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NPI 1336195627 · Honolulu, HI · Specialist
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Oleksandr Pishchalenko is a specialist provider located in Honolulu, Hawaii. This profile covers 4 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Oleksandr Pishchalenko |
| Address | 347 N. Kuakini St, Hpm-9 |
| City | Honolulu |
| State | HI |
| ZIP | 96817 |
| Taxonomy | Specialist |
| NPI Enumerated | May 26, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $899.7K |
| Medicaid | $356.9K |
This provider bills materially to both Medicare and Medicaid but Medicare is the larger payer in scale: total Medicare revenue on file is $899.7K while total Medicaid revenue is $356.9K, so the practice is not single-payer but Medicare represents the dominant revenue source. The provider is listed as a Specialist in HONOLULU, HI, which aligns with the procedural mix described below.
Medicare revenue is highly concentrated in a very small set of codes: 99310 alone accounts for $768.9K (85.7% of the provider's Medicare revenue) and the precomputed top-three share is 98.6% of total Medicare revenue. That level of concentration indicates the practice’s Medicare business is almost entirely driven by prolonged, high-complexity nursing facility follow-up visits.
Medicaid revenue is even more concentrated: 99310 generates $356K (99.3% of the provider's Medicaid revenue) and the precomputed top-three share is 100.0% of total Medicaid revenue. For Medicaid the provider is effectively single-code dependent, with nearly all state Medicaid receipts coming from the same prolonged nursing facility follow-up service.
The code mix (predominantly 99310, with supporting volume in 99306 and 99350) signals a service-line focused on nursing facility and prolonged home/residence evaluation and management visits—care that involves high medical decision making and extended time on site. This pattern suggests the provider operates primarily in post-acute, long-term care, and house-call settings rather than an office-based ambulatory practice.
Competitive standing for the Medicare-dominant code is exceptional: 99310 ranks #1 of 12486 providers nationally (100th percentile; labeled an extreme outlier), indicating far higher national volume on that code than typical peers. Secondary Medicare codes show more typical footprints—99350 ranks #335 of 7304 (95th percentile) and 99306 ranks #2292 of 12836 (82th percentile)—which supports the interpretation that the provider’s prominence is concentrated in a single dominant service.
State-level competitive position on Medicaid mirrors Medicare dominance for the same code: 99310 ranks #1 of 6 providers in-state (100th percentile; notably above typical state volume), while other Medicaid codes such as 99306 (rank #3 of 5, 50th percentile) and 99309 (rank #21 of 23, 9th percentile) show modest or below-average participation. This means the provider is a leading in-state source for prolonged nursing facility follow-up under Medicaid but not broadly dominant across other related codes.
Average paid-per-claim differences underscore payer pricing variation: for 99310 the Medicare avg paid/claim is $124 while the Medicaid avg paid/claim for the same code is $31, and for other listed codes Medicaid avg paid/claim values are in the $28–$36 range. Those differences indicate Medicare is materially more lucrative per encounter for the provider even as both payers reimburse the same service types that drive volume.
The NPI was enumerated on 2006-05-26 (~20 years ago), indicating a long-tenured practice which likely supports established referral lines into nursing facilities and home-visit programs. Combined with the extreme concentration in a small set of prolonged E/M codes, the tenure suggests a stable, specialized operational model rather than a broad multispecialty ambulatory practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 6,200 | $120 | $768.9K |
| 99350 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60… | 630 | $150 | $93.4K |
| 99306 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least… | 150 | $150 | $22.3K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 150 | $90 | $13K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 11,480 | $30 | $356K |
| 99306 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least… | 40 | $40 | $1.3K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 50 | $30 | $1.3K |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 1 | 10 | 50 | $30 | $59.6K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 21 | 20 | 180 | $20 | $18.3K |
| 99306 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least… | 3 | 10 | 40 | $40 | $4K |
Other providers in the same ZIP code as Oleksandr Pishchalenko, ranked by combined Medicare and Medicaid revenue.
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