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.

De Leon Medical Clinic Inc (NPI 1104258870)

Field	Value
Entity Type	Organization
Organization	De Leon Medical Clinic Inc
Address	1520 Liliha St Ste 203
City	Honolulu
State	HI
ZIP	96817
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 5, 2013

Payer Source	Total Paid
Medicaid	$381.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,930	$50	$346.3K
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…	860	$40	$31.6K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	100	$20	$2.3K
99397	The provider performs an established well–patient visit for a patient who is 65 years or older.	50	$20	$740
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	50	$10	$270
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an…	20	$10	$160
1036F	N/A	3,950	$0	$0
1090F	Urinary incontinence refers to the leakage of urine due to lack of bladder control. The provider assesses a female patient of 65 years or older for the presence or absence of urinary incontinence…	10	$0	$0
1101F	No Summary found for this code	10	$0	$0
1123F	No Summary found for this code	30	$0	$0

Showing 1–10 of 31

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

De Leon Medical Clinic Inc — 0 of 6 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

31 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…	314	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…	58	690	650	$90	$235.4K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	15	20	180	$20	$18.3K
99397	The provider performs an established well–patient visit for a patient who is 65 years or older.	21	30	90	$30	$5.6K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	35	50	160	$10	$2.5K
3008F	No Summary found for this code	61	90	660	$1	$1.9K
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an…	13	20	70	$10	$1.2K
S9999	Sales tax	114	240	200	$1	$820
1036F	N/A	9	120	160	$1	$110
2000F	No Summary found for this code	12	20	250	$1	$80

Showing 1–10 of 31

Nearby Providers

Other providers in the same ZIP code as De Leon Medical Clinic Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$42.8M
Kalihi Palama Health Center	HI	Federally Qualified Health Center (FQHC)	$0	$38.9M
Careresource Hawaii	HI	Home Health Agency	$0	$12.8M
Lanakila Pacific	HI	Home Delivered Meals	$0	$11.7M
Usrc Aloha LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.1M
Kuakini Medical Center	HI	General Acute Care Hospital	$0	$10.9M
Usrc Honolulu, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8.1M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.3M
Ku Aloha Ola Mau	HI	Counselor	$220.5K	$5.8M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.9M

De Leon Medical Clinic Inc — Billing Profile & Reimbursement Data

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De Leon Medical Clinic 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

Nearby Providers

Frequently Asked Questions

References