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.

Kaiser Foundation Hospitals (NPI 1396813861)

Field	Value
Entity Type	Organization
Organization	Kaiser Foundation Hospitals
Address	3288 Moanalua Rd
City	Honolulu
State	HI
ZIP	96819
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 1, 2006

Payer Source	Total Paid
Medicaid	$76.5M
Medicare	$0

Key Findings

This provider reports no Medicare billing on file and $76.5M in lifetime Medicaid revenue, making its publicly visible business effectively single‑payer Medicaid in the available data. The absence of Medicare volume suggests payer mix and reimbursement exposure are concentrated in Medicaid, which will materially shape contracting and utilization analyses for this entity.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top‑3 Medicaid codes account for 37.2% of the provider’s total Medicaid revenue. The three highest‑revenue codes are 99283 ($12M, 19.6%), 99284 ($6.3M, 10.4%), and 84443 ($4.4M, 7.1%), indicating a relatively narrow set of services driving a large share of payouts.

The code mix for the top revenue drivers points to an operational emphasis on emergency department and core clinical lab services. Codes 99283 and 99284 are ED E/M visits (low and moderate decision making), and 84443 is TSH testing, so the combination of E/M and high‑volume laboratory testing suggests the site supports both acute ED throughput and substantial outpatient/ambulatory lab volume.

Within the state competitive landscape the hospital shows a solid but not dominant ED footprint: 99283 ranks #7 of 45 (86th percentile) and 99284 ranks #17 of 47 (65th percentile), both labeled as typical, unremarkable volumes. These ranks imply the hospital is a meaningful ED participant in Hawaii but not the statewide leader for emergency services.

Laboratory and infection testing is a comparatively stronger area of state competitiveness; several lab codes place the provider at or near the top of in‑state peers. Examples include 84443 at #3 of 22 (90th percentile), 80061 at #3 of 24 (91th percentile), 87651 at #1 of 21 (100th percentile; notably above typical state volume), 83036 at #3 of 72 (97th percentile; notably above typical state volume), and U0003 at #3 of 19 (89th percentile; notably above typical state volume), which together indicate a high-volume laboratory/testing operation that likely serves significant outpatient and public‑health testing demand.

Ancillary acute care services such as observation and imaging contribute materially but to a lesser degree: G0378 (hospital observation service) is $3.3M (5.4%) and 74177 (CT abdomen/pelvis with contrast) is $2.6M (4.2%) of Medicaid revenue. These lines support a picture of an acute care hospital providing observation beds and advanced imaging tied to its ED and inpatient workflows rather than relying exclusively on ambulatory clinic visits.

Pathology and procedural pathology work also appear as supporting revenue streams: 88305 surgical pathology is $1.6M (2.7%) and other specialty lab panels (81420 at $763K, 87505 at $777.7K) show the hospital performs higher‑complexity diagnostics. The spread across histopathology, genomic panels, and multiplex pathogen testing suggests in‑house lab capacity beyond routine screening.

The provider’s NPI was enumerated on 2006-12-01 (~20 years ago), indicating a long tenure in the Honolulu market. Combined with the Medicaid concentration and the mix of ED, observation, imaging, and extensive lab testing, this tenure supports the interpretation of an established acute care hospital with a pronounced role in Medicaid‑paid emergency and diagnostic services.

Medicaid: Complete Services Breakdown

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

344 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.	38,100	$320	$12M
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.	12,530	$510	$6.3M
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	40,380	$110	$4.4M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	27,290	$140	$3.8M
G0378	Hospital observation service, per hour	3,590	$920	$3.3M
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	40,600	$80	$3.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	27,110	$110	$3M
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	12,370	$230	$2.8M
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.	3,780	$680	$2.6M
87481	The lab analyst performs a test for Candida species using amplified nucleic acid probe technique.	3,260	$790	$2.6M

Showing 1–10 of 344

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

Kaiser Foundation Hospitals — 3 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

344 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.	7	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.	17	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.	29	40	3,820	$330	$3.3M
G0378	Hospital observation service, per hour	6	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.	15	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.	8	40	1,050	$510	$1.3M
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	3	10	4,430	$160	$842.9K
87505	The lab analyst performs a test to detect three to five types or subtypes of a pathogen, such as Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia, that cause gastrointestinal…	1	10	1,880	$410	$777.9K
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	1	10	1,340	$570	$763.2K
J3490	Unclassified drugs	7	50	160	$200	$740.3K

Showing 1–10 of 344

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kaiser Foundation Hospitals, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	CA	General Acute Care Hospital	$0	$83.1M
Kaiser Foundation Health Plan Inc	HI	Health Maintenance Organization	$0	$7.4M
Yi Zheng	CA	Gastroenterology Physician	$199.6K	$118.3K

Nearby Providers

Other providers in the same ZIP code as Kaiser Foundation Hospitals, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hawaii Permanente Medical Group Inc	HI	Health Maintenance Organization	$0	$75.8M
Procare Pharmacy, L.L.C.	HI	Specialty Pharmacy	$0	$41.8M
Value Drug Ltd	HI	Pharmacy	$0	$21.7M
Care Hawaii, Inc.	HI	Community/Behavioral Health Agency	$0	$11.8M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$10M
Hawaii Life Flight, LLC	HI	Air Ambulance	$636.1K	$8.5M
City And County Of Honolulu	HI	Land Ambulance	$3.3M	$5.3M
Keiki Dental Specialists	HI	Pediatric Dentistry	$0	$5.7M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$2M
Imua Medical Equipment And Supplies,llc	HI	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Kaiser Foundation Hospitals — 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