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.

Big Island Family Medicine Inc (NPI 1124506845)

Field	Value
Entity Type	Organization
Organization	Big Island Family Medicine Inc
Address	670 Ponahawai St Ste 207
City	Hilo
State	HI
ZIP	96720
Taxonomy	Family Medicine Physician
NPI Enumerated	August 3, 2018

Payer Source	Total Paid
Medicaid	$308K
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 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…	3,640	$50	$178.5K
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…	2,860	$30	$82.8K
99204	The provider sees a new 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 provider…	360	$80	$27.1K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	710	$20	$12.7K
99203	The provider sees a new 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 provider…	40	$60	$2.5K
Q3014	Telehealth originating site facility fee	420	$1	$1.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	390	$1	$1.6K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	90	$10	$770
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	20	$30	$490
1123F	No Summary found for this code	20	$0	$0

Showing 1–10 of 19

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

Big Island Family Medicine Inc — 0 of 9 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

19 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…	148	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…	108	690	650	$90	$235.4K
99203	The provider sees a new 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 provider…	119	170	120	$70	$35.7K
99204	The provider sees a new 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 provider…	31	170	70	$90	$23.3K
Q3014	Telehealth originating site facility fee	11	30	190	$20	$17.5K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	4	20	310	$20	$6.8K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	29	30	120	$10	$3.6K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	10	30	70	$10	$1.1K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	35	150	110	$1	$560
3079F	No Summary found for this code	23	80	150	$1	$40

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Big Island Family Medicine Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hilo Benioff Medical Center	HI	General Acute Care Hospital	$0	$51.2M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$19.3M
Metropacific Group, Corp	HI	Developmentally Disabled Services Day Training Agency	$0	$13.3M
Triple Ace Venture Capital, Corp.	HI	In Home Supportive Care Agency	$0	$10.5M
Whchc - Hawaii Island Community Health Center	HI	Federally Qualified Health Center (FQHC)	$0	$8.1M
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$7.1M
Hilo Urgent Care Center, LLC	HI	Urgent Care Clinic/Center	$0	$6.5M
Alpha Care Hawaii LLC	HI	In Home Supportive Care Agency	$0	$5.9M
Mastercare Inc	HI	In Home Supportive Care Agency	$0	$5.4M
Americare Hawaii Incorporated	HI	In Home Supportive Care Agency	$0	$3.7M

Big Island Family Medicine Inc — Billing Profile & Reimbursement Data

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Big Island 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

Nearby Providers

Frequently Asked Questions

References