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.

The Arc In Hawaii (NPI 1336237882)

Field	Value
Entity Type	Organization
Organization	The Arc In Hawaii
Address	3989 Diamond Head Rd
City	Honolulu
State	HI
ZIP	96816
Taxonomy	Voluntary or Charitable Agency
NPI Enumerated	October 10, 2006

Payer Source	Total Paid
Medicaid	$12.7M
Medicare	$0

Key Findings

THE ARC IN HAWAII is effectively a Medicaid-focused provider with no Medicare billing on file and $12.7M in lifetime Medicaid revenue; the absence of Medicare activity indicates a single-payer operational footprint centered on state Medicaid programs rather than dual Medicare/Medicaid service lines.

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes account for 97.6% of this provider's total Medicaid revenue, signaling that a handful of service categories drive nearly the entire Medicaid topline.

T2016 is the single largest revenue driver: 33.7K claims, $203 avg paid/claim, $6.8M revenue (53.9% of Medicaid revenue). This provider ranks #1 of 9 in-state for T2016 and is described as notably above typical state volume, marking THE ARC IN HAWAII as a dominant residential/waiver habilitation provider in Hawaii for that per-diem service.

H2032 is the second major contributor with 41.8K claims, $108 avg paid/claim, $4.5M revenue (35.6% of Medicaid revenue). The provider ranks #3 of 14 in-state (85th percentile) for H2032, indicating a strong but not singular position in activity therapy (per 15 minutes) relative to peers.

H2021 contributes meaningfully but at a lower level: 10.2K claims, $100 avg paid/claim, $1M revenue (8.0% of Medicaid revenue). With a rank of #6 of 24 in-state (78th percentile), this provider is a mid-tier statewide reporter of community-based wrap-around services rather than a market leader for that code.

The service mix (per-diem habilitation codes like T2016 alongside per-15-minute codes such as H2032 and H2021) indicates THE ARC IN HAWAII operates a blend of residential waiver, day habilitation/activity therapy, and community wrap-around supports; this mix is consistent with organizations focused on long-term developmental-disability habilitation and intensive community services.

Smaller Medicaid line items (for example, T2020 with 250 claims, $849 avg paid/claim, $212.3K revenue and H2016 with 248 claims, $339 avg paid/claim, $84.1K revenue) together represent a very minor portion of revenue, underscoring that strategic or reimbursement shifts affecting the top three codes would materially change the provider's financial profile.

The provider has long tenure in the NPI registry (enumerated 2006-10-10, ~20 years ago), which supports the interpretation that its concentrated Medicaid billing patterns reflect an established, stable operating model focused on specific waiver and habilitation service lines rather than a transient or newly scaled operation.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	33,660	$200	$6.8M
H2032	Activity therapy, per 15 minutes	41,830	$110	$4.5M
H2021	Community-based wrap-around services, per 15 minutes	10,170	$100	$1M
T2020	Day habilitation, waiver; per diem	250	$850	$212.3K
H2016	Comprehensive community support services, per diem	250	$340	$84.1K
H2015	Comprehensive community support services, per 15 minutes	110	$60	$6.5K
T2028	Specialized supply, not otherwise specified, waiver	130	$40	$5.7K

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

The Arc In Hawaii — 1 of 7 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	10	2,740	$1,170	$8.6M
H2021	Community-based wrap-around services, per 15 minutes	6	20	4,710	$400	$3.5M
H2032	Activity therapy, per 15 minutes	3	10	1,660	$110	$1.6M
H2015	Comprehensive community support services, per 15 minutes	29	30	2,300	$30	$634.2K
T2020	Day habilitation, waiver; per diem	5	10	270	$760	$239.4K
H2016	Comprehensive community support services, per diem	3	10	240	$300	$80.1K
T2028	Specialized supply, not otherwise specified, waiver	2	10	590	$10	$8.1K

Nearby Providers

Other providers in the same ZIP code as The Arc In Hawaii, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Medical Services System Hawaii Dept Of Health	HI	Land Ambulance	$3.1M	$32.4M
State Of Hawaii Department Of Education	HI	Local Education Agency (LEA)	$0	$10.1M
Special Education Center Of Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$9.4M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.6M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.9M
Usrc Kapahulu, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.8M
Allen K. Hirai Dds LLC	HI	Pediatric Dentistry	$0	$1.7M
Kahala Childrens Medical Group LLC	HI	Pediatrics Physician	$0	$1.4M
Pedodontic Associates Inc	HI	Pediatric Dentistry	$0	$978.7K
Smiles For Keiki Pediatric Dentistry, LLC	HI	Pediatric Dentistry	$0	$736.3K

The Arc In Hawaii — Billing Profile & Reimbursement Data

Sign up for The Arc In Hawaii — Billing Profile & Reimbursement Data policy alerts

The Arc In Hawaii — Billing Profile & Reimbursement Data

Sign up for The Arc In Hawaii — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References