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.

Kahuku Medical Center (NPI 1245430065)

Key Findings

Field	Value
Entity Type	Organization
Organization	Kahuku Medical Center
Address	56-117 Pualalea St
City	Kahuku
State	HI
ZIP	96731
Taxonomy	Critical Access Hospital
NPI Enumerated	July 19, 2007

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

KAHUKU MEDICAL CENTER is effectively a single‑payer Medicaid provider: it reports $6.5M in total Medicaid revenue and has no Medicare billing on file. The facility is a Critical Access Hospital in KAHUKU, HI and its NPI was enumerated 2007-07-19 (~19 years ago), indicating nearly two decades of operation in its community.

Revenue is highly concentrated in a narrow set of emergency department E/M codes: the top three Medicaid codes (99283, 99284, 99285) together account for 87.0% of the provider’s total Medicaid revenue. This indicates the hospital’s financial base is heavily dependent on ED visits billed at low, moderate, and high levels of medical decision making.

The top three Medicaid codes break down as 99283 ($2.5M, 38.5%), 99284 ($1.7M, 26.6%), and 99285 ($1.4M, 21.9%); average paid per claim climbs with acuity ($282 for 99283, $451 for 99284, $802 for 99285), showing payment-per-visit increases for higher-acuity encounters even though higher‑acuity 99285 has fewer claims. That pattern underscores an ED workflow where many lower‑acuity visits numerically dominate but higher‑acuity visits materially lift reimbursement.

Competitive standing for the ED codes is modest within Hawaii rather than dominant: 99283 ranks #21 of 45 providers (55th percentile), 99284 ranks #22 of 47 (54th percentile), and 99285 ranks #26 of 39 (34th percentile), each described as "typical, unremarkable volume." These percentiles indicate KAHUKU MEDICAL CENTER is a mid‑tier in‑state participant for emergency visit volume rather than a market leader.

Ancillary service mix shows a meaningful but smaller role for therapy and routine labs: 97110 (therapeutic exercise) generated $197.1K (3.1% of Medicaid revenue) and ranks #29 of 110 providers (74th percentile), suggesting relatively stronger physical‑therapy activity versus peers; common lab codes such as 80061 (lipid panel, $127.4K, 2.0%) and 85025 (CBC, $72.1K, 1.1%) contribute modestly to revenue and sit near typical in‑state volumes.

Advanced imaging and specialty diagnostics appear limited: CT abdomen/pelvis with contrast 74177 produced $46.8K (0.7%) with a rank of #31 of 36 (14th percentile), and CT without contrast 74176 shows minimal volume and a bottom percentile; these low rankings are consistent with constrained on‑site advanced imaging capacity at a small rural CAH.

Operationally, the CPT mix—dominated by ED E/M codes with incremental reimbursement by acuity—aligns with a stabilization/ED throughput model common to Critical Access Hospitals. Given the $6.5M Medicaid revenue base and the 87.0% concentration in ED codes, the provider’s financial performance is likely sensitive to Medicaid payment policy and to shifts in local ED utilization patterns, particularly reductions in lower‑acuity ED visits.

Medicaid: Complete Services Breakdown

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

67 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	8,830	$280	$2.5M
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.	3,810	$450	$1.7M
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.	1,770	$800	$1.4M
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.	1,230	$180	$215.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3,580	$60	$197.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	970	$130	$127.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	6,010	$10	$72.1K
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.	30	$1,510	$46.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,130	$30	$35.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	2,030	$10	$22.3K

Showing 1–10 of 67

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

Kahuku Medical Center — 0 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

67 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.	21	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.	22	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.	26	40	3,820	$330	$3.3M
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.	20	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.	31	40	1,050	$510	$1.3M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	3	10	20,440	$30	$849.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	13	20	1,060	$60	$547.3K
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.	28	30	770	$430	$536.6K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	14	20	1,070	$50	$440.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	12	20	660	$20	$408.6K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kevin Lampert	CO	Diagnostic Radiology Physician	$451.6K	$0
David Camacho	HI	Diagnostic Radiology Physician	$414K	$0
Lori Wilhelm	HI	Diagnostic Radiology Physician	$334.9K	$0
Scott Grosskreutz	HI	Diagnostic Radiology Physician	$333.8K	$0
Ming Peng	HI	Diagnostic Radiology Physician	$283.3K	$0
Robert Saito	HI	Diagnostic Radiology Physician	$243K	$0
Stanley Smazal	CO	Diagnostic Radiology Physician	$195.4K	$0
Aaron Kirkpatrick	CO	Diagnostic Radiology Physician	$176.7K	$0
Bobby Kang	CO	Diagnostic Radiology Physician	$163.3K	$0
Andrew Olsen	CO	Diagnostic Radiology Physician	$159.6K	$0

Kahuku Medical Center — Billing Profile & Reimbursement Data

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Kahuku 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Shore Mental Health, Inc	HI	Case Management Agency	$0	$5M
Ko Olauloa Health Center	HI	Federally Qualified Health Center (FQHC)	$0	$3.5M
Kahuku Medical Center	HI	Specialist	$0	$2M
Kahuku Medical Center	HI	Rural Health Clinic/Center	$0	$99K
Jason Hughes	HI	Internal Medicine Physician	$12.3K	$0