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.

Darren Egami (NPI 1265584502)

Field	Value
Entity Type	Individual
Organization	Darren Egami
Address	1885 Main St Ste 104
City	Wailuku
State	HI
ZIP	96793
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	January 17, 2007

Payer Source	Total Paid
Medicare	$541.3K
Medicaid	$0

Key Findings

DARREN EGAMI is an orthopaedic surgery physician with an NPI enumerated 2007-01-17 (~19 years ago) and shows total Medicare revenue of $541.3K with no Medicaid billing on file; this profile is effectively single-payer (Medicare) for the claims on record. The absence of any Medicaid billing on file should be recognized by payers and analysts as a material absence of dual-payer exposure when assessing network mix or contracting leverage.

Revenue concentration is extreme: the top 3 Medicare codes (J7320, 20611, 99214) account for 93.7% of this provider's total Medicare revenue. In dollar terms those codes are J7320 $300.7K (55.7% of total), 20611 $155.6K (28.8% of total), and 99214 $49.4K (9.1% of total), indicating very high reliance on a narrow set of services.

The code mix points to an office-based procedural practice focused on joint injections and aspiration: J7320 (hyaluronan intra-articular injections) and 20611 (arthrocentesis with ultrasound guidance) drive the majority of revenue, while 99214 reflects moderate-complexity follow-up outpatient visits that support procedural throughput. This combination is consistent with a practice model that delivers frequent injectable therapies and ultrasound-guided joint procedures alongside E/M visits.

20611 is a pronounced statistical outlier: it ranks #7 of 8465 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), highlighting that this provider is a very high-volume national outlier for ultrasound-guided arthrocentesis. By contrast J7320 ranks #16 of 462 (97th percentile; typical, unremarkable volume for this code) and 99214 ranks #45114 of 479517 (91th percentile; typical, unremarkable volume for this code), indicating the provider’s dominant national signal is specific to the arthrocentesis procedure rather than across all common office codes.

Operational detail from claim counts and average payment shows a high-volume, low-per-claim pattern for the dominant injection code: J7320 has 43K claims at $7 avg paid/claim for $300.7K revenue, while 20611 has 1.9K claims at $82 avg paid/claim for $155.6K revenue. This suggests the practice generates sizable unit volumes for hyaluronan product billing and sustained throughput for ultrasound-guided procedures rather than relying on high per-claim reimbursement.

There is measurable use of imaging support in procedural work: 76942 appears with 74 claims, $48 avg paid/claim, $3.6K revenue (0.7% of total), which aligns with the ultrasound-guided descriptor for 20611 and confirms on-record use of ultrasonography to guide interventions. Including imaging aligns with the provider’s procedural profile and supports the accuracy of the 20611 coding pattern.

From a payer risk and contracting perspective, the combination of single-payer concentration (Medicare $541.3K and no Medicaid billing) and heavy dependence on three codes (93.7% of Medicare revenue) creates exposure to reimbursement or coverage changes for J7320 and 20611. Payers and network analysts should treat this provider as a specialized, procedure-focused resource whose revenue and utilization could change materially if policy or coverage for viscosupplementation or ultrasound-guided arthrocentesis shifts.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J7320	Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg	42,950	$10	$300.6K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	1,900	$80	$155.6K
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…	530	$90	$49.4K
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…	270	$70	$17.8K
J7321	Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	110	$50	$5.6K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	70	$50	$3.6K
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…	30	$120	$3.3K
20550	Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation.	50	$40	$2.1K
99203	The provider sees a new 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 provider…	20	$70	$1.6K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	120	$1	$120

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Darren Egami — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J7320	1	10	23,340	$10	$164.9K
99214	112	1,440	100	$80	$15.2K
20611	1	20	50	$80	$11.2K
99213	221	1,460	70	$60	$8.4K
J7321	4	10	100	$60	$7K
99204	338	630	30	$110	$5.3K
99203	279	450	30	$70	$3.6K
20550	11	20	50	$40	$2.9K
76942	3	30	20	$30	$1.2K
J3301	43	90	100	$1	$140

Nearby Providers

Other providers in the same ZIP code as Darren Egami, ranked by combined Medicare and Medicaid revenue.

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
Maui Medical Group Inc	HI	Internal Medicine Physician	$0	$9M
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

Darren Egami — Billing Profile & Reimbursement Data

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Darren Egami — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References