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.

Careresource Hawaii (NPI 1245299114)

Field	Value
Entity Type	Organization
Organization	Careresource Hawaii
Address	680 Iwilei Rd
City	Honolulu
State	HI
ZIP	96817
Taxonomy	Home Health Agency
NPI Enumerated	March 20, 2006

Payer Source	Total Paid
Medicaid	$12.8M
Medicare	$0

Key Findings

CARERESOURCE HAWAII reports no Medicare billing on file and $12.8M in lifetime Medicaid revenue, making its current billings effectively single-payer with Medicaid as the dominant revenue source. This concentration on Medicaid means analyses of utilization and network impact should focus on state Medicaid patterns rather than Medicare benchmarks.

Revenue is highly concentrated in a few time-based in-home care codes: S9122 accounts for $4M (31.0% of Medicaid revenue), S9123 accounts for $3.6M (28.3%), and G0299 accounts for $2.3M (18.3%), with the precomputed top-3 share totaling 77.7% of the provider’s Medicaid revenue. This concentration indicates a small set of services drives the majority of payer dollars for this agency.

The provider’s code mix — dominated by S9122 (home health aide/CNA per hour), S9123 (nursing care by RN per hour) and G0299 (direct skilled RN services per 15 minutes) — signals an operational focus on in-home direct care and skilled nursing rather than clinic-based or procedural services. Significant activity in G0151 (PT in the home; $1.1M, 8.8%) and S5130 (homemaker services; $1.1M, 8.6%) further indicates a blended model of skilled therapy and personal support services delivered in patients’ homes.

CARERESOURCE is a statewide leader on several high-volume Medicaid codes: S9122 ranks #1 of 67 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code) and G0299 ranks #1 of 15 providers in-state (100th percentile; notably above typical state volume for this code). S9123 also ranks highly at #2 of 24 providers (96th percentile; notably above typical state volume for this code), which collectively positions the agency as a dominant provider for home nursing and aide services in Hawaii.

The statistical labels in the source data underline outsized volume for core services: S9122 is explicitly flagged as an "extreme outlier," while S9123 and G0299 are described as "notably above typical" volumes. These descriptors suggest CARERESOURCE’s delivery footprint and staffing model are heavily weighted toward in-home aide and nursing capacity relative to most in-state peers.

The dominant codes are time-based (hourly and per-15-minute units), implying operational dependencies on high-volume hourly staffing, scheduling logistics, and reimbursement tied to face-to-face care minutes (examples: S9122, S9123, G0299, G0151). Payers and network managers should anticipate that payment models or prior authorization changes targeting time-based home services would materially affect this provider’s revenue.

Several listed codes appear with nonzero claim counts but $0 avg paid/claim (for example 1AA11: 413 claims, $0; A6216: 341 claims, $0; Q5001: 1.5K claims, $0), indicating a mix of low-revenue supply lines, bundled items, or reporting artifacts that contribute little to Medicaid revenue. These zero-paid lines are peripheral to the provider’s financial profile but are relevant for auditing documentation and encounter reporting completeness.

CARERESOURCE’s NPI was enumerated on 2006-03-20 (~20 years ago), indicating long tenure in the market; combined with its concentrated Medicaid revenue and top-state rankings on key home-care codes, the provider appears to be an established, specialized home health agency with entrenched Medicaid business in Hawaii.

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	47,900	$80	$4M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	16,490	$220	$3.6M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	23,000	$100	$2.3M
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	11,570	$100	$1.1M
S5130	Homemaker service, nos; per 15 minutes	26,350	$40	$1.1M
S9124	Nursing care, in the home; by licensed practical nurse, per hour	2,230	$110	$245.3K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	4,340	$60	$243.2K
G0157	Services performed by a qualified physical therapist assistant in the home health or hospice setting, each 15 minutes	2,010	$60	$124.9K
A6212	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	50	$230	$12.6K
A6197	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	10	$440	$5.2K

Showing 1–10 of 19

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

Careresource Hawaii — 6 of 11 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	1	70	5,120	$130	$1.2M
S9123	Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used)	2	20	2,130	$240	$1M
S5130	Homemaker service, nos; per 15 minutes	8	80	5,320	$90	$776.6K
G0151	Services performed by a qualified physical therapist in the home health or hospice setting, each 15 minutes	1	10	1,710	$70	$247.6K
S9124	Nursing care, in the home; by licensed practical nurse, per hour	1	10	2,230	$110	$245.2K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	1	20	980	$60	$244.4K
A6197	Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing	2	10	1,090	$210	$227.9K
G0152	Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes	1	10	430	$80	$123.8K
A6212	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	2	10	50	$70	$66.8K
Q5001	Hospice or home health care provided in patient's home/residence	2	10	300	$90	$50.8K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Careresource Hawaii, 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
Lanakila Pacific	HI	Home Delivered Meals	$0	$11.7M
Usrc Aloha LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.1M
Kuakini Medical Center	HI	General Acute Care Hospital	$0	$10.9M
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

Careresource Hawaii — Billing Profile & Reimbursement Data

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Careresource Hawaii — 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

Nearby Providers

Frequently Asked Questions

References