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.

Nestor I.c. Del Rosario Md Inc. (NPI 1184989030)

Field	Value
Entity Type	Organization
Organization	Nestor I.c. Del Rosario Md Inc.
Address	94-939 Kahuailani St
City	Waipahu
State	HI
ZIP	96797
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 6, 2012

Payer Source	Total Paid
Medicaid	$106.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

28 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…	2,740	$30	$71.2K
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…	370	$40	$13K
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…	520	$20	$10K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	210	$30	$5.2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	170	$30	$4.9K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	180	$10	$880
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	430	$1	$430
0518F	No Summary found for this code	340	$1	$340
99397	The provider performs an established well–patient visit for a patient who is 65 years or older.	30	$10	$210
Q2039	Influenza virus vaccine, not otherwise specified	20	$1	$60

Showing 1–10 of 28

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

Nestor I.c. Del Rosario Md Inc. — 0 of 10 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

28 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…	380	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…	136	690	650	$90	$235.4K
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…	42	140	140	$90	$42.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	7	20	30	$140	$40.2K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	12	20	310	$20	$6.8K
99397	The provider performs an established well–patient visit for a patient who is 65 years or older.	25	30	90	$30	$5.6K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	23	50	160	$10	$2.5K
3008F	No Summary found for this code	13	90	660	$1	$1.9K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	32	150	110	$1	$560
1036F	N/A	67	120	160	$1	$110

Showing 1–10 of 28

Nearby Providers

Other providers in the same ZIP code as Nestor I.c. Del Rosario Md Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preferred Home & Community Based Services, Inc.	HI	Developmentally Disabled Services Day Training Agency	$0	$66.9M
Bayada Home Care	HI	Developmentally Disabled Services Day Training Agency	$0	$33.3M
Hawaii Health Services, Inc.	HI	Home Health Agency	$0	$29.4M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$19.4M
Dsi Waipahu, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.7M
Blue Water Resources	HI	Case Management Agency	$0	$5.7M
Family Services Of Oahu,llc	HI	Developmentally Disabled Services Day Training Agency	$0	$4.9M
Loving Care Health Provider, Inc.	HI	In Home Supportive Care Agency	$0	$4.2M
Leeward Pedodontix, LLC	HI	Pediatric Dentistry	$0	$4.1M
Metropacific Group, Corp	HI	In Home Supportive Care Agency	$0	$2.8M

Nestor I.c. Del Rosario Md Inc. — Billing Profile & Reimbursement Data

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Nestor I.c. Del Rosario Md 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

Nearby Providers

Frequently Asked Questions

References