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.

Community Clinic Of Maui, Inc. (NPI 1528042561)

Key Findings

Field	Value
Entity Type	Organization
Organization	Community Clinic Of Maui, Inc.
Address	1881 Nani Street
City	Wailuku
State	HI
ZIP	96793
Taxonomy	Community Health Clinic/Center
NPI Enumerated	December 2, 2005

Payer Source	Total Paid
Medicaid	$21.6M
Medicare	$0

COMMUNITY CLINIC OF MAUI, INC. is effectively a single-payer Medicaid provider: there is no Medicare billing on file while reported Medicaid revenue totals $21.6M, indicating operations are concentrated in the Medicaid population rather than fee-for-service Medicare. This payer mix implies the clinic’s financial exposure and strategic focus are tied to Medicaid policy and reimbursement trends in Hawaii.

Revenue concentration in Medicaid is highly focused: the top three Medicaid codes account for 87.6% of the provider’s total Medicaid revenue, with 99213 alone representing $12.8M (59.2% of Medicaid revenue) and 99214 contributing $5.1M (23.8%). This concentration suggests primary care office visits for established patients are the dominant service line driving overall revenue.

The clinic’s code mix and volumes indicate it operates as a high-volume primary care and preventive services center for Medicaid enrollees: 99213 and 99214 (established patient E/M visits) together form the core of revenue, and multiple preventive medicine codes (99391, 99392, 99393, 99394) appear among top codes, supporting a longitudinal primary care and well‑visit emphasis including pediatric and adolescent preventive care. These patterns are consistent with a community health clinic / federally qualified health center model.

Competitive standing in-state is strong for primary care visit volume: 99213 ranks #8 of 707 providers (99th percentile, labeled extreme outlier) and 99214 ranks #15 of 690 providers (98th percentile, labeled notably above typical state volume). Those ranks indicate the clinic is a dominant statewide provider for routine established-patient office visits within the Medicaid population.

For several preventive and FQHC-specific codes the provider shows typical statewide volumes rather than dominance: 99391, 99392, 99393 and G0467 each rank in the 81st–93rd percentile range and are described as typical or unremarkable volumes in-state. This suggests breadth of preventive services and FQHC visits consistent with primary care expectations but not uniquely outsized for those specific codes.

Behavioral health and nutrition services are present but not primary revenue drivers: psychotherapy codes 90832/90834/90837 and medical nutrition therapy codes 97802/97803 appear in the top 25 but collectively account for only a small share of Medicaid revenue, indicating these services supplement rather than define the clinic’s operating footprint.

The clinic shows some code-level outliers for specific ancillary services: for example 90460 (vaccine administration to patients up to 18 years) ranks #1 of 104 providers (100th percentile, extreme outlier) despite contributing only $12.4K to total revenue, which implies very high volume but low per‑claim reimbursement for that code relative to peers. These signal programmatic emphasis areas (e.g., pediatric immunizations) that do not materially drive revenue but reflect service commitment.

Tenure is long-standing: the NPI was enumerated on 2005-12-02 (~21 years ago), indicating stable presence in the market and substantial operational history that aligns with its large Medicaid footprint and high-ranking statewide volumes for primary care E/M services.

Medicaid: Complete Services Breakdown

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

102 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…	53,840	$240	$12.8M
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…	19,280	$270	$5.1M
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…	3,860	$260	$996.1K
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…	2,850	$250	$717.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,750	$280	$480.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	6,400	$60	$364.7K
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,…	1,950	$160	$319.1K
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…	990	$200	$197K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	470	$300	$137.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	370	$340	$123.3K

Showing 1–10 of 102

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

Community Clinic Of Maui, Inc. — 4 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

102 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…	28	70	370	$150	$457.3K
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	650	$90	$274.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	7	30	1,850	$60	$248.9K
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…	15	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…	12	20	460	$160	$227.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	13	20	310	$130	$184K
83655	The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure.	6	10	4,550	$20	$144.9K
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,…	27	190	190	$100	$122.8K
90834	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…	41	80	320	$100	$119.2K
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…	8	100	210	$120	$116.7K

Showing 1–10 of 102

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amy Nakama	HI	Family Nurse Practitioner	$180	$14.1K
Tigist Mammo	HI	Internal Medicine Physician	$220	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maui Health System A Kaiser Foundation Hospitals LLC	HI	General Acute Care Hospital	$0	$60.3M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$15.6M
Maui Medical Group Inc	HI	Internal Medicine Physician	$0	$9M
Bayada Home Care	HI	Nursing Care Agency	$0	$6M
Community Clinic Of Maui, Inc.	HI	Multi-Specialty Clinic/Center	$0	$4.8M
Maui Memorial Emergency Medical Associates Inc	HI	Emergency Medicine Physician	$0	$3.8M
Bayada Home Care	HI	In Home Supportive Care Agency	$0	$3.7M
Ka Lima O Maui Ltd	HI	Developmentally Disabled Services Day Training Agency	$0	$1.7M
Metropacific Group, Corp	HI	In Home Supportive Care Agency	$0	$1.3M
Hawaii Life Flight, LLC	HI	Air Ambulance	$218.1K	$883.5K

Community Clinic Of Maui, Inc. — Billing Profile & Reimbursement Data

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Community Clinic Of Maui, Inc. — 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