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.

Usrc Pearlridge, LLC (NPI 1710554571)

Field	Value
Entity Type	Organization
Organization	Usrc Pearlridge, LLC
Address	98-1005 Moanalua Rd Spc 420
City	Aiea
State	HI
ZIP	96701
Taxonomy	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
NPI Enumerated	June 9, 2021

Payer Source	Total Paid
Medicaid	$11.7M
Medicare	$0

Key Findings

USRC PEARLRIDGE, LLC is an End-Stage Renal Disease treatment clinic in AIEA, HI with an NPI enumerated 2021-06-09 (~5 years ago). The provider reports $11.7M in lifetime Medicaid revenue and has no Medicare billing on file, making its operational footprint effectively single-payer Medicaid in scope for the claims available here.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 97.8% of the provider's total Medicaid revenue. Those top codes are 90999 ($9M, 77.3%), Q4081 ($1.9M, 16.5%), and J1756 ($456.3K, 3.9%), indicating dependence on a very small set of procedure/drug codes for the bulk of receipts.

The code mix is consistent with an in-center dialysis operation that also manages dialysis-related anemia: 90999 (general dialysis services) is the dominant revenue line, while Q4081 (epoetin alfa) and J1756 (iron sucrose) are the top drug administrations. Together these codes suggest the center bills for dialysis encounters and internal injectable anemia therapies rather than generating diversified fee-for-service revenue streams.

Despite 90999 producing the largest dollar share ($9M, 77.3%), the provider ranks #28 of 45 in the state for that code (39th percentile) and is characterized as a typical, unremarkable volume contributor for dialysis sessions versus in-state peers. In other words, the clinic’s large absolute dollar exposure to dialysis comes from concentration rather than a top statewide position in dialysis volume.

In contrast, Q4081 (epoetin alfa) shows a very different competitive standing: $1.9M in revenue (16.5% of Medicaid revenue) and a rank of #2 of 26 providers in-state (96th percentile), described as notably above typical state volume. This indicates the provider is a major dispenser of epoetin relative to peers and that Medicaid drug administration for anemia is an important competency and potential leverage point in the local market.

J1756 (iron sucrose) is a modest contributor at $456.3K (3.9% of Medicaid revenue) and ranks #21 of 39 (47th percentile), also characterized as typical, unremarkable volume; J0887 appears in the data with $256.2K (2.2%) but is a lower-percentile reporting entry (rank #31 of 32, 3th percentile) and likewise labeled typical, unremarkable. Several laboratory and supply HCPCS codes (for example A4657, many common lab CPTs) show multiple claims but $0 avg paid/claim and $0 revenue, which suggests these items are either bundled into dialysis session payments or not separately reimbursed in the Medicaid data.

From a payer and contracting perspective, the provider’s financial profile concentrates risk and savings opportunities in a narrow set of items: dialysis session billing (90999) and in-center anemia drug administration (Q4081, J1756). Given no Medicare presence, Medicaid is the only displayed revenue channel, so review and negotiations should focus on Medicaid reimbursement policies and drug administration rates for epoetin and iron products.

Summarizing statistical outliers and signals: Q4081 is flagged as notably above typical state volume and represents the clearest outlier in the provider’s profile, while 90999 and J1756 are labeled typical, unremarkable volume contributors despite their large shares of dollars. The combination of a few high-dollar codes driving 97.8% of revenue and several high-claim/$0-paid lab and supply codes paints a concentrated, dialysis-centered billing pattern that payers should prioritize in utilization review and contract discussions.

Medicaid: Complete Services Breakdown

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

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	10,020	$900	$9M
Q4081	Injection, epoetin alfa, 100 units (for esrd on dialysis)	4,510	$430	$1.9M
J1756	Injection, iron sucrose, 1 mg	1,170	$390	$456.3K
J0887	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	90	$2,850	$256.2K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	50	$120	$5.3K
80051	The lab analyst performs an electrolyte panel; this panel must include measurement of carbon dioxide, chloride, potassium, and sodium.	390	$0	$0
80069	The lab analyst performs a renal function panel test in which he measures the blood level of certain chemicals the descriptor lists to evaluate how well the kidney is functioning.	150	$0	$0
82040	The lab analyst performs a quantitative measurement on a serum, plasma, or whole blood specimen for albumin.	500	$0	$0
82108	The lab analyst performs a quantitative measurement of the element aluminum. Most commonly the source is serum or urine. This quantitation is important in patients on kidney dialysis or medications…	30	$0	$0
82310	The lab analyst measures the calcium level, primarily on a serum sample.	900	$0	$0

Showing 1–10 of 42

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

Usrc Pearlridge, LLC — 1 of 5 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

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	28	50	18,270	$130	$3.3M
J0887	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	31	30	1,820	$1,150	$3M
J3490	Unclassified drugs	43	50	160	$200	$740.3K
Q4081	Injection, epoetin alfa, 100 units (for esrd on dialysis)	2	30	840	$350	$466.6K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	19	30	100	$40	$178.7K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	46	70	230	$10	$66.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	55	90	1,810	$1	$65.6K
J1756	Injection, iron sucrose, 1 mg	21	40	1,190	$20	$62.3K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	26	50	540	$20	$34.9K
82607	The lab analyst performs a test to measure the amount of vitamin B12 in a patient specimen, typically in patient blood.	22	30	130	$10	$31.1K

Showing 1–10 of 42

Nearby Providers

Other providers in the same ZIP code as Usrc Pearlridge, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Diagnostic Laboratory Services, Inc	HI	Clinical Medical Laboratory	$10.5M	$46M
Pali Momi Medical Center	HI	General Acute Care Hospital	$0	$49.3M
Dlmc, Inc.	HI	Home Health Agency	$0	$39.5M
International Life Support Inc	HI	Ambulance	$1.2M	$8.6M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.8M
Pharmacare International, Inc.	HI	Community/Retail Pharmacy	$125.1K	$4.7M
Emergency Medicine Physicians Of Honolulu Pali Momi, LLC	HI	Emergency Medicine Physician	$0	$4.2M
Absolute Care Management Services	HI	Point of Service	$0	$3.2M
Derek B Tom Dds LLC	HI	Pediatric Dentistry	$0	$2.6M
Sleep Center Hawaii LLC	HI	Sleep Disorder Diagnostic Clinic/Center	$0	$2.5M

Usrc Pearlridge, LLC — Billing Profile & Reimbursement Data

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Usrc Pearlridge, LLC — 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

Nearby Providers

Frequently Asked Questions

References