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.

Waianae District Comprehensive Health And Hospital Board, Inc (NPI 1275566424)

Field	Value
Entity Type	Organization
Organization	Waianae District Comprehensive Health And Hospital Board, Inc
Address	86-260 Farrington Hwy
City	Waianae
State	HI
ZIP	96792
Taxonomy	Family Medicine Physician
NPI Enumerated	July 9, 2006

Payer Source	Total Paid
Medicaid	$125.3M
Medicare	$0

Key Findings

This entity reports $125.3M in lifetime Medicaid revenue and has no Medicare billing on file, making it effectively a single‑payer (Medicaid) provider in the datasets reviewed; the NPI was enumerated on 2006-07-09 (~20 years ago), indicating long tenure in the state. The absence of Medicare activity combined with large Medicaid volume suggests operational and reimbursement exposure is concentrated in state Medicaid policy and managed‑care contracting.

Medicaid revenue is highly concentrated: the top three Medicaid codes (99214, 99213, 90832) account for 76.9% of the provider’s total Medicaid revenue. Those three codes individually generate $41.4M (33.2%), $38.1M (30.6%), and $16.4M (13.2%) respectively, signaling a business model driven by high-volume established patient visits and psychotherapy services rather than a broad mix of specialty procedures.

The code mix points to a primary-care–centered delivery model with integrated behavioral health: 99214 (171K claims, $242 avg paid/claim, $41.4M) and 99213 (152.4K claims, $250 avg paid/claim, $38.1M) dominate clinical activity, implying large ambulatory throughput of established patients and frequent E/M encounters. Those volumes are consistent with a community clinic or health center handling routine and chronic care management at scale.

Behavioral health is a major service line: 90832 (68K claims, $242 avg paid/claim, $16.4M; ranks #1 of 74 providers in-state and is described as an extreme outlier), and additional mental‑health FQHC code G0470 (7.1K claims, $102 avg paid/claim, $726.4K; ranks #1 of 14) show substantial psychotherapy and mental‑health billing alongside primary care. This pattern indicates integrated behavioral health services are being delivered at volume rather than as a marginal add‑on.

FQHC and telehealth billing patterns are prominent. The provider reports G0467 (25.5K claims, $87 avg paid/claim, $2.2M; ranks #1 of 33) and G2025 (10.5K claims, $129 avg paid/claim, $1.4M; ranks #1 of 21), showing both federally qualified health center–style bundled visits and a high level of telehealth distant‑site services within Medicaid, which supports an operational model oriented to community access and remote care.

Preventive and pediatric services are meaningful components of the mix: 99391 (11.4K claims, $270 avg paid/claim, $3.1M; ranks #2 of 102) and 99392 (8K claims, $275 avg paid/claim, $2.2M; ranks #2 of 102) plus 99393 (3.7K claims, $274 avg paid/claim, $1M) indicate ongoing well‑visit throughput across age groups, reinforcing a comprehensive primary‑care footprint that includes routine prevention.

The provider’s statewide competitive standing is dominant for its core codes: 99214 and 99213 each rank #1 in‑state (100th percentile; extreme outlier) and 90832 also ranks #1 (100th percentile; extreme outlier), which classifies the organization as a major statewide participant for high‑volume E/M and psychotherapy services. Multiple other codes (e.g., G0467, G2025, 98967/98968) also appear at or near the top of in‑state rankings, underscoring its outsized role in Medicaid service delivery for the community it serves.

High concentration in a few codes (top three = 76.9% of Medicaid revenue) combined with the lack of Medicare revenue implies material payer and service concentration risk: changes to Medicaid reimbursement, prior‑authorization rules, or coding guidance for 99214/99213/90832 could have outsized financial impact. The profile does show diversification into telehealth, dental (D0140), ophthalmology (92014), and remote/telephonic services (98967/98968), but those lines are much smaller relative to the core E/M and psychotherapy volumes.

Medicaid: Complete Services Breakdown

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

171 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…	170,980	$240	$41.4M
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…	152,440	$250	$38.1M
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…	67,980	$240	$16.4M
D9999	N/A	30,080	$220	$6.6M
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,…	15,020	$240	$3.6M
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…	11,420	$270	$3.1M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	25,540	$90	$2.2M
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…	8,000	$280	$2.2M
D0140	Limited oral evaluation – problem focused	6,900	$230	$1.6M
99442	N/A	6,560	$230	$1.5M

Showing 1–10 of 171

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

Waianae District Comprehensive Health And Hospital Board, Inc — 16 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

171 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D9999	N/A	2	20	2,200	$280	$1.6M
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…	1	70	370	$150	$457.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	10	30	2,500	$40	$455.4K
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.	5	20	660	$20	$408.6K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	5	20	1,050	$30	$375.8K
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…	18	30	1,370	$110	$333.9K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	12	10	2,220	$60	$300.4K
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…	1	710	650	$90	$274.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	1	30	1,850	$60	$248.9K
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…	1	690	650	$90	$235.4K

Showing 1–10 of 171

Related Providers

Other providers that share a Tax Identification Number (TIN) with Waianae District Comprehensive Health And Hospital Board, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$18.5M
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$3.3M
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$2.2M
Amr El-sergany	HI	Vascular Surgery Physician	$1.5M	$0
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$1.4M
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$1.1M
Robert Aki	HI	Podiatrist	$58.9K	$960.1K
Waianae District Comprehensive Health And Hospital Board, Incorporated	HI	Federally Qualified Health Center (FQHC)	$0	$893.6K
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
Ryan Jean-baptiste	CA	Diagnostic Radiology Physician	$517K	$47K

Nearby Providers

Other providers in the same ZIP code as Waianae District Comprehensive Health And Hospital Board, Inc, 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	$8.9M
Kokua Villa, Inc.	HI	Developmental Disabilities Clinic/Center	$0	$3.9M
Usrc Waianae, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.4M
Alternative Structures International	HI	Developmentally Disabled Services Day Training Agency	$0	$3.2M
Dm Wellness LLC	HI	Community/Behavioral Health Agency	$0	$746.3K
Moana Gaspar	HI	Mental Health Counselor	$0	$745.9K
Waianae Valley Physical Therapy, Inc.	HI	Physical Therapist	$0	$737.6K
Jamie Liu	HI	Dentist	$0	$559K
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$531K
Waianae District Comprehensive Health And Hospital Board, Inc	HI	Clinical Medical Laboratory	$20.5K	$279.2K

Waianae District Comprehensive Health And Hospital Board, Inc — Billing Profile & Reimbursement Data

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Waianae District Comprehensive Health And Hospital Board, Inc — 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