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 Sim (NPI 1174634067)

Field	Value
Entity Type	Individual
Organization	James Sim
Address	1319 Punahou St Ste 1160
City	Honolulu
State	HI
ZIP	96826
Taxonomy	Pediatric Cardiology Physician
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$761.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1,880	$120	$229.7K
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…	1,220	$130	$161.2K
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…	1,820	$90	$156.1K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	1,900	$40	$81.6K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	1,960	$30	$52.8K
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…	340	$120	$40.4K
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…	1,980	$20	$33.6K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	910	$10	$6.4K

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

James Sim — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	193	690	650	$90	$235.4K
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…	21	60	650	$110	$152.2K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	2	10	200	$120	$100.7K
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…	5	30	140	$120	$48.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	21	40	1,140	$10	$37.6K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	2	10	190	$40	$26K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	3	10	770	$20	$18.9K
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…	6	50	180	$20	$14.6K

Nearby Providers

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

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
Kapiolani Medical Specialists	HI	Multi-Specialty Clinic/Center	$0	$5.1M
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

James Sim — Billing Profile & Reimbursement Data

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James Sim — 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