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 Veterans Memorial Hospital (NPI 1467620328)

Kauai Veterans Memorial Hospital is a specialist provider located in Waimea, Hawaii. This profile covers 0 Medicare and 22 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 Veterans Memorial Hospital
Address	4643 Waimea Canyon Drive
City	Waimea
State	HI
ZIP	96796
Taxonomy	Specialist
NPI Enumerated	February 13, 2008

Payer Source	Total Paid
Medicaid	$295.4K
Medicare	$0

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

22 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…	2,060	$50	$94.9K
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…	2,770	$30	$83.1K
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…	820	$60	$50K
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…	430	$80	$36.2K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	840	$10	$10.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	100	$60	$5.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	400	$10	$3.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	260	$10	$2.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	480	$10	$2.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	40	$50	$2K

Showing 1–10 of 22

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 Veterans Memorial Hospital — 0 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

22 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…	152	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…	172	690	650	$90	$235.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	169	190	190	$100	$122.8K
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…	27	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…	34	100	210	$110	$101.4K
S9088	Services provided in an urgent care center (list in addition to code for service)	37	40	1,230	$10	$65.9K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	37	50	1,250	$10	$60.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	72	110	230	$90	$55.7K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	12	10	90	$60	$40.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	91	90	180	$70	$31.4K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kauai Veterans Memorial Hospital	HI	Critical Access Hospital	$0	$6.2M
Minghsun Liu	CA	Infectious Disease Physician	$952.7K	$418.7K
Brandon Mason	OK	Diagnostic Radiology Physician	$277.6K	$0
Amanda Marn	HI	Cardiovascular Disease Physician	$194.9K	$0
Pradeep Bollu	SC	Neurology Physician	$137.1K	$0
Jean Shein	HI	Ophthalmology Physician	$118.8K	$0
Paul Hayward	HI	General Practice Physician	$73.8K	$0
Steven Fein	NY	Cardiovascular Disease Physician	$52.9K	$15.4K
Frederick Mechanik	CO	Primary Podiatric Medicine Podiatrist	$61.7K	$0
Micheal Johnson	FL	Diagnostic Radiology Physician	$60.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hoola Lahui Hawaii	HI	Federally Qualified Health Center (FQHC)	$0	$2.3M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.7M
Samuel Mahelona Memorial Hospital	HI	Rural Health Clinic/Center	$0	$397.7K
Brian Newman	HI	Internal Medicine Physician	$54K	$0
Robert Millard	HI	Anesthesiology Physician	$6.1K	$0

Kauai Veterans Memorial Hospital — Billing Profile & Reimbursement Data

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Kauai Veterans Memorial Hospital — 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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