Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidGregg Kokame
    Ask Trek AI about this page

    Gregg Kokame — Billing Profile & Reimbursement Data

    NPI 1760590988 · Aiea, HI · Ophthalmology Physician

    Customize your policy alerts

    Sign up for Gregg Kokame — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Gregg Kokame is a ophthalmology physician provider located in Aiea, Hawaii. This profile covers 11 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationGregg Kokame
    Address98-1079 Moanalua Road
    CityAiea
    StateHI
    ZIP96701
    TaxonomyOphthalmology Physician
    NPI EnumeratedAugust 28, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$991.7K
    Medicaid$0

    Key Findings

    This provider’s Medicare revenue is concentrated heavily in a small set of drug and exam codes: total Medicare revenue is $991.7K and the top three Medicare codes account for 83.7% of that revenue, with J0178 alone representing $649.1K (65.5% of total Medicare revenue). Such concentration means a majority of payments are tied to a single high-value drug code rather than a broad mix of office visits or minor procedures.

    The code mix indicates a retina-focused ophthalmology practice centered on intravitreal pharmacologic therapy and retinal imaging: high-revenue drug codes include J0178 (injection, aflibercept) and J2777 (injection, faricimab-svoa), supported by procedural codes such as 67028 (vitreous injection) and imaging codes like 92134 (retinal OCT). E/M codes 92014 and 92012 for established-patient eye exams also appear, showing a mix of ongoing medical retina management and procedural treatment.

    This provider is effectively single‑payer from a public program perspective: Medicare billing is $991.7K while Medicaid shows none (no Medicaid billing on file), so the practice’s public-reimbursement exposure is concentrated in Medicare rather than a split Medicare/Medicaid mix. Analysts should treat Medicaid-related utilization or reimbursement comparisons as not applicable for this clinician.

    On competitive standing for the primary drug therapy, J0178 is ranked #1348 of 3204 providers nationally and characterized as "typical, unremarkable volume," which describes the provider as a modest-to-moderate national participant in aflibercept administration rather than a dominant injector. By contrast, J2777 (faricimab) has large claim volume (3.8K claims) but is ranked low nationally and is also labeled "typical, unremarkable volume," indicating the provider’s faricimab activity is not an outlier among peers.

    Imaging and examination activity show above-typical utilization in specific diagnostics: 92134 (retinal OCT) appears with 1.3K claims and $41.5K revenue and is labeled "notably above typical national volume," suggesting the practice performs OCT at higher-than-typical rates for ophthalmologists. Concurrently, established-patient exam codes 92014 (747 claims, $69.5K) and 92012 (500 claims, $35K) are present and labeled "typical, unremarkable volume," indicating steady office follow-up alongside diagnostic imaging and injections.

    The procedural mix includes both injection and diagnostic angiography services, reflecting a full-service medical retina workflow: 67028 (vitreous injection) shows 634 claims and $58.3K revenue, angiography codes 92242 and 92235 appear with billed revenue, and J7999 (compounded drug) is present at $3K. This combination of therapeutics, compounded drugs, and imaging aligns with in-office treatment and monitoring of retinal disease.

    The provider’s claim-level economics show a disparity in average paid amounts across drugs and services that likely drives revenue composition: J0178 averages $692 avg paid/claim while J2777 averages $29 avg paid/claim, indicating that fewer high-dollar J0178 administrations can dominate revenue despite differing claim counts. Analysts should note that claim volume alone does not equate to revenue impact when high-priced injectables are in use.

    The provider has a long Medicare enrollment history (NPI enumerated 2006-08-28 (~20 years ago)), and lifetime Medicare receipts approaching $1M indicate sustained Medicare-facing clinical activity. Given the high revenue concentration in a few injectable drugs (top 3 = 83.7%) and no Medicaid billing on file, the practice has material exposure to changes in Medicare drug policy and utilization patterns but limited exposure to state Medicaid reimbursement variability.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J0178Injection, aflibercept, 1 mg940$690$649.1K
    J2777Injection, faricimab‑svoa, 0.1 mg3,840$30$111.4K
    92014An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…750$90$69.5K
    67028The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.630$90$58.3K
    92134The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.1,300$30$41.5K
    92012For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…500$70$35K
    99204The 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…80$120$9.8K
    92250Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…230$30$6.8K
    92242The provider injects two different special dyes into one or both eyes that cause the blood vessels to stand out in photographic images timed so that multiple frames are taken in rapid succession. He…20$240$4.2K
    J7999Compounded drug, not otherwise classified40$70$3K

    Showing 1–10 of 11

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    11 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J0178320330$680$350.4K
    J27778104,140$30$173.8K
    67028720390$90$44.1K
    9201423220120$90$22.5K
    9224241080$210$14.4K
    9201213150110$60$13.1K
    J79991210100$70$12.8K
    9223591030$110$11K
    92134915060$30$7.2K
    992048763030$110$5.3K

    Showing 1–10 of 11

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Gregg Kokame, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Raymond WeeHIOphthalmology Physician$1.5M$0
    James LaiHIOphthalmology Physician$1.4M$0
    Sarah ReadHIOphthalmology Physician$939.4K$0
    Retina Consultants Of Hawaii IncHIOphthalmology Physician$0$646.3K
    Elysse TomHIOphthalmology Physician$147.6K$0

    Nearby Providers

    Other providers in the same ZIP code as Gregg Kokame, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Diagnostic Laboratory Services, IncHIClinical Medical Laboratory$10.5M$46M
    Pali Momi Medical CenterHIGeneral Acute Care Hospital$0$49.3M
    Dlmc, Inc.HIHome Health Agency$0$39.5M
    Usrc Pearlridge, LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$11.7M
    International Life Support IncHIAmbulance$1.2M$8.6M
    Dialysis Newco LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$5.8M
    Pharmacare International, Inc.HICommunity/Retail Pharmacy$125.1K$4.7M
    Emergency Medicine Physicians Of Honolulu Pali Momi, LLCHIEmergency Medicine Physician$0$4.2M
    Absolute Care Management ServicesHIPoint of Service$0$3.2M
    Derek B Tom Dds LLCHIPediatric Dentistry$0$2.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Hawaii Distribution
    Gregg Kokame — 0 of 11 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Hawaii