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.

Emergency Medicine Physicians Of Honolulu Kapiolani, LLC (NPI 1760894984)

Field	Value
Entity Type	Organization
Organization	Emergency Medicine Physicians Of Honolulu Kapiolani, LLC
Address	1319 Punahou St
City	Honolulu
State	HI
ZIP	96826
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 22, 2014

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

Key Findings

EMERGENCY MEDICINE PHYSICIANS OF HONOLULU KAPIOLANI, LLC is effectively a Medicaid-focused emergency medicine practice: there is no Medicare billing on file while total Medicaid revenue is $7.9M. The NPI was enumerated on 2014-05-22 (~12 years ago), indicating roughly a decade of activity under this enrollment.

Revenue is highly concentrated in a small set of emergency department E/M codes: the precomputed top three Medicaid codes account for 97.3% of the provider's total Medicaid revenue. Those top codes are 99284 (56.0% of Medicaid revenue), 99283 (30.7%), and 99285 (10.6%), showing that almost all payment flows from ED evaluation-and-management services.

The code mix and descriptions identify this entity as an emergency department services provider that primarily delivers moderate- and low-complexity ED care. The predominance of 99284 and 99283 payments, and the comparatively smaller share from 99285, suggest day-to-day operations are driven by high-volume E/M encounters rather than a majority of very high-complexity ED cases.

Payer mix is effectively single-payer at the claim level: Medicare revenue is listed as none while Medicaid revenue totals $7.9M, so analyses of utilization, pricing, and competitive position should treat Medicaid as the primary commercial influence for this billing profile. This concentration has implications for contract negotiations and risk exposure tied to state Medicaid policy.

For 99284 the provider reports 54.5K claims, $81 avg paid/claim, and $4.4M revenue, and it ranks #4 of 47 providers in-state (93th percentile; notably above typical state volume for this code). That ranking and high claim count indicate the provider is a major state-level participant on this code and a primary driver of its Medicaid revenue.

For 99283 the provider reports 41.1K claims, $59 avg paid/claim, and $2.4M revenue, and it ranks #4 of 45 providers in-state (93th percentile; typical, unremarkable volume for this code). This combination of high claim volume and a characterization of typical throughput suggests large-scale ED throughput but within expected state patterns for lower-complexity visits.

99285 and 99291 appear as smaller contributors to revenue and critical-care activity: 99285 shows 8.3K claims, $100 avg paid/claim, $833.4K revenue and ranks #11 of 39 providers in-state (74th percentile; typical, unremarkable volume for this code), while 99291 shows 1.1K claims, $193 avg paid/claim, $209K revenue and ranks #10 of 34 providers in-state (73th percentile; typical, unremarkable volume for this code). These placements indicate some capacity for high-acuity and critical care services but not a dominant statewide position on those codes.

Ancillary and non-clinical line items generate negligible Medicaid revenue: 76815, S9999, and 99053 are present at low claim counts and effectively $0 revenue in the dataset. The provider's financial footprint is therefore overwhelmingly centered on core ED E/M services rather than imaging or after-hours fee lines in Medicaid payment data.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	54,500	$80	$4.4M
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.	41,060	$60	$2.4M
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.	8,330	$100	$833.4K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,080	$190	$209K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	80	$30	$2.2K
99053	The provider renders overnight services at a 24 hour facility.	20	$0	$0
S9999	Sales tax	190	$0	$0

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

Emergency Medicine Physicians Of Honolulu Kapiolani, LLC — 0 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

7 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.	4	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.	4	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.	11	40	3,820	$330	$3.3M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	10	30	200	$290	$329.1K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	13	20	160	$70	$107.8K
99053	The provider renders overnight services at a 24 hour facility.	6	10	1,000	$1	$9.7K
S9999	Sales tax	125	240	200	$1	$820

Related Providers

Other providers that share a Tax Identification Number (TIN) with Emergency Medicine Physicians Of Honolulu Kapiolani, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chijioke Kalu	IN	Family Medicine Physician	$89.2K	$0
Timothy Walbridge	IN	Internal Medicine Physician	$84.3K	$0
Torey Arita	HI	Emergency Medicine Physician	$72.6K	$0
Roderick Alfonso	HI	Emergency Medicine Physician	$69.2K	$580
Lily Gallagher	HI	Emergency Medicine Physician	$61.7K	$0
Wayne Jones	PA	Emergency Medicine Physician	$49.3K	$1.8K
Kathy Short	KY	Family Medicine Physician	$44.4K	$0
Mark Baker	HI	Emergency Medicine Physician	$43.2K	$0
Jonathan Aki	PA	Emergency Medicine Physician	$30.2K	$0
Christopher John	PA	Physician Assistant	$24.7K	$0

Nearby Providers

Other providers in the same ZIP code as Emergency Medicine Physicians Of Honolulu Kapiolani, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kapiolani Medical Center For Women & Children	HI	Children's Hospital	$0	$102.4M
Usrc Beretania, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.3M
Kapiolani Medical Specialists	HI	Multi-Specialty Clinic/Center	$0	$5.1M
Hawaii Anesthesia Group Inc	HI	Anesthesiology Physician	$0	$3.6M
Waikiki Health	HI	Federally Qualified Health Center (FQHC)	$0	$3.5M
Kapiolani Medical Center For Women & Children	HI	Multi-Specialty Clinic/Center	$0	$3.3M
Shriners Hospitals For Children	HI	Children's Hospital	$0	$2.8M
Pediatric Ophthalmology Associates Of Hawaii Inc	HI	Ophthalmology Physician	$0	$1.7M
Dentistry For Children Inc.	HI	Pediatric Dentistry	$0	$1.5M
Peggy Liao	HI	Ophthalmology Physician	$3.3K	$968K

Emergency Medicine Physicians Of Honolulu Kapiolani, LLC — Billing Profile & Reimbursement Data

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Emergency Medicine Physicians Of Honolulu Kapiolani, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References