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.

Lori Wilhelm (NPI 1609825728)

Field	Value
Entity Type	Individual
Organization	Lori Wilhelm
Address	77-311 Sunset Dr
City	Kailua Kona
State	HI
ZIP	96740
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicare	$334.9K
Medicaid	$0

Key Findings

This provider reports Total Medicare revenue: $334.9K and has no Medicaid billing on file, making their public billing footprint effectively single‑payer Medicare; absence of Medicaid activity suggests limited engagement with state Medicaid contracts or that Medicaid services are billed under a different taxonomy or entity. The NPI was enumerated on 2006-05-08 (~20 years ago), indicating two decades of enrollment that could support established referral relationships despite the narrow payer mix.

Revenue is concentrated in a small set of diagnostic imaging services: the precomputed top-3 Medicare codes account for 46.5% of this provider's total Medicare revenue, driven primarily by breast imaging and abdominal/pelvic cross‑sectional studies. Specifically, 77067 contributes 27.9% of Medicare revenue with 565 claims at $131 avg paid/claim, 77063 contributes 10.5% with 559 claims at $50 avg paid/claim, and 74177 contributes 8.0% with 209 claims at $102 avg paid/claim; this mix points to a practice anchored in high-volume screening mammography plus a secondary CT service line.

The code mix and unit values show a business model combining high-volume, lower‑paid screening procedures with lower-volume, higher‑paid cross‑sectional imaging: 77067 (screening mammography) is the single largest revenue driver by far (27.9% of Medicare revenue), while CT abdomen/pelvis 74177 and MRI lumbar 72148 produce higher per‑claim reimbursements ($102 and $130 avg paid/claim respectively). This suggests the provider operates as a broad diagnostic radiology service rather than a narrow specialty shop, offering mammography, CT, MRI, DXA (77080), ultrasound, and vascular duplex studies.

Competitive standing on Medicare is modest-to-moderate across most common codes rather than dominant. For its largest code, 77067 ranks #3676 of 15198 providers nationally (76th percentile; typical, unremarkable volume for this code), and 77063 ranks #3454 of 14277 (76th percentile; typical, unremarkable volume), indicating volumes above median but not at market-leading levels; several cross‑sectional and ultrasound codes also sit in mid‑to‑high percentiles (for example, 71271 at the 88th percentile and 76705 at the 91th percentile) consistent with localized strengths rather than national dominance.

There are no clear statistical red flags in the percentile labels provided: most codes are characterized as "typical, unremarkable volume for this code," including the top revenue generators, and even the relatively low national rank for 74183 (19th percentile; typical, unremarkable volume for this code) is presented in the same neutral language. Where percentiles are higher (for example 71271 at the 88th percentile and 76705 at the 91th percentile) the provided descriptor remains "typical, unremarkable volume," so the pattern is best read as a practice with some above‑median activity in select imaging modalities rather than extreme outlier behavior.

Operationally, the combination of heavy screening mammography volume (77067 and 77063 together account for a large share of cases and include many low‑unit payment encounters) plus meaningful CT and MRI work implies investment in both digital mammography/tomosynthesis equipment and cross‑sectional imaging capability. That equipment mix supports routine preventive screening and acute diagnostic imaging referrals from primary care and inpatient settings, which aligns with a diagnostic radiology physician taxonomy.

From a payer strategy perspective, reliance on Medicare only (no Medicaid billing on file) concentrates revenue exposure: any changes to Medicare imaging reimbursement, screening guidelines, or local referral patterns could materially affect practice revenue given that Total Medicare revenue is $334.9K and Medicaid adds no offset. For payers and network planners, this entity should be treated as a Medicare-focused diagnostic imaging provider with notable mammography capacity but limited or no on-file Medicaid participation.

Medicare: Complete Services Breakdown

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

77 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	570	$130	$74K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	560	$50	$27.9K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	210	$100	$21.3K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	100	$130	$12.6K
71271	The provider performs a low–dose computed tomography (LDCT), with low–dose ionizing radiation, for examination of the thorax without using contrast material to screen for lung cancer.	80	$110	$9.3K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	120	$80	$9.2K
73721	In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.	70	$120	$8.9K
77080	The provider performs an imaging procedure, called dual–energy X–ray absorptiometry (DXA), of one or more bony areas on the trunk to determine the bone mineral density (BMD) and whether the patient…	230	$40	$8.8K
73221	In this diagnostic procedure, the provider performs a magnetic resonance imaging, or MRI imaging, of any of the joints of a patient’s upper extremity, which can be the shoulder, elbow, wrist, or…	70	$120	$8.7K
74178	The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional…	40	$220	$8.1K

Showing 1–10 of 77

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 77 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Lori Wilhelm — 0 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

77 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	12	50	230	$80	$29.9K
77014	21	20	350	$50	$21.1K
93925	29	30	40	$180	$16.6K
77063	11	50	250	$40	$14.4K
93880	21	40	50	$110	$9.2K
76641	7	10	40	$90	$9K
74177	11	90	90	$80	$8.1K
70553	33	40	40	$150	$7.9K
72197	15	20	30	$150	$7.8K
73221	5	20	30	$130	$7.3K

Showing 1–10 of 77

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Radiology Imaging Associates, PC	CO	Diagnostic Radiology Physician	$0	$18.8M
Kahuku Medical Center	HI	Critical Access Hospital	$0	$6.5M
Honolulu Imaging Center, LLC	HI	Diagnostic Radiology Physician	$2.6M	$1.1M
Hawaii Radiologic Associates, Ltd.	HI	Diagnostic Radiology Physician	$0	$3.5M
John Wade	HI	Diagnostic Radiology Physician	$795K	$0
Nebiyu Beteselassie	MO	Diagnostic Radiology Physician	$627.2K	$0
Eric Hoyer	WY	Diagnostic Radiology Physician	$534.9K	$0
Kevin Lampert	CO	Diagnostic Radiology Physician	$451.6K	$0
David Camacho	HI	Diagnostic Radiology Physician	$414K	$0
Richard Sibley	IN	Diagnostic Radiology Physician	$406.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$46.8M
S&g Labs Hawaii LLC	HI	Clinical Medical Laboratory	$292.7K	$15.1M
Full Life	HI	Developmentally Disabled Services Day Training Agency	$0	$11M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9M
Mf Med Inc	HI	Pain Medicine (Anesthesiology) Physician	$0	$4.3M
Jennifer Logigian	HI	Dentist	$0	$1.8M
Transformation Health Network	HI	Urgent Care Clinic/Center	$0	$1.7M
Access Capabilities, Inc	HI	Community/Behavioral Health Agency	$0	$1.3M
Alii Health Center	HI	Multi-Specialty Clinic/Center	$0	$799.9K
Edwin Herd	HI	Pediatrics Physician	$0	$640.5K

Lori Wilhelm — 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