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.

Waikiki Health (NPI 1679646509)

Key Findings

Field	Value
Entity Type	Organization
Organization	Waikiki Health
Address	277 Ohua Avenue
City	Honolulu
State	HI
ZIP	96815
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 16, 2006

Payer Source	Total Paid
Medicaid	$22.3M
Medicare	$0

WAIKIKI HEALTH is an FQHC based in HONOLULU, HI with $22.3M in lifetime Medicaid revenue and no Medicare billing on file; this makes the organization effectively single-payer (Medicaid)-dependent for the claims observed. The NPI was enumerated 2006-11-16 (~20 years ago), indicating a multi-year presence in the state Medicaid market.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99213, 90832, 99214) account for 77.5% of the provider's total Medicaid revenue. In particular, 99213 alone represents $12.5M (56.1% of Medicaid revenue), making it by far the largest single revenue driver.

The code mix points to an integrated primary care and behavioral health operation: large-volume E/M established patient visits (99213 and 99214) combined with high-volume psychotherapy codes (90832, 90834, 90837) indicate routine primary care outpatient care alongside significant mental health service delivery. Presence of FQHC bundle codes (G0467 and G0470) confirms federally qualified health center–style bundled visit billing consistent with a community health center model.

On competitive standing, the provider is a dominant statewide player for routine E/M established visits: 99213 ranks #7 of 707 providers in-state (99th percentile; extreme outlier), signaling unusually high volume relative to peers and a major share of in-state delivery for that service. 99214 also ranks highly at #28 of 690 (96th percentile; typical, unremarkable volume), reinforcing that established-patient office visits are a core capability.

Telehealth activity is a distinctive operational feature: Q3014 (telehealth originating site facility fee) shows $301.6K in revenue and ranks #1 of 29 providers in-state (100th percentile; extreme outlier), indicating exceptional use of telehealth originating-site billing compared with peers. This complements the psychotherapy volumes and suggests significant remote behavioral health or hybrid service delivery.

Several codes show extreme or notable outlier status on volume metrics outside the top E/M drivers: 3008F has 53.1K claims and $159.4K revenue and ranks #2 of 86 (99th percentile; extreme outlier) despite a low per-claim payment, while 90791 (psychiatric evaluation) and 90832 (short psychotherapy) rank in the upper percentiles (90791 #5 of 60, 93rd percentile; 90832 #5 of 74, 95th percentile). These patterns point to a high-visit, potentially visit-length–varied behavioral health program alongside high-frequency low-unit-value encounters.

Operational and contracting implications follow from the payer mix and concentration: with $22.3M of Medicaid revenue and no Medicare claims, payer negotiations, care-management investments, and utilization changes tied to Medicaid reimbursement policy would materially affect overall revenue. Because 99213 alone is $12.5M (56.1% of Medicaid revenue) and the top three codes represent 77.5% of revenue, any rate or utilization shifts for these codes create outsized financial risk or opportunity for the provider.

The provider’s longevity (NPI enumerated 2006-11-16 (~20 years ago)) combined with extreme-volume rankings on core codes suggests an established market position in state Medicaid delivery for primary care and behavioral health. Analysts evaluating network contracting, capacity planning, or care-integration investments should prioritize Medicaid-specific metrics and the provider’s high-volume telehealth and E/M workflows.

Medicaid: Complete Services Breakdown

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

92 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…	61,360	$200	$12.5M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	14,400	$190	$2.8M
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…	11,130	$180	$2M
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,…	7,870	$180	$1.4M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	4,210	$170	$711.7K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	9,840	$60	$580.6K
Q3014	Telehealth originating site facility fee	8,150	$40	$301.6K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	1,510	$180	$270.6K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,490	$180	$270.6K
99441	N/A	1,720	$160	$266.8K

Showing 1–10 of 92

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

Waikiki Health — 6 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. Hawaii median

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	5	70	370	$150	$457.3K
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…	7	710	650	$90	$274.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	5	30	1,850	$60	$248.9K
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…	28	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	16	20	310	$130	$184K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	11	10	490	$190	$172.3K
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,…	7	190	190	$100	$122.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	80	320	$100	$119.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	34	440	500	$90	$116.1K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	5	10	610	$70	$111.5K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Waikiki Health	HI	Federally Qualified Health Center (FQHC)	$0	$3.5M
Robert Aki	HI	Podiatrist	$58.9K	$960.1K
Jonathan Aki	PA	Emergency Medicine Physician	$30.2K	$0
Kyle Oroku	HI	Optometrist	$7.2K	$0
Seulyn Au	HI	Optometrist	$3.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wihc, LLC	HI	Clinical Medical Laboratory	$72.5K	$8.6M
Radford Y. Goto, Dmd, LLC	HI	Dental Clinic/Center	$0	$1.5M
Hale Maka Ike LLC	HI	Optometrist	$0	$920.6K
Kellen Kashiwa	HI	Optometrist	$784.8K	$0
Phillip Duran	HI	Optometrist	$1.6K	$628.6K
Peter Hurlbut-miller	HI	Retina Specialist (Ophthalmology) Physician	$509.4K	$0
Errol Hamarat	HI	Psychologist	$0	$489.9K
Rebecca Beardsley	HI	Counseling Psychologist	$0	$375.8K
Center For Sight - West Oahu LLC	HI	Ophthalmology Physician	$0	$365.6K
Aaron Kaplan, Ph.d., Inc.	HI	Clinical Psychologist	$0	$178.8K

Waikiki Health — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References