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.

West Hawaii Community Health Center, Inc. (NPI 1689814022)

West Hawaii Community Health Center, Inc. is a federally qualified health center (fqhc) provider located in Pahoa, Hawaii. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	West Hawaii Community Health Center, Inc.
Address	15-2866 Pahoa Village Rd
City	Pahoa
State	HI
ZIP	96778
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 25, 2009

Payer Source	Total Paid
Medicaid	$284K
Medicare	$0

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

13 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…	610	$200	$122.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	310	$210	$63.4K
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…	230	$210	$48.4K
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…	150	$210	$30.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	50	$200	$9.9K
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…	30	$240	$6.6K
99203	The provider sees a new 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 provider…	10	$190	$2.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	800	$0	$0
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	410	$0	$0
90474	In this procedure, the provider administers an additional live attenuated vaccine either via oral or intranasal route after the administration of the first vaccine.	10	$0	$0

Showing 1–10 of 13

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

West Hawaii Community Health Center, Inc. — 0 of 7 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

13 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…	365	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…	629	690	650	$90	$235.4K
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…	65	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…	48	100	210	$110	$101.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	48	110	230	$90	$55.7K
99203	The provider sees a new 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 provider…	158	170	120	$70	$35.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	11	50	50	$40	$33.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	67	90	180	$70	$31.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	34	230	140	$20	$16.1K
90474	In this procedure, the provider administers an additional live attenuated vaccine either via oral or intranasal route after the administration of the first vaccine.	3	10	10	$20	$1.6K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kau Hospital	HI	Rural Health Clinic/Center	$0	$2.4M
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$2M
Kinesis Hawaii Inc.	HI	Physical Therapy Clinic/Center	$0	$494.8K
Pahoa Counseling LLC	HI	Mental Health Counselor	$0	$318.2K
Longs Drug Stores California LLC	HI	Pharmacy	$144K	$68K
Sirius Research Group Inc	HI	Clinical Social Worker	$0	$208.6K
Carol Iadeluca-myrianthis	HI	Physical Therapist	$65.4K	$0
Melissa Merrill	HI	Chiropractor	$36.6K	$0
Hart Miller	HI	Adult Medicine Physician	$19.4K	$0
Nicolas Myrianthis	HI	Physical Therapist	$18.1K	$0

West Hawaii Community Health Center, Inc. — Billing Profile & Reimbursement Data

Sign up for West Hawaii Community Health Center, Inc. — Billing Profile & Reimbursement Data policy alerts

West Hawaii Community Health Center, Inc. — Billing Profile & Reimbursement Data

Sign up for West Hawaii Community Health Center, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References