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.

Wahiawa General Hospital (NPI 1689643553)

Key Findings

Field	Value
Entity Type	Organization
Organization	Wahiawa General Hospital
Address	128 Lehua St
City	Wahiawa
State	HI
ZIP	96786
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 14, 2006

Payer Source	Total Paid
Medicaid	$16.9M
Medicare	$0

WAHIAWA GENERAL HOSPITAL is a General Acute Care Hospital with an NPI enumerated 2006-03-14 (~20 years ago), indicating roughly two decades of billing activity under the current identifier and an established presence in WAHIAWA, HI. The taxonomy and tenure are consistent with a community hospital that provides emergency and diagnostic services.

This provider effectively operates as a single-payer Medicaid facility: there is no Medicare billing on file and all recorded program revenue is Medicaid-only, with total Medicaid revenue of $16.9M. The absence of Medicare billing makes Medicaid the dominant and only reported public payer in this dataset.

Revenue is highly concentrated in three emergency department evaluation-and-management codes: 99284 ($5.3M, 31.7% of total Medicaid revenue), 99283 ($5.2M, 31.1% of total Medicaid revenue), and 99285 ($2.8M, 16.5% of total Medicaid revenue). Collectively these top three codes account for 79.3% of the provider's Medicaid revenue, signaling a heavy dependence on ED visits for Medicaid-funded activity.

The code mix (dominance of 99284/99283/99285) indicates the hospital’s operational focus is emergency care with substantial volume of moderate- and low-level medical decision-making ED visits and a meaningful share of high-acuity ED encounters. The presence of CT abdomen/pelvis codes 74177 ($1.3M, 7.9%) and 74176 ($699.5K, 4.1%) among top billings further suggests that ED-driven imaging is an important adjunct service supporting acute diagnostic workups.

Competitive standing for the ED codes is middle-of-market statewide: 99284 ranks #16 of 47 (67th percentile; typical, unremarkable volume for this code), 99283 ranks #15 of 45 (68th percentile; typical, unremarkable volume for this code), and 99285 ranks #18 of 39 (55th percentile; typical, unremarkable volume for this code). These ranks show the hospital is a modest/typical participant in Hawaii for emergency E/M services rather than a dominant statewide provider.

Imaging and diagnostic services appear moderately scaled: 74177 ranks #16 of 36 (57th percentile; typical, unremarkable volume for this code) and 74176 ranks #11 of 28 (63th percentile; typical, unremarkable volume for this code). Additional imaging codes (e.g., 70450, 77067) generate smaller shares of revenue, indicating imaging is an important but not primary revenue driver compared with ED E/M codes.

Critical care billing is present but limited relative to ED volume: 99291 shows 189 claims, $1184 avg paid/claim, $223.8K revenue (1.3% of total Medicaid revenue) and ranks #18 of 34 (48th percentile; typical, unremarkable volume for this code). This pattern suggests the hospital provides some critical care services but most Medicaid revenue is tied to ED throughput rather than extended critical care.

Across the top 25 Medicaid codes listed, the recurring characterization is "typical, unremarkable volume for this code," and percentiles largely fall in the mid-range; the one relatively higher percentile is 94640 at #6 of 29 (82th percentile; typical, unremarkable volume for this code). Overall there are no clear statistical outliers in the statewide comparison—activity appears consistent with a mid-tier community hospital focused on emergency care and associated imaging.

Medicaid: Complete Services Breakdown

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

126 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	12,670	$420	$5.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	16,140	$330	$5.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	4,260	$650	$2.8M
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.	1,440	$930	$1.3M
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.	1,310	$540	$699.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2,660	$240	$632.1K
99281	The provider sees a patient for the lowest level emergency department visit.	1,680	$160	$274.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	190	$1,180	$223.8K
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…	1,140	$110	$119.8K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,330	$20	$53.5K

Showing 1–10 of 126

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

Wahiawa General Hospital — 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. Hawaii median

126 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	15	50	8,590	$340	$5.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	16	50	3,740	$290	$3.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	18	40	3,820	$330	$3.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	16	30	2,660	$330	$1.5M
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.	16	40	1,050	$510	$1.3M
J3490	Unclassified drugs	27	50	160	$200	$740.3K
99281	The provider sees a patient for the lowest level emergency department visit.	7	20	950	$220	$651.2K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	14	20	1,060	$60	$547.3K
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.	11	30	770	$430	$536.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	16	30	2,500	$40	$455.4K

Showing 1–10 of 126

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary Myers	HI	Psychologist	$24.8K	$319.5K
Randall Nitta	HI	Family Medicine Physician	$47.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Wahiawa Center For Community Health	HI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Hi'ilani Health Corporation	HI	Home Health Agency	$0	$8.2M
Hiilani Health Corporation	HI	Developmentally Disabled Services Day Training Agency	$0	$5.1M
Usrc Wahiawa LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.1M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Wahiawa Family Dental Care, LLP	HI	General Practice Dentistry	$0	$852K
Hawaiian Eye Center Inc	HI	Ophthalmology Physician	$0	$681.8K
Nora Phillips LLC	HI	Family Nurse Practitioner	$0	$523.3K
Longs Drug Stores California LLC	HI	Community/Retail Pharmacy	$249.8K	$90.5K
Hawaiian Eye Center Inc	HI	Ambulatory Surgical Clinic/Center	$242K	$79.7K

Wahiawa General Hospital — Billing Profile & Reimbursement Data

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Wahiawa General Hospital — 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