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.

Children's Doctors (NPI 1396936811)

Field	Value
Entity Type	Organization
Organization	Children's Doctors
Address	1029 Kapahulu Ave
City	Honolulu
State	HI
ZIP	96816
Taxonomy	Pediatrics Physician
NPI Enumerated	August 8, 2007

Payer Source	Total Paid
Medicaid	$110.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	3,650	$10	$51.2K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	610	$30	$20.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	6,630	$1	$13.3K
99441	N/A	480	$10	$5.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	$20	$4.1K
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…	210	$20	$4.1K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,640	$1	$3.6K
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…	60	$20	$1.1K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	260	$1	$1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	60	$20	$990

Showing 1–10 of 23

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

Children's Doctors — 2 of 18 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

23 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…	124	710	650	$90	$274.1K
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…	79	100	210	$120	$116.7K
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…	52	100	210	$110	$101.4K
99441	N/A	13	40	90	$50	$65.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	57	110	230	$90	$55.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	63	90	180	$70	$31.4K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	14	70	290	$30	$14K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	70	80	90	$10	$12.5K
0072A	N/A	43	50	50	$30	$5.1K
0071A	N/A	44	50	50	$30	$4.9K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Children's Doctors, 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
The Arc In Hawaii	HI	Voluntary or Charitable Agency	$0	$12.7M
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

Children's Doctors — Billing Profile & Reimbursement Data

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Children's Doctors — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References