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.

Portner Orthopedic Rehabilitation Incorporated (NPI 1316087315)

Portner Orthopedic Rehabilitation Incorporated is a physical medicine & rehabilitation physician provider located in Kaneohe, Hawaii. This profile covers 0 Medicare and 12 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Portner Orthopedic Rehabilitation Incorporated
Address	45-1144 Kamehameha Hwy Ste 200
City	Kaneohe
State	HI
ZIP	96744
Taxonomy	Physical Medicine & Rehabilitation Physician
NPI Enumerated	February 7, 2007

Payer Source	Total Paid
Medicaid	$672.8K
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	10,210	$30	$326.8K
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…	4,290	$70	$312.8K
98925	The provider performs controlled manual pressure in one or two body regions to treat somatic and nonsomatic disorders.	630	$20	$10K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	750	$10	$9.8K
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…	200	$30	$5.1K
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,…	190	$30	$4.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	80	$30	$2.1K
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…	10	$50	$550
98926	The provider performs controlled manual pressure in three to four body regions to treat somatic and nonsomatic disorders.	20	$20	$380
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	60	$10	$340

Showing 1–10 of 12

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

Portner Orthopedic Rehabilitation Incorporated — 1 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

12 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…	38	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…	91	690	650	$90	$235.4K
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,…	93	190	190	$100	$122.8K
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…	86	110	1,000	$40	$108.5K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	71	90	690	$20	$47.3K
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…	108	170	120	$70	$35.7K
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…	165	170	70	$90	$23.3K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	13	40	310	$10	$11.6K
98925	The provider performs controlled manual pressure in one or two body regions to treat somatic and nonsomatic disorders.	1	10	40	$20	$3.4K
98926	The provider performs controlled manual pressure in three to four body regions to treat somatic and nonsomatic disorders.	3	10	60	$60	$2.9K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott Miscovich	HI	Family Medicine Physician	$157.4K	$0
Spencer Lau	HI	General Practice Physician	$42.3K	$45.7K
Ka'ohimanu Akiona	HI	Family Medicine Physician	$39.9K	$0
Vincent Leon	HI	Family Medicine Physician	$6.7K	$0

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

Portner Orthopedic Rehabilitation Incorporated — Billing Profile & Reimbursement Data

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Portner Orthopedic Rehabilitation Incorporated — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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