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.

Kau Hospital (NPI 1174777916)

Kau Hospital is a rural health clinic/center provider located in Pahoa, Hawaii. This profile covers 0 Medicare and 19 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	Kau Hospital
Address	15-2662 Pahoa Village Rd
City	Pahoa
State	HI
ZIP	96778
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	November 6, 2008

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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
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…	7,770	$130	$1M
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…	5,860	$120	$685.6K
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,…	2,600	$100	$254.3K
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…	1,660	$120	$195.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,590	$80	$127.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	620	$110	$67.3K
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…	340	$90	$31.9K
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…	50	$140	$7.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	480	$10	$3.3K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	10	$180	$2.5K

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

Kau Hospital — 0 of 18 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
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	73	70	370	$150	$457.3K
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…	59	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…	63	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,…	21	190	190	$100	$122.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	30	80	320	$100	$119.2K
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…	102	140	140	$90	$42.9K
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…	13	170	120	$70	$35.7K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	7	10	70	$100	$25.9K
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…	32	170	70	$90	$23.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	6	70	80	$60	$20.6K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kau Hospital	HI	Critical Access Hospital	$0	$4.9M
Kau Hospital	HI	Rural Health Clinic/Center	$0	$1.5M
Kau Hospital	HI	Rural Health Clinic/Center	$0	$1.4M
Kau Hospital	HI	Rural Health Clinic/Center	$0	$713.8K
Nathaniel Valin	FL	Cardiovascular Disease Physician	$703.2K	$0
Kau Hospital	HI	Rural Health Clinic/Center	$0	$573.1K
Giselle Baquero Caranama	HI	Interventional Cardiology Physician	$349.8K	$0
Sanjeev Ravipudi	MO	Interventional Cardiology Physician	$348.8K	$0
Jorge Gonzalez	MI	Neurology Physician	$147K	$114.2K
Marvin Chang	TX	Pain Medicine (Anesthesiology) Physician	$228.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$2M
Kinesis Hawaii Inc.	HI	Physical Therapy Clinic/Center	$0	$494.8K
Pahoa Counseling LLC	HI	Mental Health Counselor	$0	$318.2K
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$284K
Longs Drug Stores California LLC	HI	Pharmacy	$144K	$68K
Sirius Research Group Inc	HI	Clinical Social Worker	$0	$208.6K
Carol Iadeluca-myrianthis	HI	Physical Therapist	$65.4K	$0
Melissa Merrill	HI	Chiropractor	$36.6K	$0
Hart Miller	HI	Adult Medicine Physician	$19.4K	$0
Nicolas Myrianthis	HI	Physical Therapist	$18.1K	$0

Kau Hospital — Billing Profile & Reimbursement Data

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Kau Hospital — 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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