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.

James Muto (NPI 1134222151)

Field	Value
Entity Type	Individual
Organization	James Muto
Address	89 Hookele St
City	Kahului
State	HI
ZIP	96732
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	September 6, 2006

Payer Source	Total Paid
Medicare	$937.3K
Medicaid	$0

Key Findings

This provider’s billed Medicare activity is concentrated and material: Total Medicare revenue is $937.3K and there is no Medicaid billing on file, making the practice effectively single‑payer (Medicare) based on available claims. The absence of Medicaid activity should be considered when assessing payer mix and network reach in Hawaii.

Revenue concentration is high: the top 3 Medicare codes (99214, 93306, 93925) account for 64.5% of this provider’s total Medicare revenue. In dollar terms those codes are 99214 ($334.8K, 35.7%), 93306 ($209.5K, 22.4%), and 93925 ($60K, 6.4%), indicating most revenue derives from a small set of E/M and diagnostic imaging services.

The code mix points to an outpatient cardiology practice that integrates evaluation/management with on‑site diagnostic imaging and vascular testing. High revenue from 99214 (office E/M) alongside large volumes of 93306 (echocardiography) and multiple duplex/vascular codes (93925, 93880, 93978) suggests the provider delivers both clinical visits and in‑house cardiac and peripheral vascular diagnostic services.

Competitive standing is unusually strong for several imaging and E/M services: 99214 ranks #136 of 479517 providers nationally (100th percentile; extreme outlier) and 93306 ranks #98 of 24624 providers nationally (100th percentile; extreme outlier), signaling national‑level volume dominance for those codes. Additionally, 93356 (speckle tracking) is listed as rank #1 of 4427 providers nationally (100th percentile; extreme outlier), which further highlights an outsized role in specialty echo procedures relative to peers.

While some vascular and monitoring services are extreme or notable outliers, their relative standing varies: 93925 ranks #233 of 10098 providers nationally (98th percentile; notably above typical volume) and 93880 ranks #448 of 21316 providers nationally (98th percentile; notably above typical volume). This pattern indicates exceptional activity in cardiology imaging and monitoring overall, with particularly dominant positions in echo-related codes and somewhat less extreme—but still above‑typical—volume in peripheral vascular studies.

Operationally, the provider’s claim volumes include several high‑count services that reinforce an imaging‑heavy workflow: for example, 93000 shows 2.7K claims ($30.2K revenue, rank #47 of 71016 providers nationally; 100th percentile; extreme outlier) and 93356 records 1.3K claims ($41.6K revenue). These claim counts suggest substantial throughput for ECG and advanced echo procedures, consistent with a practice that performs frequent diagnostic testing alongside office visits.

The single‑payer profile (Medicare $937.3K vs. no Medicaid billing on file) creates both concentration risk and strategic clarity: revenue and utilization trends will be sensitive to Medicare policy and local referral patterns, and there appears to be limited or no Medicaid footprint to diversify payers. Analysts should interpret performance and growth potential in light of this Medicare dependence.

The provider has long tenure in the Medicare program, with an NPI enumerated on 2006-09-06 (~20 years ago), indicating a sustained presence in the market. Combined with the provider’s outsized national ranks on multiple cardiology imaging codes, this tenure supports a picture of an established, imaging‑centered cardiology practice with outsized utilization in several specialized procedures.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

20 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…	3,490	$100	$334.8K
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…	1,410	$150	$209.5K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	290	$210	$60K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	370	$140	$51.9K
93978	The provider performs a complete study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts using duplex Doppler ultrasound scanning. He performs the study to assess…	390	$130	$50.4K
93356	The provider performs speckle tracking of myocardial mechanics to assess myocardial strain in addition to standard echocardiography.	1,300	$30	$41.6K
93351	In this procedure, the provider performs continuous transthoracic echocardiography both at rest and after exercise and reviews images evaluating and assessing global and ventricular performance and…	200	$200	$40K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	2,750	$10	$30.2K
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…	230	$120	$28K
93923	Noninvasive arterial diagnostic procedures are performed to examine the rate of blood flow in an area and to assess the presence of a blockage in the upper and lower extremity arteries.…	270	$80	$22.7K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

James Muto — 13 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	1	60	190	$90	$22.8K
93978	2	20	130	$130	$19K
93925	3	30	40	$180	$16.6K
99214	1	1,440	100	$80	$15.2K
99215	88	380	40	$120	$11.2K
93880	2	40	50	$110	$9.2K
93356	1	10	140	$30	$8K
93351	1	10	20	$170	$7.4K
93923	1	10	50	$80	$7K
99204	9	630	30	$110	$5.3K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with James Muto, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maui Cardiology, Ltd.	HI	Cardiovascular Disease Physician	$0	$2.3M

Nearby Providers

Other providers in the same ZIP code as James Muto, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Americare Hawaii, Incorporated	HI	In Home Supportive Care Agency	$0	$4.7M
Aloha House, Inc.	HI	Mental Health Counselor	$0	$4.5M
Hale Mahaolu	HI	Home Delivered Meals	$0	$3.7M
Americare Hawaii, LLC	HI	Home Health Agency	$0	$3.2M
Gammie Homecare, Inc.	HI	Durable Medical Equipment & Medical Supplies	$0	$1.8M
Pedodontic Associates Inc	HI	Pediatric Dentistry	$0	$1.4M
Pediatric Therapies Hawaii	HI	Pediatric Physical Therapist	$0	$1.4M
Aloha Dermatology And Laser Center LLC	HI	Dermatology Physician	$0	$1.3M
Anamcara Care Hawaii Inc	HI	In Home Supportive Care Agency	$0	$1.3M
Aloha Surgical Center LLC	HI	Ambulatory Surgical Clinic/Center	$826.3K	$247K

James Muto — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References