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.

Dlmc, Inc. (NPI 1114159449)

Field	Value
Entity Type	Organization
Organization	Dlmc, Inc.
Address	98-023 Hekaha Street
City	Aiea
State	HI
ZIP	96701
Taxonomy	Home Health Agency
NPI Enumerated	August 20, 2009

Payer Source	Total Paid
Medicaid	$39.5M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused operation: Total Medicaid revenue is $39.5M while Medicare revenue is listed as none (no Medicare billing on file), indicating almost all billed activity and financial exposure are concentrated in Medicaid programs rather than Medicare. That payer concentration should drive contracting and compliance priorities toward state Medicaid policy and managed care relationships.

Revenue is highly concentrated in a small set of Medicaid service lines: the precomputed top 3 codes account for 78.4% of the provider's Medicaid revenue, led by H2021 ($18.8M, 47.7%), followed by T2016 ($7.8M, 19.6%) and S5125 ($4.4M, 11.1%). This concentration means a few codes drive the majority of receipts and performance measures.

The mix of top codes points to a service model centered on community-based wrap-around and personal/residential supports: H2021 (Community-based wrap-around services) is the largest revenue source, alongside T2016 (Habilitation, residential, waiver) and S5125 (Attendant care services). Combined with significant volumes in S9122 (home health aide/CNA) and S5130 (homemaker services), the profile suggests operations focused on high-frequency, unit-based in-home and residential support rather than episodic skilled Medicare-style home health.

Competitive standing by code shows dominance in several Medicaid lines. H2021 ranks #1 of 24 providers in-state (100th percentile) and is described as an extreme outlier — indicating this provider operates at far greater scale than peers for community-based wrap-around; S5125 also ranks #1 of 17 (100th percentile, notably above typical state volume), while T2016 is more typical at #4 of 9 (63th percentile). These rank/percentile positions imply the provider is a market leader for wrap-around and attendant-care services, but only a mid-level participant in residential habilitation among the smaller set of waiver providers.

Several other code-level standings reinforce a broad footprint in personal and homemaker supports: S5130 (31.5K claims, $2.6M) ranks #5 of 83 (95th percentile, notably above typical state volume) and S9122 (22K claims, $2.6M) ranks #9 of 67 (88th percentile). The provider’s top-percentile placements across multiple in-home support codes indicate substantial operational scale in delivering frequent, time-based services across the state.

Operational and workforce implications are clear from the claim counts and billing units: H2021 has 45.1K claims, S5130 has 31.5K claims, and S9122 has 22K claims — these high claim volumes and predominantly per-15-minute or per-hour payment units imply heavy reliance on hourly caregivers, scheduling capacity, and care coordination to manage throughput and quality. Staffing, training, and retention are likely material drivers of cost and capacity for the organization.

Financial and policy risk is concentrated: with 78.4% of Medicaid revenue coming from the top three codes and no Medicare revenue to diversify income, changes to state reimbursement, waiver rules, or utilization for H2021/T2016/S5125 would materially affect the provider’s topline. This single-payer Medicaid exposure elevates sensitivity to state policy shifts, audit focus, and managed-care contracting dynamics.

The provider has an established presence in the market, with NPI enumeration dated 2009-08-20 (~17 years ago), which suggests long-tenured operations and likely familiarity with Hawaii Medicaid program requirements and payer relationships; tenure combined with the code concentration helps explain the scale observed in the state rankings for core service lines.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2021	Community-based wrap-around services, per 15 minutes	45,080	$420	$18.8M
T2016	Habilitation, residential, waiver; per diem	5,380	$1,440	$7.8M
S5125	Attendant care services; per 15 minutes	17,340	$250	$4.4M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	21,960	$120	$2.6M
S5130	Homemaker service, nos; per 15 minutes	31,490	$80	$2.6M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	2,490	$560	$1.4M
S5150	Unskilled respite care, not hospice; per 15 minutes	6,540	$130	$843K
S5140	Foster care, adult; per diem	400	$1,590	$639.6K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	390	$670	$257.8K
H2032	Activity therapy, per 15 minutes	330	$330	$107.9K

Showing 1–10 of 11

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

Dlmc, Inc. — 4 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	4	10	2,740	$1,170	$8.6M
H2021	Community-based wrap-around services, per 15 minutes	1	20	4,710	$400	$3.5M
S5140	Foster care, adult; per diem	3	10	340	$4,170	$3.2M
S5125	Attendant care services; per 15 minutes	1	20	1,140	$640	$2.9M
H2032	Activity therapy, per 15 minutes	13	10	1,660	$110	$1.6M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	9	70	5,120	$130	$1.2M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	11	20	2,130	$240	$1M
S5130	Homemaker service, nos; per 15 minutes	5	80	5,320	$90	$776.6K
S5150	Unskilled respite care, not hospice; per 15 minutes	1	10	100	$150	$337.2K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	5	10	390	$400	$139.7K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Dlmc, Inc., 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
Pali Momi Medical Center	HI	General Acute Care Hospital	$0	$49.3M
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

Dlmc, Inc. — Billing Profile & Reimbursement Data

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Dlmc, 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

Nearby Providers

Frequently Asked Questions

References