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.

Medical Clinic, Inc. (NPI 1144234402)

Medical Clinic, Inc. is a multi-specialty clinic/center provider located in Kailua, Hawaii. This profile covers 0 Medicare and 10 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	Medical Clinic, Inc.
Address	414 Uluniu St
City	Kailua
State	HI
ZIP	96734
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 29, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	8,890	$50	$426.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10,070	$40	$372.7K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,720	$170	$284K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,150	$130	$147.3K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	730	$90	$68.6K
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…	50	$140	$7.3K
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…	40	$80	$3.3K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	150	$10	$2.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	90	$10	$980
S9999	Sales tax	7,650	$0	$0

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

Medical Clinic, Inc. — 3 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

10 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…	47	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…	602	690	650	$90	$235.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	6	190	190	$100	$122.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1	10	810	$130	$91.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1	10	270	$160	$79K
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…	20	30	140	$120	$48.5K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	3	20	170	$90	$32K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	138	230	140	$20	$16.1K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	41	110	70	$10	$1.6K
S9999	Sales tax	9	240	200	$1	$820

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Philip Kuo	HI	Allergy & Immunology Physician	$61.1K	$0
Sylvia Wang	HI	Internal Medicine Physician	$54.3K	$0
Philip Kuo	HI	Allergy & Immunology (Internal Medicine) Physician	$48.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Castle Medical Center	HI	General Acute Care Hospital	$0	$37.6M
Hawaii Emergency Physicians Associated Inc	HI	Emergency Medicine Physician	$0	$20.2M
Howard Y Kim Dds Inc	HI	Pediatric Dentistry	$0	$3.3M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.1M
Pacific Island Medical, Inc.	HI	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Hawaii Dermatology Centers, Inc	HI	Specialist	$0	$1.4M
Kupunaride Corporation	HI	Non-emergency Medical Transport (VAN)	$0	$943.9K
Stuart Lerner, M.d. LLC	HI	Family Medicine Physician	$0	$920.4K
Windward Heart Center LLC	HI	Cardiovascular Disease Physician	$0	$885K
Hawaii Endodontics LLC	HI	Endodontics	$0	$719.3K

Medical Clinic, Inc. — Billing Profile & Reimbursement Data

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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

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