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.

Kauai Medical Clinic (NPI 1376596643)

Kauai Medical Clinic is a multi-specialty clinic/center provider located in Lihue, Hawaii. This profile covers 0 Medicare and 102 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	Kauai Medical Clinic
Address	3-3420 Kuhio Hwy
City	Lihue
State	HI
ZIP	96766
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

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

102 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…	55,720	$30	$1.5M
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.	18,510	$40	$814.3K
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…	49,480	$20	$791.7K
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.	9,000	$60	$558.2K
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…	7,830	$40	$281.9K
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…	4,900	$20	$98K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,770	$20	$86.6K
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…	2,090	$30	$71.2K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1,770	$40	$70.7K
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.	1,370	$40	$56.3K

Showing 1–10 of 102

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

Kauai Medical Clinic — 7 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

102 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.	33	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.	11	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.	10	40	3,820	$330	$3.3M
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.	22	40	1,050	$510	$1.3M
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.	22	30	770	$430	$536.6K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	5	10	670	$60	$385.4K
J0585	Injection, onabotulinumtoxina, 1 unit	4	10	50	$1,110	$350.9K
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…	15	30	1,370	$110	$333.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	28	30	200	$290	$329.1K
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…	9	710	650	$90	$274.1K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vinh Trang	WA	Hematology & Oncology Physician	$280.9K	$0
Brandon Mason	OK	Diagnostic Radiology Physician	$277.6K	$0
Carrie Fitzgerald	NJ	Urology Physician	$227.8K	$0
Jonathan Farrell	RI	Emergency Medicine Physician	$166.6K	$0
John Funai	HI	Cardiovascular Disease Physician	$166.3K	$0
Andrew So	PA	Cardiovascular Disease Physician	$148.8K	$0
Tyler Chihara	HI	Podiatrist	$140.6K	$0
Thomas Capelli	HI	Internal Medicine Physician	$137.3K	$0
Willie Nunez	NM	Vascular & Interventional Radiology Physician	$118.2K	$0
Amy Corliss	HI	Hospitalist Physician	$103.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wilcox Memorial Hospital	HI	Rural Acute Care Hospital	$0	$28M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.7M
Bayada Home Care	HI	In Home Supportive Care Agency	$0	$3.5M
Karin Stoll	HI	Mental Health Counselor	$52.7K	$1.2M
Kuhio Pediatric Dental LLC	HI	General Practice Dentistry	$0	$925.9K
Hawaiian Island Dental, Inc.	HI	General Practice Dentistry	$0	$875.6K
Hawaii Life Flight, LLC	HI	Air Ambulance	$458.5K	$370K
Toothbuds Kauai, LLC	HI	Dentist	$0	$803.9K
Stephanie Skow Md Inc	HI	Psychiatry Physician	$0	$545.8K
Mastercare Inc	HI	In Home Supportive Care Agency	$0	$522.7K

Kauai Medical Clinic — Billing Profile & Reimbursement Data

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Kauai Medical Clinic — 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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