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.

Evergreen Adult Day Care (NPI 1649724089)

Field	Value
Entity Type	Organization
Organization	Evergreen Adult Day Care
Address	1124 Fort Street Mall Fl 2
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Adult Day Care Clinic/Center
NPI Enumerated	August 14, 2016

Payer Source	Total Paid
Medicaid	$8.9M
Medicare	$0

Key Findings

EVERGREEN ADULT DAY CARE is effectively a single-payer provider in the available claims data: there is no Medicare billing on file and all reported federal claims activity is through Medicaid, with total Medicaid revenue of $8.9M. The absence of Medicare claims indicates the entity’s operations and payer relationships are concentrated in the Medicaid program rather than a mixed Medicare/Medicaid model.

Revenue for this provider is highly concentrated in a single service line: S5105 (Day care services, center-based) accounts for $7.7M and 87.2% of the provider’s Medicaid revenue. The precomputed top-3 Medicaid codes together account for 100.0% of Medicaid revenue, signaling that nearly all billings are tied to a narrow set of service codes rather than a broad code mix.

The code mix aligns with the provider’s taxonomy as an Adult Day Care Clinic/Center: the dominant S5105 code reflects center-based day care services as the core business, while S5130 (Homemaker service) and S9122 (Home health aide/CNA) — which together make up 12.8% of Medicaid revenue ($762.4K and $372.1K respectively) — suggest supplemental in-home or ancillary supports are billed alongside the center-based program. This pattern is consistent with a day-care operator that also facilitates accompanying home-support services for its client population.

S5105 is a clear competitive outlier in-state: the provider ranks #1 of 6 for S5105 and sits at the 100th percentile, described in the data as "notably above typical state volume for this code." That ranking and share indicate a dominant in-state position for center-based day care billing and likely market leadership among comparable providers in Hawaii on this specific service.

By contrast, the provider’s volumes on non-day-care codes are modest relative to broader in-state peer groups: S5130 ranks #21 of 83 providers (76th percentile) and S9122 ranks #30 of 67 providers (56th percentile), both characterized as typical or unremarkable volumes. These placements imply the organization is a specialist leader for day care services while being a mid-tier participant for homemaker and home health aide services.

Average paid-per-claim values are moderate across its top codes and consistent with service types: S5105 shows $54 avg paid/claim, S5130 $64 avg paid/claim, and S9122 $58 avg paid/claim. Combined with the large claim counts (e.g., 143.3K claims for S5105), the revenue profile reflects high utilization of center-based day care rather than high unit prices driving revenue.

The provider has an established operating history in the NPI registry, with enumeration on 2016-08-14 (~10 years ago), indicating a multi-year presence in the market that corresponds with the large cumulative Medicaid revenue figure. This tenure supports the interpretation that its leading S5105 volumes are the result of sustained service delivery rather than a short-term spike.

From a business and payer-strategy perspective, Evergreen’s financial exposure and strategic focus are concentrated in Medicaid-funded adult day care. Analysts evaluating network sufficiency, capacity, or payment-rate sensitivity should treat changes to Medicaid policy or reimbursement for S5105 as having outsized impact, since S5105 alone represents $7.7M (87.2%) of the provider’s $8.9M Medicaid revenue and the top three codes collectively represent 100.0% of Medicaid revenue.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5105	Day care services, center-based; services not included in program fee, per diem	143,270	$50	$7.7M
S5130	Homemaker service, nos; per 15 minutes	11,910	$60	$762.4K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	6,420	$60	$372.1K

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

Evergreen Adult Day Care — 1 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5105	Day care services, center-based; services not included in program fee, per diem	1	10	2,510	$60	$1.5M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	30	70	5,120	$130	$1.2M
S5130	Homemaker service, nos; per 15 minutes	21	80	5,320	$90	$776.6K

Nearby Providers

Other providers in the same ZIP code as Evergreen Adult Day Care, 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
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M

Evergreen Adult Day Care — Billing Profile & Reimbursement Data

Sign up for Evergreen Adult Day Care — Billing Profile & Reimbursement Data policy alerts

Evergreen Adult Day Care — Billing Profile & Reimbursement Data

Sign up for Evergreen Adult Day Care — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References