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.

Pacific Vascular Institute-kona (NPI 1720697931)

Pacific Vascular Institute-kona is a clinic/center provider located in Kailua Kona, Hawaii. This profile covers 0 Medicare and 9 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	Pacific Vascular Institute-kona
Address	75-184 Hualalai Rd Ste 100-101
City	Kailua Kona
State	HI
ZIP	96740
Taxonomy	Clinic/Center
NPI Enumerated	July 24, 2020

Payer Source	Total Paid
Medicaid	$196K
Medicare	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	410	$130	$53.8K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	520	$90	$47.9K
36475	In this procedure, the provider inserts a specially designed radiofrequency probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code for…	70	$670	$43.3K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	170	$150	$25.1K
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…	200	$60	$11.5K
36471	In this procedure, the provider injects a sclerosing solution into more than one incompetent veins of the same leg, most commonly to treat varicose veins. It may be used to treat other vascular…	60	$100	$5.9K
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…	140	$30	$4.3K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	80	$40	$3K
99204	The provider sees a new 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 provider…	70	$20	$1.1K

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

Pacific Vascular Institute-kona — 1 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36475	In this procedure, the provider inserts a specially designed radiofrequency probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code for…	2	10	310	$920	$281.6K
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…	508	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…	494	690	650	$90	$235.4K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	7	10	170	$110	$53.6K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	6	20	270	$90	$46.1K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	4	10	80	$60	$45.6K
99204	The provider sees a new 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 provider…	81	170	70	$90	$23.3K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	4	20	250	$30	$13.7K
36471	In this procedure, the provider injects a sclerosing solution into more than one incompetent veins of the same leg, most commonly to treat varicose veins. It may be used to treat other vascular…	1	10	40	$90	$3.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Horng Bruce Lin	CA	Vascular & Interventional Radiology Physician	$1.7M	$0
Amr El-sergany	HI	Vascular Surgery Physician	$1.5M	$0
Delaram Taghipour	HI	Phlebology Physician	$205.6K	$0
Nathan Tomita	HI	Surgery Physician	$194.4K	$0
Dennis Good	AZ	Medical Physician Assistant	$133.2K	$0
Cole Nishikawa	HI	Vascular Surgery Physician	$86.1K	$0
Nathan Itoga	HI	Vascular Surgery Physician	$57.8K	$0
Michael Shin	MN	Emergency Medicine Physician	$46.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$46.8M
S&g Labs Hawaii LLC	HI	Clinical Medical Laboratory	$292.7K	$15.1M
Full Life	HI	Developmentally Disabled Services Day Training Agency	$0	$11M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9M
Mf Med Inc	HI	Pain Medicine (Anesthesiology) Physician	$0	$4.3M
Jennifer Logigian	HI	Dentist	$0	$1.8M
Transformation Health Network	HI	Urgent Care Clinic/Center	$0	$1.7M
Access Capabilities, Inc	HI	Community/Behavioral Health Agency	$0	$1.3M
Alii Health Center	HI	Multi-Specialty Clinic/Center	$0	$799.9K
Edwin Herd	HI	Pediatrics Physician	$0	$640.5K

Pacific Vascular Institute-kona — Billing Profile & Reimbursement Data

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Pacific Vascular Institute-kona — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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