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.

Maui Medical Group Inc (NPI 1215963970)

Key Findings

Field	Value
Entity Type	Organization
Organization	Maui Medical Group Inc
Address	2180 Main St
City	Wailuku
State	HI
ZIP	96793
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 24, 2006

Payer Source	Total Paid
Medicaid	$9M
Medicare	$0

MAUI MEDICAL GROUP INC is effectively a single-payer Medicaid provider: there is no Medicare billing on file while Medicaid revenue totals $9M. This makes Medicaid the sole documented source of payer revenue in the dataset and indicates the provider’s operations and scale should be evaluated primarily through its Medicaid activity.

Revenue concentration is high: the precomputed top 3 Medicaid codes by revenue account for 68.9% of the provider’s total Medicaid revenue. Those top drivers are dominated by office/outpatient evaluation and management codes—99214, 99213, and 99233—indicating a concentrated mix where a small set of services produces most of the clinic’s billings.

Business/service-line implications from the top codes: 99214 ($3.4M, 40.0% of Medicaid revenue) and 99213 ($1.6M, 18.3%) show the practice is primarily delivering high-volume outpatient established-patient visits at moderate and low complexity levels, respectively. 99233 ($902.5K, 10.6%) and other inpatient E/M codes (99232, 99223, 99239) in the top list also indicate the group provides substantial hospital-based follow-up and inpatient care, so operations likely span both ambulatory clinic workflows and inpatient consults.

Competitive standing in-state is unusually strong for several high-volume codes: the provider ranks #2 of 690 for 99214 (100th percentile, described as an extreme outlier) and #6 of 707 for 99213 (99th percentile, extreme outlier), signaling the group is a dominant statewide provider of established-patient office visits under Medicaid. For pediatric preventive visit codes 99393 and 99394 the provider ranks #1 in-state (100th percentile), further highlighting leadership in well-child services for ages 5–17.

Several codes are flagged as statistical outliers or notably above typical state volume: 99214 and 99213 are labeled extreme outliers, 99233 is described as notably above typical state volume, and 99393/99394 are extreme outliers as well. These labels reinforce that this provider’s claim volumes for core E/M and preventive pediatric services are far above typical in Hawaii, implying a concentration of primary-care and hospital follow-up activity relative to peers.

Operational mix includes ancillary services but at much smaller scale: diagnostic imaging (77067, 71046, 77063), allergy testing/preparation (95165, 95004), therapeutic exercise (97110), and ENT endoscopy (31231) appear in the top-25 Medicaid list but each contributes well under 2% of Medicaid revenue. These line items suggest the group offers diversified outpatient capabilities onsite or via close referrals, but they do not drive revenue compared with core E/M visits.

The NPI was enumerated on 2006-06-24 (~20 years ago), indicating long tenure in the market. Combined with the provider’s dominant in-state ranks on multiple high-volume codes, this suggests an established practice with sustained high Medicaid engagement and referral or catchment advantages in WAILUKU, HI.

Medicaid: Complete Services Breakdown

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

145 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…	81,380	$40	$3.4M
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…	65,230	$20	$1.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	18,050	$50	$902.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,560	$50	$370.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,690	$50	$267.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,240	$30	$255.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2,680	$90	$249.1K
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…	2,290	$100	$217.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	3,910	$50	$211.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,610	$50	$166.1K

Showing 1–10 of 145

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

Maui Medical Group Inc — 9 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

145 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…	64	70	370	$150	$457.3K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	19	30	1,370	$110	$333.9K
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…	26	30	200	$290	$329.1K
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…	6	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…	2	690	650	$90	$235.4K
H0031	Mental health assessment, by non-physician	2	10	2,010	$80	$153.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3	70	520	$50	$125.4K
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,…	54	190	190	$100	$122.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9	100	210	$120	$116.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	422	440	500	$90	$116.1K

Showing 1–10 of 145

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lana Wilkinson	HI	Diagnostic Radiology Physician	$271.8K	$0
Ellecia Cook	HI	Dermatology Physician	$211.4K	$0
Robert Loree	HI	Diagnostic Radiology Physician	$197.5K	$0
Aaron Milstone	TN	Pulmonary Disease Physician	$193.9K	$0
Marc Rosenthal	HI	Otolaryngology Physician	$190.9K	$0
Turgut Berkmen	CT	Vascular & Interventional Radiology Physician	$155.4K	$0
George Powell	HI	Neurology Physician	$141.9K	$0
Yachao Zhang	DC	Diagnostic Radiology Physician	$96.8K	$44.1K
Constantin Novoselsky	HI	Internal Medicine Physician	$122.8K	$0
William Mitchell	HI	Internal Medicine Physician	$107.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maui Health System A Kaiser Foundation Hospitals LLC	HI	General Acute Care Hospital	$0	$60.3M
Community Clinic Of Maui, Inc.	HI	Community Health Clinic/Center	$0	$21.6M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$15.6M
Bayada Home Care	HI	Nursing Care Agency	$0	$6M
Community Clinic Of Maui, Inc.	HI	Multi-Specialty Clinic/Center	$0	$4.8M
Maui Memorial Emergency Medical Associates Inc	HI	Emergency Medicine Physician	$0	$3.8M
Bayada Home Care	HI	In Home Supportive Care Agency	$0	$3.7M
Ka Lima O Maui Ltd	HI	Developmentally Disabled Services Day Training Agency	$0	$1.7M
Metropacific Group, Corp	HI	In Home Supportive Care Agency	$0	$1.3M
Hawaii Life Flight, LLC	HI	Air Ambulance	$218.1K	$883.5K

Maui Medical Group Inc — Billing Profile & Reimbursement Data

Sign up for Maui Medical Group Inc — Billing Profile & Reimbursement Data policy alerts

Maui Medical Group Inc — Billing Profile & Reimbursement Data

Sign up for Maui Medical Group Inc — Billing Profile & Reimbursement Data policy alerts

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