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.

Stephen T Foley Md LLC (NPI 1386087187)

Field	Value
Entity Type	Organization
Organization	Stephen T Foley Md LLC
Address	1329 Lusitana St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	April 10, 2013

Payer Source	Total Paid
Medicaid	$382K
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	2,130	$80	$165.9K
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…	1,620	$90	$137.9K
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…	1,110	$40	$41.1K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	360	$70	$24.7K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	130	$40	$5.9K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	410	$10	$2.9K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	540	$1	$1.6K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	10	$90	$1K
87210	The lab analyst or microbiologist performs a wet mount preparation of a specimen, usually from material collected on a swab or placed directly on a microscope slide.	200	$10	$1000

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

Stephen T Foley Md LLC — 0 of 9 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

9 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…	288	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…	203	690	650	$90	$235.4K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	5	20	160	$70	$107.8K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	17	20	550	$50	$100.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	20	20	30	$140	$40.2K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	18	40	170	$40	$28.9K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	37	70	560	$1	$6.4K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	15	30	350	$1	$2.2K
87210	The lab analyst or microbiologist performs a wet mount preparation of a specimen, usually from material collected on a swab or placed directly on a microscope slide.	4	10	90	$1	$760

Nearby Providers

Other providers in the same ZIP code as Stephen T Foley Md LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M

Stephen T Foley Md LLC — Billing Profile & Reimbursement Data

Sign up for Stephen T Foley Md LLC — Billing Profile & Reimbursement Data policy alerts

Stephen T Foley Md LLC — Billing Profile & Reimbursement Data

Sign up for Stephen T Foley Md LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References