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.

Paniolo Pediatric And Family Medicine Inc (NPI 1053812990)

Paniolo Pediatric And Family Medicine Inc is a pediatrics physician provider located in Kamuela, Hawaii. This profile covers 0 Medicare and 55 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Paniolo Pediatric And Family Medicine Inc
Address	64-1032 Mamalahoa Hwy Ste 204
City	Kamuela
State	HI
ZIP	96743
Taxonomy	Pediatrics Physician
NPI Enumerated	February 26, 2018

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	17,120	$20	$410.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,480	$70	$291.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,090	$60	$232.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	4,450	$40	$186.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,860	$50	$140K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	1,910	$40	$74.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	970	$40	$36.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	330	$60	$20.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	9,370	$1	$9.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	510	$20	$8.7K

Showing 1–10 of 55

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

Paniolo Pediatric And Family Medicine Inc — 4 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	20	710	650	$90	$274.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	86	690	650	$90	$235.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	60	190	190	$100	$122.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7	100	210	$120	$116.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7	100	210	$110	$101.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5	110	230	$90	$55.7K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	7	10	50	$40	$32.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	13	90	180	$70	$31.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	3	40	160	$60	$31K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	2	20	60	$150	$26.6K

Showing 1–10 of 55

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Queens North Hawaii Community Hospital	HI	General Acute Care Hospital	$0	$13M
Hawaii Life Flight, LLC	HI	Air Ambulance	$379.2K	$2M
Five Mountains Hawaii, Inc	HI	Rural Health Clinic/Center	$0	$1.6M
Liberty Dialysis-north Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Vein Clinics Of Hawaii LLC	HI	Vascular Surgery Physician	$0	$673.3K
Queen's North Hawaii Community Hospital	HI	General Practice Physician	$0	$642K
Queen's North Hawaii Community Hospital	HI	Obstetrics & Gynecology Physician	$0	$622.5K
John Mascaro	HI	Marriage & Family Therapist	$0	$523.3K
Steven Chelminiak	HI	Clinical Social Worker	$0	$498.8K
Duerler, Inc.	HI	Family Medicine Physician	$0	$479.7K

Paniolo Pediatric And Family Medicine Inc — Billing Profile & Reimbursement Data

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Paniolo Pediatric And Family Medicine Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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