentile), while critical care code 99291 accounts for $549.1K (0.9% of Medicaid revenue) with 430 claims and ranks #12 of 34 (67th percentile). These patterns are consistent with a facility that operates an observation unit and provides some level of critical care but is not primarily a high-intensity critical care center based on Medicaid billing.
The provider has an established enrollment record, with the NPI enumerated on 2016-03-24 (~10 years ago), which supports treating the observed Medicaid-driven case mix as a persistent operating pattern rather than a short-term anomaly. Given the decade of enumeration and the concentrated Medicaid revenue profile, strategic engagement or competitive analysis should focus on ED throughput, imaging capacity, and infusion/IV service lines.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
239 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 40,670 | $520 | $21.1M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 23,460 | $600 | $14.1M |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 5,730 | $1,040 | $6M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 14,580 | $350 | $5.1M |
| G0378 | Hospital observation service, per hour | 3,250 | $1,040 | $3.4M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 3,690 | $750 | $2.8M |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 2,180 | $930 | $2M |
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 5,520 | $250 | $1.4M |
| 80307 | The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date. | 7,090 | $130 | $885.6K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 17,430 | $40 | $627.6K |
Showing 1–10 of 239
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
239 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 6 | 50 | 8,590 | $340 | $5.2M |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 8 | 50 | 3,740 | $290 | $3.8M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 21 | 40 | 3,820 | $330 | $3.3M |
| G0378 | Hospital observation service, per hour | 7 | 10 | 3,250 | $480 | $2.3M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 4 | 30 | 2,660 | $330 | $1.5M |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 5 | 40 | 1,050 | $510 | $1.3M |
| J3490 | Unclassified drugs | 9 | 50 | 160 | $200 | $740.3K |
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 3 | 20 | 950 | $220 | $651.2K |
| 41899 | Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available. | 4 | 10 | 140 | $1,690 | $601.5K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 11 | 20 | 1,060 | $60 | $547.3K |
Showing 1–10 of 239
Other providers in the same ZIP code as Maui Health System A Kaiser Foundation Hospitals LLC, ranked by combined Medicare and Medicaid revenue.
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