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.

Molokai General Hospital (NPI 1366486979)

Key Findings

Field	Value
Entity Type	Organization
Organization	Molokai General Hospital
Address	280 Homeolu Place
City	Kaunakakai
State	HI
ZIP	96748
Taxonomy	Critical Access Hospital
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

MOLOKAI GENERAL HOSPITAL shows no Medicare billing on file (Medicare revenue: none) and is effectively a single-payer Medicaid operation at scale (Total Medicaid revenue: $14.5M). The absence of Medicare claims means assessors should treat Medicaid performance as the primary indicator of the hospital’s inpatient/outpatient activity and financial footprint.

Revenue is highly concentrated in emergency-department evaluation & management codes: the precomputed top three Medicaid codes (99283, 99284, 99282) account for 77.0% of the provider’s Medicaid revenue. The single largest code, 99283, generated $5.9M in revenue (8.6K claims, $686 avg paid/claim) and alone represents 41.0% of Medicaid receipts, indicating that ED visits are the dominant revenue driver.

The detailed Medicaid mix reinforces an ED-centered service profile: 99284 produced $3.3M (3.8K claims, $867 avg paid/claim; 22.8% of Medicaid revenue) and 99282 produced $1.9M (4.1K claims, $459 avg paid/claim; 13.2% of Medicaid revenue). Taken together, these ED E/M codes (99282–99284) form the core clinical offering and suggest the hospital operates with a high volume of unscheduled/emergency care.

Because 77.0% of Medicaid revenue is concentrated in three ED codes, the hospital is exposed to utilization or reimbursement changes affecting emergency services. That concentration implies financial sensitivity to policy or payer edits targeting ED E/M coding and payments, and it underscores the operational importance of maintaining ED throughput and staffing.

Competitive standing within the state for the top ED codes is modest and generally mid‑range rather than dominant: 99283 ranks #23 of 45 providers (50th percentile), 99284 ranks #23 of 47 (52nd percentile), and 99282 ranks #12 of 31 (63rd percentile). These percentiles characterize MOLOKAI as a typical in‑state participant for these ED services, with solid volume but not a leading statewide position.

Ancillary services complement the ED-driven mix: 85025 (CBC) produced $452.8K on 11.9K claims (3.2% of Medicaid revenue) and ranks #19 of 85 providers (79th percentile), while CT and lab panels (74177, 70450, 80053, 80048) also appear in the top codes with meaningful per‑claim payments. These data indicate consistent lab and basic imaging throughput supporting emergency care rather than a procedure-heavy specialty profile.

On statistical standing, no top Medicaid codes are flagged as outliers in the supplied labels; most codes are described as "typical, unremarkable volume for this code." A few lab/test codes sit in higher percentiles (for example, 85025 at the 79th percentile and 87880 at the 81st percentile), which suggests relatively stronger lab testing compared with peers despite the overall characterization as typical.

The provider’s administrative tenure is long enough to indicate established operations: NPI enumerated on 2006-06-15 (~20 years ago). That longevity combined with a Medicaid-centric and ED-focused revenue mix suggests the hospital is a stable, community-level acute care provider whose fiscal health will largely track Medicaid ED volumes and related ancillary services.

Medicaid: Complete Services Breakdown

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

98 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	8,590	$690	$5.9M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	3,770	$870	$3.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	4,130	$460	$1.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,100	$800	$1.7M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	11,920	$40	$452.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	90	$2,340	$201.1K
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…	2,870	$60	$180.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	9,440	$20	$179.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	290	$400	$115.7K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	880	$110	$94.6K

Showing 1–10 of 98

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

Molokai General Hospital — 0 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

98 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	23	50	8,590	$340	$5.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	23	50	3,740	$290	$3.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	25	40	3,820	$330	$3.3M
S5170	Home delivered meals, including preparation; per meal	6	10	4,260	$110	$2.5M
G0378	Hospital observation service, per hour	13	10	3,250	$480	$2.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	12	30	2,660	$330	$1.5M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	27	40	1,050	$510	$1.3M
J3490	Unclassified drugs	10	50	160	$200	$740.3K
99281	The provider sees a patient for the lowest level emergency department visit.	15	20	950	$220	$651.2K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	25	30	770	$430	$536.6K

Showing 1–10 of 98

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Molokai General Hospital	HI	Rural Health Clinic/Center	$0	$3.1M
Ilya Yepishin	HI	Family Medicine Physician	$47.9K	$0
Jason Woo	HI	Emergency Medicine Physician	$31K	$0
Eesha Bhattacharyya	HI	Obstetrics & Gynecology Physician	$8.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Molokai Ohana Health Care, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$3.1M
Careresource Hawaii	HI	In Home Supportive Care Agency	$0	$2M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.1M
Molokai Ohana Health Care, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$612.7K
Hawaii Life Flight, LLC	HI	Air Ambulance	$0	$568.8K
Aluli And Reyes LLP	HI	Family Medicine Physician	$0	$172.6K
Molokai Drugs, Inc.	HI	Community/Retail Pharmacy	$18.1K	$2.1K

Molokai General Hospital — 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