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.

Hawaii Permanente Medical Group Inc (NPI 1710945969)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hawaii Permanente Medical Group Inc
Address	3288 Moanalua Rd
City	Honolulu
State	HI
ZIP	96819
Taxonomy	Health Maintenance Organization
NPI Enumerated	May 3, 2006

Payer Source	Total Paid
Medicaid	$75.8M
Medicare	$0

HAWAII PERMANENTE MEDICAL GROUP INC is effectively a single-payer provider in these files: there is no Medicare billing on record while Medicaid revenue totals $75.8M. This concentration means Medicaid dominates its publicly visible payer mix and any payer-strategy analysis should treat Medicaid as the primary revenue driver for the practice.

Revenue concentration within Medicaid is high: the precomputed top three Medicaid codes account for 51.1% of the provider's total Medicaid revenue. This indicates a relatively narrow set of services produce the majority of billed Medicaid dollars and suggests service-line planning or negotiations should focus on these core code families.

Primary service-line signals point to high-volume ambulatory primary care and preventive services combined with imaging and ED E/M. The top codes include 99213 and 99214 (established patient office visits), multiple preventive visit codes (99391/99392/99393/99394), high-volume vaccine administration codes (90471/90472/90686/90670), and screening mammography 77067, which together imply a large integrated outpatient clinic operation with substantial vaccination, preventive pediatrics, primary care, and imaging throughput.

HAWAII PERMANENTE ranks as a dominant in-state performer on many high-volume outpatient and preventive codes: 99213 is #2 of 707 providers in-state (100th percentile; labeled an extreme outlier), 99392 is #1 of 102 (100th percentile; extreme outlier), and vaccine administration codes such as 90471, 90472, 90686 and 90670 are consistently ranked #1 in-state (100th percentile). These rankings indicate the provider is a major statewide source for routine office visits, immunizations, and well-care.

For several ED and diagnostic categories the provider’s volume is more typical: 99284 and 99283 emergency department E/M codes appear at median-to-typical state percentiles (59th and 64th respectively), and codes like 76811/76816/76815 (obstetric ultrasound series) and chest X-ray 71046 sit at middle or modest percentiles. This mix suggests that while ambulatory primary care and preventive services are exceptional, emergency and some specialty diagnostic services are within normal state ranges.

The provider shows operational scale across low- and mid-acuity office visits: 99212, 99213, 99214 together contribute a substantial share of Medicaid revenue (with 99213 alone representing $22M or 32.9% of total Medicaid revenue) and rank at or near the top statewide (99212 #2 of 186, 99214 #10 of 690). That pattern is consistent with a high-volume, broad-access outpatient practice treating established patients frequently.

Tenure data indicate long-standing enrollment: the NPI was enumerated in 2006-05-03 (~20 years ago). This longevity aligns with high-state market presence and likely established referral and patient panels that support the large volumes observed across preventive, vaccination, and routine E/M codes.

From a contracting and competitive standpoint, payers should view this entity as a strategically important Medicaid partner for population-health and preventive-care initiatives given its outsized volumes in well visits and vaccinations. Conversely, because there is no Medicare billing on file, Medicare network or fee negotiations are not relevant based on these claims records and any Medicare-driven risk strategies cannot be assessed from this dataset.

Medicaid: Complete Services Breakdown

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

198 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…	146,750	$150	$22M
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…	34,310	$220	$7.5M
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…	11,560	$410	$4.7M
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.	9,870	$360	$3.5M
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.	15,430	$220	$3.4M
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…	14,620	$230	$3.4M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	67,330	$50	$3.1M
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…	12,960	$190	$2.5M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	9,630	$220	$2.1M
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,…	21,840	$90	$1.9M

Showing 1–10 of 198

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

Hawaii Permanente Medical Group Inc — 17 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

198 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.	17	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.	20	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.	28	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.	23	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.	20	40	1,050	$510	$1.3M
99281	The provider sees a patient for the lowest level emergency department visit.	18	20	950	$220	$651.2K
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…	45	70	370	$150	$457.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5	30	1,750	$70	$378K
J0585	Injection, onabotulinumtoxina, 1 unit	8	10	50	$1,110	$350.9K
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…	2	30	1,370	$110	$333.9K

Showing 1–10 of 198

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	HI	General Acute Care Hospital	$0	$76.5M
Procare Pharmacy, L.L.C.	HI	Specialty Pharmacy	$0	$41.8M
Value Drug Ltd	HI	Pharmacy	$0	$21.7M
Care Hawaii, Inc.	HI	Community/Behavioral Health Agency	$0	$11.8M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$10M
Hawaii Life Flight, LLC	HI	Air Ambulance	$636.1K	$8.5M
City And County Of Honolulu	HI	Land Ambulance	$3.3M	$5.3M
Keiki Dental Specialists	HI	Pediatric Dentistry	$0	$5.7M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$2M
Imua Medical Equipment And Supplies,llc	HI	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Hawaii Permanente Medical Group Inc — Billing Profile & Reimbursement Data

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Hawaii Permanente Medical Group Inc — 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