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.

Innovation Md LLC (NPI 1225352966)

Field	Value
Entity Type	Organization
Organization	Innovation Md LLC
Address	45-1151 Kamehameha Hwy Ste C
City	Kaneohe
State	HI
ZIP	96744
Taxonomy	Family Medicine Physician
NPI Enumerated	March 24, 2010

Payer Source	Total Paid
Medicaid	$360.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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…	3,080	$60	$194K
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…	3,790	$40	$163.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	130	$10	$1.8K
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…	60	$30	$1.6K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	10	$10	$80
3008F	No Summary found for this code	730	$0	$0
3077F	No Summary found for this code	70	$0	$0
3080F	No Summary found for this code	70	$0	$0
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	60	$0	$0
S9999	Sales tax	260	$0	$0

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

Innovation Md LLC — 0 of 5 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

10 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…	120	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…	123	690	650	$90	$235.4K
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…	16	20	310	$20	$6.8K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	65	90	240	$1	$2.5K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	36	70	130	$10	$2.4K
3008F	No Summary found for this code	41	90	660	$1	$1.9K
S9999	Sales tax	112	240	200	$1	$820
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	46	50	60	$1	$550
3080F	No Summary found for this code	14	30	70	$1	$20
3077F	No Summary found for this code	33	40	180	$1	$20

Nearby Providers

Other providers in the same ZIP code as Innovation Md LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Alcoholic Rehabilitation Services Of Hawaii Inc	HI	Substance Abuse Rehabilitation Facility	$0	$4.5M
Oahu Oral And Maxillofacial Surgery	HI	Oral and Maxillofacial Surgery Clinic/Center	$0	$3.7M
Po Ailani	HI	Mental Illness Community Based Residential Treatment Facility	$0	$3.3M
Usrc Ko'olau LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.6M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.1M
Western Health Resources	HI	Home Health Agency	$0	$1.9M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.5M
Usrc Windward, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.4M
Paul M.t. Yim	HI	Dentist	$0	$960.9K
Windward Pediatrics, Inc.	HI	Specialist	$0	$848.2K

Innovation Md LLC — Billing Profile & Reimbursement Data

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Innovation Md LLC — 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