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.

Pali Momi Medical Center (NPI 1013961408)

Field	Value
Entity Type	Organization
Organization	Pali Momi Medical Center
Address	98-1079 Moanalua Rd
City	Aiea
State	HI
ZIP	96701
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$49.3M
Medicare	$0

Key Findings

PALI MOMI MEDICAL CENTER reports no Medicare billing on file and $49.3M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer Medicaid. The provider’s NPI was enumerated on 2006-05-20 (~20 years ago), indicating two decades of enrollment during which Medicaid has been the dominant publicly billed payer.

Revenue is highly concentrated in emergency department E/M codes: the precomputed top‑3 Medicaid codes account for 73.6% of this provider's total Medicaid revenue. Those three codes are 99283 ($14M, 29.1%), 99285 ($11.2M, 23.2%), and 99284 ($10.3M, 21.4%), which together drive the bulk of reported Medicaid receipts and signal concentrated dependence on ED services.

The code mix (predominantly 99283/99284/99285) and high claim volumes (31.3K claims for 99283, 20.8K for 99284, 15.8K for 99285) identify PALI MOMI as operating a high‑volume emergency department with a full acuity range from low to high medical decision making. This pattern is consistent with a general acute care hospital that funnels substantial patient flow through ED evaluation and management rather than through Medicare inpatient or outpatient procedural billing.

Supporting services and downstream care are visible in the Medicaid mix: hospital observation hours (G0378, $2.5M, 4.2K claims, 5.1%) and advanced imaging such as CT abdomen/pelvis with contrast (74177, $2.3M, 3.8K claims, 4.8%) are notable contributors. Those codes and their ranks (G0378 ranks #4 of 13, 75th percentile; 74177 ranks #7 of 36, 83th percentile) suggest the ED workload is backed by observation capacity and onsite imaging resources.

Competitive standing on core ED codes is above typical statewide volumes but not uniquely dominant: 99285 ranks #6 of 39 (87th percentile), 99283 ranks #8 of 45 (84th percentile), and 99284 ranks #10 of 47 (80th percentile). These placements indicate PALI MOMI is a strong, high‑volume ED provider within Hawaii but generally within the range labeled as “typical, unremarkable volume” relative to peers rather than an extreme outlier or the single market leader.

Certain ancillary service lines show notably above‑typical state volume: pelvic ultrasound (76856) is in the 93th percentile (3.2K claims, $232.8K, 0.5% of Medicaid revenue), diagnostic mammography codes 77065 and 77066 are in the 92th and 90th percentiles respectively, and 76856/77065/77066 are described as "notably above typical state volume." This points to a comparatively strong women’s imaging service line supporting the hospital’s broader acute‑care activity.

The provider also bills large counts of low‑unit‑price supply and infusion codes (A4649: 55.5K claims, $7 avg paid/claim, $388.8K revenue; 96365/96366 present with many claims but low avg paid/claim), indicating substantial throughput of low‑reimbursement items and routine infusions. While individually these codes contribute small shares of revenue (A4649 is 0.8% of Medicaid revenue), their high claim volumes reflect operational scale and the resource intensity of ED and ambulatory care workflows.

Taken together, the combination of two decades of enrollment, a Medicaid‑only billing profile, and heavy reliance on ED E/M codes suggests PALI MOMI functions primarily as a Medicaid‑facing acute care hospital with significant emergency and imaging capacity. For payers and network analysts, this profile implies negotiation and utilization-management focus areas around emergency care pathways, observation utilization, and high‑volume imaging services rather than traditional Medicare DRG or outpatient procedural contracting.

Medicaid: Complete Services Breakdown

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

253 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.	31,320	$450	$14M
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.	15,840	$710	$11.2M
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.	20,750	$500	$10.3M
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.	7,640	$350	$2.7M
G0378	Hospital observation service, per hour	4,200	$580	$2.5M
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.	3,850	$610	$2.3M
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.	2,630	$470	$1.2M
L8699	Prosthetic implant, not otherwise specified	750	$880	$654.9K
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…	6,080	$90	$516.5K
A4649	Surgical supply; miscellaneous	55,550	$10	$388.8K

Showing 1–10 of 253

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

Pali Momi Medical Center — 0 of 25 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

253 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.	8	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.	10	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.	6	40	3,820	$330	$3.3M
G0378	Hospital observation service, per hour	4	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.	5	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.	7	40	1,050	$510	$1.3M
J3490	Unclassified drugs	1	50	160	$200	$740.3K
99281	The provider sees a patient for the lowest level emergency department visit.	8	20	950	$220	$651.2K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	9	20	1,060	$60	$547.3K
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.	4	30	770	$430	$536.6K

Showing 1–10 of 253

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pali Momi Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pali Momi Medical Center	HI	Multi-Specialty Clinic/Center	$0	$599.4K
Vinh Trang	WA	Hematology & Oncology Physician	$280.9K	$0
Andrew So	PA	Cardiovascular Disease Physician	$148.8K	$0
Michael Lui	HI	Neurology Physician	$148.6K	$0
Gregory Chow	HI	Orthopaedic Surgery of the Spine Physician	$128K	$0
John Kao	HI	Interventional Cardiology Physician	$103.3K	$0
Charles Kim	HI	Urology Physician	$93.4K	$0
Eric Crawley	HI	Pulmonary Disease Physician	$83K	$0
Jeffrey Liu	HI	Neurology Physician	$79.2K	$0
C Choy	HI	Hematology & Oncology Physician	$62.7K	$0

Nearby Providers

Other providers in the same ZIP code as Pali Momi Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Diagnostic Laboratory Services, Inc	HI	Clinical Medical Laboratory	$10.5M	$46M
Dlmc, Inc.	HI	Home Health Agency	$0	$39.5M
Usrc Pearlridge, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.7M
International Life Support Inc	HI	Ambulance	$1.2M	$8.6M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.8M
Pharmacare International, Inc.	HI	Community/Retail Pharmacy	$125.1K	$4.7M
Emergency Medicine Physicians Of Honolulu Pali Momi, LLC	HI	Emergency Medicine Physician	$0	$4.2M
Absolute Care Management Services	HI	Point of Service	$0	$3.2M
Derek B Tom Dds LLC	HI	Pediatric Dentistry	$0	$2.6M
Sleep Center Hawaii LLC	HI	Sleep Disorder Diagnostic Clinic/Center	$0	$2.5M

Pali Momi Medical Center — 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