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.

Kuakini Medical Center (NPI 1215939335)

Field	Value
Entity Type	Organization
Organization	Kuakini Medical Center
Address	347 N Kuakini St
City	Honolulu
State	HI
ZIP	96817
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 1, 2005

Payer Source	Total Paid
Medicaid	$10.9M
Medicare	$0

Key Findings

KUAKINI MEDICAL CENTER appears functionally single‑payer in the available claims data: there is no Medicare billing on file while total Medicaid revenue is $10.9M, so Medicaid accounts for essentially all reported government payer activity for this NPI. This concentration means the facility’s public‑program revenue exposure is concentrated in state Medicaid reimbursement and utilization patterns.

The provider has an established presence in the dataset, with NPI enumeration date 2005-06-01 (~21 years ago), indicating long‑standing participation in public programs and an operational history that could support ongoing ED and observation services. This tenure supports the interpretation of stable service lines rather than a transient billing pattern.

Revenue is highly concentrated in a small set of codes: the top three Medicaid codes (99285, 99283, and G0378) together account for 52.7% of the provider’s total Medicaid revenue. Specifically, 99285 produced $2.4M (22.4% of Medicaid revenue), 99283 produced $1.8M (16.3%), and G0378 produced $1.5M (14.0%), showing that just these three services drive the majority of reported Medicaid dollars.

The coding mix and descriptions point to a hospital whose Medicaid revenue is driven by emergency department visits and observation care: 99285 (3.3K claims, $743 avg paid/claim, $2.4M revenue) and 99283 (6.5K claims, $274 avg paid/claim, $1.8M revenue) plus G0378 observation hours (1.8K claims, $836 avg paid/claim, $1.5M revenue) together dominate. These entries suggest a high reliance on acute ED throughput and hospital observation services rather than inpatient DRG revenue in the Medicaid dataset.

Competitive standing on core ED and observation codes is modest to typical rather than dominant. For example, 99285 ranks #22 of 39 in‑state (45th percentile; typical, unremarkable volume for this code), 99283 ranks #25 of 45 (45th percentile; typical, unremarkable volume), and G0378 ranks #9 of 13 (33th percentile; typical, unremarkable volume), indicating KUAKINI is a routine statewide participant in these services rather than a market leader.

There are pockets of relatively higher or lower specialty volume within the Medicaid mix that affect operational interpretation: 99282 shows 6.2K claims, $219 avg paid/claim, $1.4M revenue (12.4%) and ranks #7 of 31 (80th percentile; typical, unremarkable volume for this code), which signals comparatively stronger volume in lower‑complexity ED visits even as higher‑complexity ED claims like 99285 sit at median levels. Conversely, critical care coding (99291) is limited (28 claims, $2888 avg paid/claim, $80.9K revenue) and ranks #29 of 34 (15th percentile; typical, unremarkable volume), suggesting limited Medicaid critical care billing relative to peers.

Diagnostic and ancillary services support the acute care footprint: CT abdomen/pelvis with contrast 74177 generated $979.2K (9.0% of Medicaid revenue) and ranks #18 of 36 (51th percentile; typical, unremarkable volume), while CT head 70450 produced $472.3K (4.3%) and pathology 88305 produced $366.6K (3.4%). These figures indicate meaningful downstream imaging and pathology revenue tied to ED/observation activity.

From a payer‑strategy and revenue‑risk perspective, the combination of no Medicare billing on file and a heavy Medicaid concentration—plus the top‑3 code reliance (52.7%) on ED/observation services—suggests the provider’s Medicaid revenue is sensitive to changes in ED utilization patterns, observation‑unit policy, or state Medicaid reimbursement edits. That profile is important for analysts considering contracting, capitation, or risk‑adjustment exposure for this facility.

Medicaid: Complete Services Breakdown

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

140 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,290	$740	$2.4M
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.	6,500	$270	$1.8M
G0378	Hospital observation service, per hour	1,830	$840	$1.5M
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.	6,200	$220	$1.4M
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.	1,390	$710	$979.2K
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.	2,570	$280	$728.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,470	$190	$472.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,370	$270	$366.6K
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.	510	$630	$323.2K
99281	The provider sees a patient for the lowest level emergency department visit.	1,720	$150	$261.9K

Showing 1–10 of 140

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

Kuakini Medical Center — 1 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

140 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.	25	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.	26	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.	22	40	3,820	$330	$3.3M
G0378	Hospital observation service, per hour	9	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.	7	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.	18	40	1,050	$510	$1.3M
99281	The provider sees a patient for the lowest level emergency department visit.	6	20	950	$220	$651.2K
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.	17	30	770	$430	$536.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	25	30	2,500	$40	$455.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	14	30	1,750	$70	$378K

Showing 1–10 of 140

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kuakini Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hingson Chun	HI	Cardiovascular Disease Physician	$175.8K	$0
Ronson Sato	HI	Pulmonary Disease Physician	$67K	$0
Mark Kanemori	HI	Radiation Oncology Physician	$58.9K	$0

Nearby Providers

Other providers in the same ZIP code as Kuakini Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$42.8M
Kalihi Palama Health Center	HI	Federally Qualified Health Center (FQHC)	$0	$38.9M
Careresource Hawaii	HI	Home Health Agency	$0	$12.8M
Lanakila Pacific	HI	Home Delivered Meals	$0	$11.7M
Usrc Aloha LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.1M
Usrc Honolulu, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8.1M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.3M
Ku Aloha Ola Mau	HI	Counselor	$220.5K	$5.8M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.9M
Coastal Medical Supply, Inc.	HI	Durable Medical Equipment & Medical Supplies	$0	$4.7M

Kuakini Medical Center — Billing Profile & Reimbursement Data

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Kuakini 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