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.

Ken Arakawa (NPI 1558334888)

Field	Value
Entity Type	Individual
Organization	Ken Arakawa
Address	1329 Lusitana St Ste 206
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Specialist
NPI Enumerated	February 8, 2006

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

This provider is effectively single‑payer: lifetime Medicare revenue totals $3.8M while Medicaid shows none (no Medicaid billing on file), meaning analyses of utilization, contract risk, and revenue sensitivity should focus on Medicare reimbursement and benefit changes rather than Medicaid dynamics. The absence of Medicaid billing also reduces payer diversification and concentrates payment and utilization risk into the Medicare population.

Revenue is highly concentrated in a small set of biologic drug codes: the precomputed top‑3 Medicare codes account for 63.3% of total Medicare revenue, driven by J0129 (32.3%), J0717 (16.7%), and J0897 (14.3%). This concentration means a large portion of the provider’s revenue depends on continued administration and reimbursement of a few high‑impact injectable agents.

The mix of high‑revenue J‑codes together with administration and infusion codes indicates an infusion/biologics‑focused specialty practice model: the top drug codes (J0129, J0717, J0897, J3245, J3111, J1745) are biologic agents used in autoimmune and bone‑health indications, and the presence of 96365, 96372, and 96413 shows on‑site infusion/injection services and chemotherapy/infusion capability. Combined with frequent E&M codes (99214, 99215) and imaging (multiple X‑ray and DXA codes), the pattern is consistent with a specialist clinic that both evaluates patients and administers high‑cost injectables.

For several high‑revenue drugs this provider is a national outlier: J0129 generated $1.2M (32.3% of Medicare revenue) and ranks #23 of 1221 providers nationally (98th percentile; extreme outlier), while J0897 produced $541.1K (14.3%) and ranks #101 of 10057 providers nationally (99th percentile; extreme outlier). These ranks position the provider well above typical national volumes for those specific agents, indicating unusually high throughput or focus on those drugs compared with peers.

Office visit and administration activity is also unusually high for certain services: 99214 contributed $215.8K (5.7% of Medicare revenue) and ranks #553 of 479517 providers nationally (100th percentile; extreme outlier), and 96372 contributed $21.4K and ranks in the 100th percentile (extreme outlier). These signals together suggest heavy office‑based management and frequent in‑office injections or supervised administrations beyond what is typical for most specialists.

Imaging and ancillary services are meaningful and concentrated compared with national peers: 73130 generated $17.9K and ranks #45 of 20344 providers nationally (100th percentile; extreme outlier), 72110 generated $14.2K and ranks #98 of 13711 providers nationally (99th percentile; extreme outlier), and 73521 generated $10.5K and ranks #14 of 2721 providers nationally (100th percentile; notably above typical national volume). This indicates the practice performs substantial musculoskeletal imaging in‑house, supporting diagnosis and management linked to the biologic and office treatment volume.

Operational and revenue‑risk implications flow from the combination of high biologic drug revenue and single‑payer concentration: with $3.8M in Medicare receipts concentrated in a few injectable biologics, the practice faces exposure to changes in drug coverage, reimbursement rates, or utilization management for those agents. Maintaining infusion capability, drug procurement, and billing expertise appears central to the business model and to preserving current revenue levels.

The provider has an established NPI history, enumerated on 2006-02-08 (~20 years ago), suggesting long tenure in the market; that longevity combined with the concentrated specialization in biologic administration implies an entrenched operational model rather than a recent high‑volume outlier emergence. Analysts should pair tenure with utilization trends over time to see whether these high volumes are persistent or represent more recent concentration.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	37,100	$30	$1.2M
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	158,000	$1	$632K
J0897	Injection, denosumab, 1 mg	30,060	$20	$541.1K
J3245	Injection, tildrakizumab, 1 mg	4,600	$100	$464.6K
J3111	Injection, romosozumab-aqqg, 1 mg	46,830	$10	$327.8K
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…	2,480	$90	$215.8K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,060	$30	$131.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	8,150	$10	$48.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	560	$60	$32K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	230	$100	$22.8K

Showing 1–10 of 52

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Ken Arakawa — 12 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. state median

52 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	1	10	37,100	$30	$1.2M
J0717	1	10	158,000	$1	$603.5K
J3245	1	10	4,600	$100	$462.9K
J3111	2	10	33,920	$10	$262.5K
80061	9	10	170	$10	$142.4K
J1745	1	10	5,060	$30	$129.2K
J0897	1	20	2,530	$20	$121.5K
J1602	1	10	7,580	$10	$62.2K
36415	4	30	50	$10	$56.2K
85025	6	30	50	$10	$40.5K

Showing 1–10 of 52

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ken Arakawa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ken C. Arakawa Md Inc.	HI	VA Clinic/Center	$0	$112K
Heejae Jung	HI	Rheumatology Physician	$40.9K	$0
Liliana Bellini	HI	Physician Assistant	$5.5K	$0

Nearby Providers

Other providers in the same ZIP code as Ken Arakawa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
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
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M

Ken Arakawa — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References