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 Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii 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. Hawaii (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.

The Emergency Group, Inc. (NPI 1013943414)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Emergency Group, Inc.
Address	1301 Punchbowl St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 25, 2006

Payer Source	Total Paid
Medicaid	$15M
Medicare	$0

THE EMERGENCY GROUP, INC. appears to operate principally as an emergency department service provider: its Medicaid revenue is dominated by E/M emergency visit codes 99285, 99284, and 99283, and the code descriptions indicate a mix of high, moderate, and low levels of medical decision making consistent with ED throughput rather than ambulatory primary care. The presence of critical care code 99291 (6.7K claims, $728.4K revenue) further signals capacity to manage high-acuity presentations within the emergency setting.

Revenue concentration is highly focused: the precomputed top 3 Medicaid codes by revenue account for 92.1% of this provider's total Medicaid revenue, with 99285 generating $6.9M (46.0%), 99284 generating $5.8M (38.8%), and 99283 generating $1.1M (7.3%). This tight concentration around three ED E/M codes indicates that a small set of service lines drive the overwhelming majority of billing and payment activity.

Payer mix is effectively single-payer Medicaid: the profile shows Total Medicaid revenue of $15M and no Medicare billing on file, so Medicaid is the exclusive recorded federal payer source in this dataset. Analysts should treat this entity as Medicaid-dependent in the available claims data rather than dual-payer for Medicare/Medicaid comparisons.

State-level competitive standing for high-acuity ED care is unusually strong: 99285 ranks #2 of 39 providers in-state at the 97th percentile and is labeled an "extreme outlier," while 99284 ranks #2 of 47 at the 98th percentile and is also an "extreme outlier." Those placements indicate this provider bills far above typical state volumes for the most resource-intensive ED visit levels, positioning it as a major statewide player for these codes.

Additional procedure-level outliers reinforce an ED-focused profile: 93010 (ECG interpretation) shows 62.3K claims and $311.5K revenue and ranks #1 of 35 providers at the 100th percentile (extreme outlier), and 99291 (critical care) ranks #2 of 34 at the 97th percentile (notably above typical). High volumes of ECG interpretation and critical care add-ons are consistent with continuous, high-throughput acute care operations.

While several top codes are extreme outliers, other code-level ranks are more typical — for example, 99283 is #9 of 45 at the 82th percentile (typical, unremarkable volume) and 99223 (initial inpatient/observation) is #11 of 65 at the 84th percentile (typical, unremarkable). This pattern suggests the provider’s dominance is concentrated in emergency-department E/M and related acute procedures rather than across all inpatient or ancillary service lines.

The raw claim volumes imply substantial operational scale: 81K claims for 99285 and 89.6K claims for 99284 are large absolute volumes that imply sustained ED patient throughput and corresponding staffing, documentation, and billing workflows to support high-acuity and moderate-acuity visits. High claim counts combined with high placement in state percentiles signal that resource planning (physician coverage, nursing, EKG capacity, and critical care capability) is likely a central operational priority for this provider.

The provider has long-standing enrollment in NPI records, enumerated on 2006-06-25 (~20 years ago), indicating an established presence in the state market. Combined with the concentrated Medicaid revenue and the extreme outlier ranks for several ED codes, tenure reinforces that these utilization patterns reflect an enduring service footprint rather than a new or transient billing profile.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	81,030	$90	$6.9M
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.	89,570	$70	$5.8M
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.	23,810	$50	$1.1M
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…	6,740	$110	$728.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	62,300	$10	$311.5K
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…	760	$100	$76.2K
99217	N/A	820	$40	$31.3K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	6,010	$1	$24.1K
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…	710	$10	$4.3K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	860	$1	$3.4K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.

Claims Volume vs. Hawaii Distribution

The Emergency Group, Inc. — 5 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

16 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.	9	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.	2	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.	2	40	3,820	$330	$3.3M
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.	29	30	2,660	$330	$1.5M
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	30	200	$290	$329.1K
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…	32	50	1,250	$10	$60.5K
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…	11	70	130	$90	$45.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	1	40	1,140	$10	$37.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	17	50	1,920	$1	$27.6K
99292	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…	5	10	240	$80	$24.5K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M

The Emergency Group, Inc. — Billing Profile & Reimbursement Data

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The Emergency Group, 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sophia Cohen	HI	Emergency Medicine Physician	$67.3K	$0
Melissa Schmidt	HI	Emergency Medicine Physician	$64.9K	$0
Derek Uemura	HI	Emergency Medicine Physician	$57.7K	$0
Taichi Imamura	HI	Emergency Medicine Physician	$56.6K	$0
Wynn Wakuzawa	HI	Emergency Medicine Physician	$48.2K	$0
Gregory Suares	HI	Emergency Medicine Physician	$47.8K	$0
Kyle Perry	HI	Emergency Medicine Physician	$47.6K	$0
Michael Shin	MN	Emergency Medicine Physician	$46.6K	$0
Ajay Bhatt	HI	Emergency Medicine Physician	$44.4K	$0
Alexandra Ditullio	HI	Emergency Medicine Physician	$21.6K	$0