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.

Kapiolani Medical Specialists (NPI 1124071014)

Kapiolani Medical Specialists is a multi-specialty clinic/center provider located in Honolulu, Hawaii. This profile covers 0 Medicare and 112 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	Kapiolani Medical Specialists
Address	1319 Punahou St
City	Honolulu
State	HI
ZIP	96826
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$5.1M
Medicare	$0

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

112 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…	12,640	$70	$897.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	5,970	$100	$567.4K
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…	7,170	$50	$329.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5,500	$50	$296.7K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	980	$250	$242.8K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2,410	$100	$241.1K
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…	29,280	$10	$175.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	1,250	$130	$164K
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…	18,580	$10	$148.6K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	1,180	$110	$131.2K

Showing 1–10 of 112

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

Kapiolani Medical Specialists — 7 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

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	21	40	1,050	$510	$1.3M
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.	20	30	770	$430	$536.6K
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…	11	30	1,370	$110	$333.9K
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…	66	710	650	$90	$274.1K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	980	$250	$242.5K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	1	10	2,410	$100	$239.9K
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…	21	690	650	$90	$235.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	4	20	460	$160	$227.9K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	14	10	130	$410	$218.1K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	16	60	650	$110	$152.2K

Showing 1–10 of 112

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Audrey Nath	TX	Neurological Surgery Physician	$210.5K	$0
Saki Onda	HI	Obstetrics & Gynecology Physician	$149.7K	$0
Jay Marumoto	HI	Sports Medicine (Orthopaedic Surgery) Physician	$103.6K	$0
Anthony Herrera	HI	Diagnostic Radiology Physician	$99.2K	$0
Aileen Yee	HI	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	$94.6K	$0
Lee Goerner	HI	Diagnostic Radiology Physician	$63.7K	$0
Bryan Gushiken	HI	Diagnostic Ultrasound Physician	$59.6K	$0
Leah Ridge	HI	Neurology Physician	$45.1K	$5.7K
Tamara Biega	HI	Diagnostic Radiology Physician	$49.8K	$0
Jorge Samaniego	HI	Hospitalist Physician	$49.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kapiolani Medical Center For Women & Children	HI	Children's Hospital	$0	$102.4M
Emergency Medicine Physicians Of Honolulu Kapiolani, LLC	HI	Emergency Medicine Physician	$0	$7.9M
Usrc Beretania, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.3M
Hawaii Anesthesia Group Inc	HI	Anesthesiology Physician	$0	$3.6M
Waikiki Health	HI	Federally Qualified Health Center (FQHC)	$0	$3.5M
Kapiolani Medical Center For Women & Children	HI	Multi-Specialty Clinic/Center	$0	$3.3M
Shriners Hospitals For Children	HI	Children's Hospital	$0	$2.8M
Pediatric Ophthalmology Associates Of Hawaii Inc	HI	Ophthalmology Physician	$0	$1.7M
Dentistry For Children Inc.	HI	Pediatric Dentistry	$0	$1.5M
Peggy Liao	HI	Ophthalmology Physician	$3.3K	$968K

Kapiolani Medical Specialists — 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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