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.

Hi'ilani Health Corporation (NPI 1417352063)

Field	Value
Entity Type	Organization
Organization	Hi'ilani Health Corporation
Address	108 Olokani Place
City	Wahiawa
State	HI
ZIP	96786
Taxonomy	Home Health Agency
NPI Enumerated	October 24, 2014

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

Key Findings

HI'ILANI HEALTH CORPORATION is effectively a single-payer Medicaid operator: there is no Medicare billing on file while lifetime Medicaid revenue totals $8.2M, indicating the organization's entire reported federal reimbursement footprint in our dataset comes from Medicaid. This concentration means analyses of payer mix, utilization, and financial exposure should be focused on Medicaid programs and reimbursement rules rather than Medicare policies.

Revenue is highly concentrated in two per-diem residential/foster care habilitation codes: S5140 accounts for $5.2M (63.1% of the provider's total Medicaid revenue) and T2016 accounts for $3M (36.9% of the provider's total Medicaid revenue). The precomputed top-3 codes together account for 100.0% of Medicaid revenue, so operational and financial risk is tightly linked to continued authorization and reimbursement for these service lines.

The code mix (S5140 — Foster care, adult; per diem — and T2016 — Habilitation, residential, waiver; per diem) signals that HI'ILANI operates residential or group-living support services rather than typical home health skilled-nursing visits. This suggests the organization’s business model centers on custodial, habilitative, and foster-care per-diem placements and daily residential supports rather than episodic medical care.

On state-market competitiveness, HI'ILANI ranks #2 of 7 providers in-state for S5140 and sits at the 83th percentile, which indicates it is a leading but not exclusive provider of adult foster-care per-diem services in Hawaii. Conversely, for T2016 it ranks #7 of 9 providers and is at the 25th percentile, indicating comparatively modest scale in the state for residential habilitation waiver services. These differing ranks show the entity is strong in foster-care per-diem services but only a modest participant in the habilitation waiver segment.

Tenure data show the NPI was enumerated on 2014-10-24 (~12 years ago). This length of active enrollment suggests an established presence in the state Medicaid market and that observed revenue patterns reflect multi-year operations rather than a very recent entrant. Analysts should consider historical continuity when assessing network relationships and referrals.

Volume and unit-payment patterns differ between the two top codes: S5140 has 1.3K claims with an average paid per claim of $3883, while T2016 has 793 claims with an average paid per claim of $3819. The similar average per-claim payments with differing claim counts explain why S5140 produces a larger share of revenue despite both being per-diem residential care codes; resource allocation and staffing should align with the heavier claim volume in S5140.

Because 100.0% of Medicaid revenue is explained by the top three codes and there is no Medicare revenue, the provider’s financial and operational performance is highly sensitive to changes in Medicaid per-diem rates, eligibility, and service authorization for foster-care and habilitation residential services. Any policy or contracting changes affecting these per-diem payments could have outsized impact on the organization’s revenue.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5140	Foster care, adult; per diem	1,330	$3,880	$5.2M
T2016	Habilitation, residential, waiver; per diem	790	$3,820	$3M

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

Hi'ilani Health Corporation — 0 of 2 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

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	7	10	2,740	$1,170	$8.6M
S5140	Foster care, adult; per diem	2	10	340	$4,170	$3.2M

Nearby Providers

Other providers in the same ZIP code as Hi'ilani Health Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wahiawa General Hospital	HI	General Acute Care Hospital	$0	$16.9M
The Wahiawa Center For Community Health	HI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Hiilani Health Corporation	HI	Developmentally Disabled Services Day Training Agency	$0	$5.1M
Usrc Wahiawa LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.1M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Wahiawa Family Dental Care, LLP	HI	General Practice Dentistry	$0	$852K
Hawaiian Eye Center Inc	HI	Ophthalmology Physician	$0	$681.8K
Nora Phillips LLC	HI	Family Nurse Practitioner	$0	$523.3K
Longs Drug Stores California LLC	HI	Community/Retail Pharmacy	$249.8K	$90.5K
Hawaiian Eye Center Inc	HI	Ambulatory Surgical Clinic/Center	$242K	$79.7K

Hi'ilani Health Corporation — Billing Profile & Reimbursement Data

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Hi'ilani Health Corporation — 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

Nearby Providers

Frequently Asked Questions

References