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.

The Queens Medical Center (NPI 1184612764)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Queens Medical Center
Address	1301 Punchbowl St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 7, 2005

Payer Source	Total Paid
Medicaid	$200M
Medicare	$0

THE QUEENS MEDICAL CENTER is effectively a single-payer Medicaid facility in the available dataset — it has no Medicare billing on file and reports $200M in Medicaid revenue, indicating Medicaid is the primary (and only reported) source of government program revenue for this provider. Analysts should treat comparisons and trends as Medicaid-centric because Medicare data is absent.

Revenue is highly concentrated in a small set of emergency department E/M codes: 99283, 99285, and 99284 together account for 63.4% of the provider's total Medicaid revenue, signaling that ED evaluation and management visits are the dominant revenue drivers. This mix implies substantial acute care and emergency services volume rather than outpatient primary care or elective procedural specialization.

THE QUEENS MEDICAL CENTER shows dominant statewide market standing on multiple high-volume codes. It ranks in top percentiles for ED E/M codes (e.g., 99283, 99285, 99284 are each in the 95th–96th percentiles and rank #3 in-state), and leads the state for several imaging and procedure codes (e.g., 74177 and 74176 rank #2 and #1 respectively with language indicating extreme outlier status), suggesting the hospital is a major hub for emergency, advanced imaging, and procedural care in Hawaii.

Specific procedural and imaging services are extreme outliers against in-state peers: 74177 (CT abdomen/pelvis with contrast) is described as an "extreme outlier, far above typical state volume" and ranks #2 of 36; 74176 ranks #1 and is likewise an "extreme outlier." These data indicate unusually high CT utilization for abdominal/pelvic indications relative to other Hawaii providers and point to significant radiology capacity tied to emergency and inpatient workflows.

Observation and short-stay services and critical care also contribute meaningfully to Medicaid revenue: G0378 (hospital observation service, per hour) is the top-ranked in-state code (100th percentile) and 99291 (critical care) contributes $4.2M and sits at a typical statewide volume (88th percentile). Together with the heavy ED E/M mix, this pattern is consistent with a high-throughput emergency department that funnels patients into observation and critical care pathways.

On oncology and advanced therapies, the provider reports meaningful Medicaid revenue for high-cost drugs and advanced imaging: J9271 (pembrolizumab) contributes $2.5M and ranks #1 of 1 providers in-state (no peer comparison available), while 78815 (PET/CT) contributes $3.3M and ranks #1 of 5 providers (100th percentile). These items indicate an oncology service line with access to high-cost immunotherapy and PET imaging for Medicaid patients.

Procedure volumes for endoscopy and interventional GI are also substantial: 45380 and 45385 (colonoscopy with biopsy and snare polypectomy) each rank #1 in-state and together reflect a high-volume scope/endoscopy program contributing nontrivial Medicaid revenue. This supports a broader acute care role beyond the ED, including diagnostic and therapeutic GI services.

The provider has long-tenured enrollment in the NPI registry (enumerated ~21 years ago, 2005-10-07), indicating institutional stability and the likelihood that these utilization patterns reflect an established care delivery footprint rather than a new entrant effect. This tenure reinforces its competitive position as a sustained major Medicaid provider in Hawaii.

Medicaid: Complete Services Breakdown

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

561 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	68,760	$540	$37.4M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	40,580	$880	$35.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	56,950	$620	$35.4M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	14,860	$810	$12.1M
G0378	Hospital observation service, per hour	19,000	$380	$7.2M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	14,900	$340	$5.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,150	$700	$4.3M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2,890	$1,440	$4.2M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	2,260	$1,440	$3.3M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	26,930	$100	$2.7M

Showing 1–10 of 561

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

The Queens Medical Center — 15 of 25 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

561 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	3	50	8,590	$340	$5.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	3	50	3,740	$290	$3.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	3	40	3,820	$330	$3.3M
J9271	Injection, pembrolizumab, 1 mg	1	10	430	$5,800	$2.5M
G0378	Hospital observation service, per hour	1	10	3,250	$480	$2.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3	30	2,660	$330	$1.5M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2	40	1,050	$510	$1.3M
S9480	Intensive outpatient psychiatric services, per diem	1	10	8,770	$120	$1.1M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	1	10	870	$780	$981.5K
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	1	10	2,070	$440	$905.8K

Showing 1–10 of 561

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$42.7M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Queen Emma Clinics	HI	Clinic/Center	$0	$2M
Garth Tormoen	NV	Radiation Oncology Physician	$321K	$0
Michael Bornemann	HI	Specialist	$51.6K	$161.3K
Jeffrey Loh	CA	Pain Medicine (Anesthesiology) Physician	$201.3K	$0
Reid Hoshide	HI	Neurological Surgery Physician	$196.8K	$0
Christian Spies	CA	Interventional Cardiology Physician	$193.9K	$0
Michiko Bruno	HI	Neurology Physician	$159.5K	$0
Derek Mito	HI	Family Medicine Physician	$17.9K	$137.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M
Kaiser Foundation Health Plan Inc	HI	Health Maintenance Organization	$0	$7.4M

The Queens Medical Center — Billing Profile & Reimbursement Data

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The Queens Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References