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.

Samuel Mahelona Memorial Hospital (NPI 1669068680)

Field	Value
Entity Type	Organization
Organization	Samuel Mahelona Memorial Hospital
Address	4643 Waimea Canyon Dr. Ste.b
City	Waimea
State	HI
ZIP	96796
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 14, 2020

Payer Source	Total Paid
Medicaid	$397.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

27 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…	2,380	$70	$175.8K
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…	1,120	$80	$88.5K
99442	N/A	910	$60	$54.5K
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…	240	$60	$14.6K
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…	170	$70	$12K
0002A	N/A	280	$40	$10.1K
0001A	N/A	270	$40	$9.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	70	$90	$6.6K
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,…	150	$40	$6.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	70	$80	$5.8K

Showing 1–10 of 27

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

Samuel Mahelona Memorial Hospital — 0 of 20 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	171	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…	250	690	650	$90	$235.4K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	18	20	310	$130	$184K
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,…	104	190	190	$100	$122.8K
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…	49	100	210	$120	$116.7K
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…	64	100	210	$110	$101.4K
99442	N/A	6	60	80	$130	$67.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	75	110	230	$90	$55.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	90	140	140	$90	$42.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	68	90	180	$70	$31.4K

Showing 1–10 of 27

Related Providers

Other providers that share a Tax Identification Number (TIN) with Samuel Mahelona Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samuel Mahelona Memorial Hospital	HI	Critical Access Hospital	$0	$7M
Kauai Veterans Memorial Hospital	HI	Critical Access Hospital	$0	$6.2M
Minghsun Liu	CA	Infectious Disease Physician	$952.7K	$418.7K
Samuel Mahelona Memorial Hospital	HI	Rural Health Clinic/Center	$0	$342.5K
Brandon Mason	OK	Diagnostic Radiology Physician	$277.6K	$0
John Funai	HI	Cardiovascular Disease Physician	$166.3K	$0
Pradeep Bollu	SC	Neurology Physician	$137.1K	$0
Steven Fein	NY	Cardiovascular Disease Physician	$52.9K	$15.4K
Frederick Mechanik	CO	Primary Podiatric Medicine Podiatrist	$61.7K	$0
Micheal Johnson	FL	Diagnostic Radiology Physician	$60.7K	$0

Nearby Providers

Other providers in the same ZIP code as Samuel Mahelona Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hoola Lahui Hawaii	HI	Federally Qualified Health Center (FQHC)	$0	$2.3M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.7M
Kauai Veterans Memorial Hospital	HI	Specialist	$0	$295.4K
Brian Newman	HI	Internal Medicine Physician	$54K	$0
Robert Millard	HI	Anesthesiology Physician	$6.1K	$0

Samuel Mahelona Memorial Hospital — Billing Profile & Reimbursement Data

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Samuel Mahelona Memorial 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

Related Providers

Nearby Providers

Frequently Asked Questions

References