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.

Queens North Hawaii Community Hospital (NPI 1528049814)

Queens North Hawaii Community Hospital is a orthopaedic surgery physician provider located in Kamuela, Hawaii. This profile covers 0 Medicare and 25 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	Queens North Hawaii Community Hospital
Address	67-1125 Mamalahoa Hwy
City	Kamuela
State	HI
ZIP	96743
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	November 14, 2005

Payer Source	Total Paid
Medicaid	$230.7K
Medicare	$0

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

25 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…	2,910	$50	$139.5K
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…	1,620	$20	$38.9K
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…	490	$40	$18.5K
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…	170	$50	$8.6K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	410	$10	$5.8K
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…	40	$90	$3.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	90	$30	$3K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	40	$60	$2.6K
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…	50	$50	$2.5K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	90	$20	$2.1K

Showing 1–10 of 25

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

Queens North Hawaii Community Hospital — 0 of 17 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

25 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…	66	70	370	$150	$457.3K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	27	30	1,370	$110	$333.9K
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…	221	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…	130	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…	15	20	460	$160	$227.9K
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…	32	60	650	$110	$152.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	12	10	1,110	$80	$141K
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…	82	100	210	$120	$116.7K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	16	20	160	$70	$107.8K
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…	77	170	120	$70	$35.7K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Queens North Hawaii Community Hospital	HI	General Acute Care Hospital	$0	$13M
Patrick Gonzales	CA	Vascular & Interventional Radiology Physician	$2.7M	$0
Vivek Kesari	MD	Nuclear Medicine Physician	$1.4M	$0
Patrick Ryan	CA	Diagnostic Radiology Physician	$722.4K	$0
Queen's North Hawaii Community Hospital	HI	General Practice Physician	$0	$642K
Edwin Herd	HI	Pediatrics Physician	$0	$640.5K
Queen's North Hawaii Community Hospital	HI	Obstetrics & Gynecology Physician	$0	$622.5K
Sunil Gandhi	CA	Diagnostic Radiology Physician	$551.9K	$0
Faisal Shah	NY	Diagnostic Radiology Physician	$245.2K	$259.8K
Nicholas Vu	CT	Diagnostic Radiology Physician	$472.5K	$1.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hawaii Life Flight, LLC	HI	Air Ambulance	$379.2K	$2M
Five Mountains Hawaii, Inc	HI	Rural Health Clinic/Center	$0	$1.6M
Liberty Dialysis-north Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Paniolo Pediatric And Family Medicine Inc	HI	Pediatrics Physician	$0	$1.4M
Vein Clinics Of Hawaii LLC	HI	Vascular Surgery Physician	$0	$673.3K
John Mascaro	HI	Marriage & Family Therapist	$0	$523.3K
Steven Chelminiak	HI	Clinical Social Worker	$0	$498.8K
Duerler, Inc.	HI	Family Medicine Physician	$0	$479.7K
Keiki Therapy LLC	HI	Occupational Therapist	$0	$230.2K
Bodypro Physical Therapy Inc	HI	Physical Therapist	$0	$191.1K

Queens North Hawaii Community Hospital — Billing Profile & Reimbursement Data

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Queens North Hawaii Community 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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