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.

Queen's North Hawaii Community Hospital (NPI 1780177493)

Queen's North Hawaii Community Hospital is a general practice physician provider located in Kamuela, 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	Queen's North Hawaii Community Hospital
Address	65-1267 Kawaihae Rd
City	Kamuela
State	HI
ZIP	96743
Taxonomy	General Practice Physician
NPI Enumerated	June 8, 2018

Payer Source	Total Paid
Medicaid	$642K
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
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	2,350	$130	$312.9K
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…	2,270	$70	$163.7K
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…	1,400	$100	$137.4K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	240	$70	$16.9K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	140	$30	$3.9K
90834	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…	40	$70	$2.9K
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…	20	$150	$2.6K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	20	$80	$1.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	30	$10	$250

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

Queen's North Hawaii Community Hospital — 0 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
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…	179	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…	230	690	650	$90	$235.4K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	4	20	310	$130	$184K
90834	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…	66	80	320	$100	$119.2K
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…	94	100	210	$120	$116.7K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	59	90	500	$30	$56.4K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	7	20	190	$80	$48.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	37	40	50	$90	$39.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	91	100	290	$1	$3.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Queens North Hawaii Community Hospital	HI	General Acute Care Hospital	$0	$13M
Patrick Gonzales	CA	Vascular & Interventional Radiology Physician	$2.7M	$0
Vivek Kesari	MD	Nuclear Medicine Physician	$1.4M	$0
Patrick Ryan	CA	Diagnostic Radiology Physician	$722.4K	$0
Edwin Herd	HI	Pediatrics Physician	$0	$640.5K
Queen's North Hawaii Community Hospital	HI	Obstetrics & Gynecology Physician	$0	$622.5K
Sunil Gandhi	CA	Diagnostic Radiology Physician	$551.9K	$0
Faisal Shah	NY	Diagnostic Radiology Physician	$245.2K	$259.8K
Nicholas Vu	CT	Diagnostic Radiology Physician	$472.5K	$1.7K
Joshua Rabang	CA	Diagnostic Radiology Physician	$307.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hawaii Life Flight, LLC	HI	Air Ambulance	$379.2K	$2M
Five Mountains Hawaii, Inc	HI	Rural Health Clinic/Center	$0	$1.6M
Liberty Dialysis-north Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Paniolo Pediatric And Family Medicine Inc	HI	Pediatrics Physician	$0	$1.4M
Vein Clinics Of Hawaii LLC	HI	Vascular Surgery Physician	$0	$673.3K
John Mascaro	HI	Marriage & Family Therapist	$0	$523.3K
Steven Chelminiak	HI	Clinical Social Worker	$0	$498.8K
Duerler, Inc.	HI	Family Medicine Physician	$0	$479.7K
Queens North Hawaii Community Hospital	HI	Orthopaedic Surgery Physician	$0	$230.7K
Keiki Therapy LLC	HI	Occupational Therapist	$0	$230.2K

Queen's North Hawaii Community Hospital — Billing Profile & Reimbursement Data

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Queen's North Hawaii Community Hospital — 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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