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.

The Queen's Medical Center (NPI 1487693586)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Queen's Medical Center
Address	1301 Punchbowl St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$10.3M
Medicare	$0

This facility has no Medicare billing on file and all recorded federal payer revenue in our dataset is Medicaid-only, with total Medicaid revenue of $10.3M. The absence of Medicare activity in these files means the provider’s measurable public-payer footprint is effectively single-payer (Medicaid) for the available claims data.

Revenue is highly concentrated in a small set of codes: the precomputed top three Medicaid codes account for 57.0% of the provider’s Medicaid revenue. Those top drivers are 99214 ($2.6M revenue, 26.6% of Medicaid revenue), 99233 ($2.2M revenue, 21.8%), and 99291 ($858.7K revenue, 8.7%).

The code mix indicates a dual outpatient–inpatient operating profile with heavy E/M volume: 99214 ($2.6M) and 99215 ($626.3K) together show large established outpatient visit volume, while 99203 ($281.9K) and 99204 ($179.9K) demonstrate substantial new-patient clinic activity. High paid/claim levels for higher-complexity office E/M (99215) alongside high claim counts for 99214 suggest significant ambulatory clinic throughput.

Clinical acuity and inpatient services appear prominent: 99233 ($2.2M, 21.8%) is a top revenue driver and 99291 ($858.7K, 8.7%) indicates sustained critical-care billing. Supporting inpatient codes such as 99232 ($523.6K) and 99223 ($463.5K) further confirm materially sized hospital inpatient and observation care operations in the Medicaid population.

Cardiac imaging and procedural services are a visible revenue component: 93306 generates $746.3K (7.5% of Medicaid revenue) and ranks #1 in-state, pointing to very high echocardiography volume relative to peers. Procedural and sedation-related activity is also present at lower but meaningful levels (43239 $36.5K; 99152 $31.4K), showing integrated diagnostic and procedure capacity.

Across multiple high-revenue codes this provider is a statewide outlier: 99233, 99291, 93306, and 99215 all carry a rank of #1 or are described as an "extreme outlier" or at the 100th percentile in-state, signaling dominance in those service lines relative to other Hawaii providers. Several other E/M codes (e.g., 99214 at the 100th percentile despite being rank #4 of 690) also sit far above typical state volumes, reinforcing a competitive leadership position in Medicaid billing for core acute-care services.

Behavioral health and pain-management services are evident but smaller contributors: psychotherapy codes 90834 ($157.3K), 90792 ($124.1K), and 90832 ($106.2K) indicate an active psychiatric service line, while spinal injection codes 62321 ($73.4K) and 62323 ($65.6K) show interventional pain procedures are offered and billed to Medicaid. These lines diversify the revenue base beyond E/M and inpatient care.

The provider has a long-standing NPI (enumerated 2006-06-05, ~20 years ago), which aligns with the broad scope and high volumes observed across outpatient visits, inpatient follow-ups, critical care, and diagnostic imaging; tenure may contribute to established referral patterns and the provider’s dominant in-state billing position for several high-acuity codes.

Medicaid: Complete Services Breakdown

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

121 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…	49,850	$50	$2.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	45,020	$50	$2.2M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	7,220	$120	$858.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	18,200	$40	$746.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	6,660	$90	$626.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	15,400	$30	$523.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,880	$100	$463.5K
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…	8,710	$40	$374.7K
99203	The provider sees a new 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 provider…	4,620	$60	$281.9K
99204	The provider sees a new 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 provider…	2,140	$80	$179.9K

Showing 1–10 of 121

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

The Queen's Medical Center — 11 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

121 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	14	70	370	$150	$457.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1	30	200	$290	$329.1K
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…	50	710	650	$90	$274.1K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	6	10	320	$550	$252.9K
62321	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)…	2	10	1,080	$220	$241K
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…	4	690	650	$90	$235.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	11	20	460	$160	$227.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	12	20	90	$550	$222.1K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	11	20	190	$340	$177.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1	60	650	$110	$152.2K

Showing 1–10 of 121

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$42.7M
Queen Emma Clinics	HI	Clinic/Center	$0	$2M
Garth Tormoen	NV	Radiation Oncology Physician	$321K	$0
Michael Bornemann	HI	Specialist	$51.6K	$161.3K
Jeffrey Loh	CA	Pain Medicine (Anesthesiology) Physician	$201.3K	$0
Reid Hoshide	HI	Neurological Surgery Physician	$196.8K	$0
Christian Spies	CA	Interventional Cardiology Physician	$193.9K	$0
Michiko Bruno	HI	Neurology Physician	$159.5K	$0
Derek Mito	HI	Family Medicine Physician	$17.9K	$137.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M
Kaiser Foundation Health Plan Inc	HI	Health Maintenance Organization	$0	$7.4M

The Queen's Medical Center — Billing Profile & Reimbursement Data

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The Queen's Medical Center — 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