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NPI 1669425906 · Honolulu, HI · Geriatric Medicine (Family Medicine) Physician
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Robert Gries is a geriatric medicine (family medicine) physician provider located in Honolulu, Hawaii. This profile covers 3 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Robert Gries |
| Address | 6163 Summer St |
| City | Honolulu |
| State | HI |
| ZIP | 96821 |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| NPI Enumerated | May 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $1.3M |
| Medicare | $338.9K |
Practice profile and service line: The provider’s top codes are 99307, 99308, and 99304 — all nursing facility evaluation and management visits — which indicates an operational focus on long-term care or skilled nursing facility services consistent with the Geriatric Medicine (Family Medicine) taxonomy. The code mix and dominance of nursing-facility E/M services suggest visits are concentrated in institutional settings rather than office-based primary care.
Revenue concentration by payer: For Medicare, the top three codes (99307, 99308, 99304) account for 100.0% of this provider’s total Medicare revenue, with 99307 contributing $181.2K (53.6%), 99308 $107.6K (31.8%), and 99304 $49.2K (14.6%). For Medicaid, the same three codes also drive 100.0% of Medicaid revenue, led by 99308 at $679K (51.6%), 99307 at $566.4K (43.0%), and 99304 at $70.8K (5.4%).
Payer-scale and mix: This provider reports Total Medicare revenue: $338.9K versus Total Medicaid revenue: $1.3M, indicating a Medicaid-dominant revenue profile where Medicaid receipts are roughly several times larger than Medicare. The business is therefore effectively dual-payer but heavily weighted toward Medicaid-covered nursing facility work.
Competitive standing — Medicare: The provider is a high-volume national outlier on Medicare for several nursing-facility codes: 99307 ranks #7 of 8370 providers nationally (100th percentile; extreme outlier) and 99304 ranks #13 of 3303 providers nationally (100th percentile; extreme outlier), while 99308 ranks #1010 of 25763 providers (96th percentile; notably above typical national volume). These ranks indicate the provider is a nationally prominent biller for certain nursing-facility E/M services, not a marginal participant.
Competitive standing — Medicaid (in-state): Within Hawaii, the provider is the top reported biller for the three highest Medicaid revenue codes: 99308 ranks #1 of 19 providers in-state (100th percentile; extreme outlier), 99307 ranks #1 of 7 providers in-state (100th percentile; notably above typical state volume), and 99304 ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume). This pattern signals a dominant statewide position for nursing-facility E/M billing under Medicaid.
Volume and payment characteristics: Claim volumes and average paid-per-claim differ by payer and code — on Medicare, 99307 has 6.2K claims at $29 avg paid/claim, 99308 has 1.9K claims at $56 avg paid/claim, and 99304 has 794 claims at $62 avg paid/claim; on Medicaid, 99307 has 35.4K claims at $16 avg paid/claim, 99308 has 33.9K claims at $20 avg paid/claim, and 99304 has 3.1K claims at $23 avg paid/claim. The Medicaid side shows substantially larger claim volumes but lower average paid-per-claim compared with Medicare, which is typical for state Medicaid fee levels versus Medicare.
Operational implications for network and contracting: Given the provider’s heavy concentration in nursing-facility E/M codes and the Medicaid-dominant revenue mix, payers and health systems should treat this entity as a specialty nursing-facility clinician for network adequacy and contract negotiations. The provider’s statewide leadership in volume for key Medicaid nursing-facility codes suggests leverage in Medicaid network discussions and potential importance for aged-care managed care panels.
Tenure and stability: The provider’s NPI was enumerated on 2006-05-18 (~20 years ago), indicating long-standing participation in federal and state programs; combined with consistent, high-volume billing across Medicare and Medicaid nursing-facility codes, this suggests an established practice footprint in the long-term care market rather than a recent entrant.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 6,250 | $30 | $181.2K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 1,920 | $60 | $107.6K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 790 | $60 | $49.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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 |
|---|---|---|---|---|
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 33,950 | $20 | $679K |
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 35,400 | $20 | $566.4K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 3,080 | $20 | $70.8K |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99307 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the… | 1 | 10 | 230 | $20 | $85K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 1 | 20 | 510 | $20 | $50.9K |
| 99304 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves straightforward or low medical decision making or the provider… | 1 | 10 | 1,590 | $20 | $36.7K |
Other providers in the same ZIP code as Robert Gries, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Aina Haina Family Dental | HI | Dental Clinic/Center | $0 | $551.6K |
| Longs Drug Stores California LLC | HI | Pharmacy | $255.6K | $39K |
| Donald E Nicol Md Inc | HI | Preferred Provider Organization | $0 | $239K |
| Amelia Fong | HI | Ophthalmology Physician | $156.9K | $0 |
| Gregory Caputy | HI | Plastic Surgery Physician | $112.5K | $0 |
| Spencer Lau | HI | General Practice Physician | $42.3K | $45.7K |
| Michael Turner | HI | Orthopedic Physical Therapist | $78.1K | $0 |
| Nathan Itoga | HI | Vascular Surgery Physician | $57.8K | $0 |
| Rayna Ling-hawkins | HI | Physical Therapist | $53.7K | $0 |
| Janet Tham | HI | Optometrist | $52.2K | $0 |
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