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.

Hilo Benioff Medical Center (NPI 1780757856)

Field	Value
Entity Type	Organization
Organization	Hilo Benioff Medical Center
Address	1190 Waianuenue Ave
City	Hilo
State	HI
ZIP	96720
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 16, 2006

Payer Source	Total Paid
Medicaid	$51.2M
Medicare	$0

Key Findings

HILO BENIOFF MEDICAL CENTER is effectively a Medicaid-driven provider: there is no Medicare billing on file and total Medicaid revenue is $51.2M, so the hospital’s commercial/Medicare exposure appears minimal in the available data and financial performance is concentrated on state program payments. This single-payer skew increases exposure to Medicaid rate changes and policy decisions at the state level.

Revenue concentration is high: the top three Medicaid codes (99283, 99284, 99282) together account for 58.6% of the provider’s total Medicaid revenue, with 99283 at $12.3M (25.5%), 99284 at $11.5M (23.9%), and 99282 at $4.5M (9.2%). This concentration indicates that a majority of Medicaid dollars flow from emergency department evaluation-and-management activity.

The code mix indicates the hospital functions as an emergency-centric acute care hub: high-revenue E/M ED codes (99281–99285) dominate the Medicaid portfolio alongside observation services (G0378) and frequent advanced imaging (74177, 70450, 74176). Large claim counts for 99281 (26.1K claims) and 99283/99284 (40.8K and 25.7K claims respectively) point to sustained ED throughput that likely drives both admissions and observation stays.

State competitive standing is mixed but includes clear dominance in lower-acuity ED volume: 99282 ranks #1 of 31 providers in-state (100th percentile; labeled an extreme outlier) and 99281 also ranks #1 of 18 providers in-state (100th percentile; extreme outlier), indicating HILO is far above typical peers for low-level ED visits. By contrast, its volumes for 99283 and 99284 are high but described as typical for the state (ranks #5 of 45 at the 91th percentile and #6 of 47 at the 89th percentile respectively), so the hospital is a major but not singular provider at those mid-acuity levels.

Clinical capability appears broad: presence of 99291 critical care ($1.2M, 2.5%) and imaging codes such as 74177 CT abdomen/pelvis ($4.1M, 8.4%) and 70450 CT head ($451.7K) indicate capacity to manage both urgent, higher-acuity cases and rapid diagnostic workflows. High-volume lab and point-of-care testing codes (87502 at $1.6M and 80307 at $1.2M) further suggest a busy emergency and inpatient diagnostic pipeline supporting infectious disease testing and drug screening.

Operational throughput is emphasized by very large claim counts for low-unit-price services: 96374 shows 26.4K claims ($634.5K, 1.3%) and 71045 shows 20.3K claims ($142.3K, 0.3%), indicating the hospital generates material revenue from high-frequency, low-paid procedures and tests typical of an ED-heavy practice. These volumes align with the extreme outlier status on several ED visit codes and amplify the revenue impact of incremental visit volume.

The facility’s role in infusion and time-based observation is visible: 96365 (initial IV infusion) and G0378 (hospital observation service, per hour) are both present in the top codes, and 96374 (single IV push) ranks notably high in-state (rank #2 of 24, 96th percentile). Together with the 99291 critical care activity, this pattern supports a profile that manages a mix of brief infusions, observation-level care, and episodic critical interventions.

The provider has a longstanding NPI tenure (enumerated 2006-11-16, ~20 years ago), indicating an established presence in the HILO market. Coupled with the Medicaid concentration and outsized ED volumes, the hospital appears to be a long-standing, safety-net–style acute care resource for the state Medicaid population rather than a Medicare-focused or specialty outpatient center.

Medicaid: Complete Services Breakdown

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

272 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	40,780	$300	$12.3M
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.	25,690	$450	$11.5M
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.	22,510	$200	$4.5M
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.	7,330	$560	$4.1M
99281	The provider sees a patient for the lowest level emergency department visit.	26,050	$130	$3.3M
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.	4,310	$670	$2.9M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	9,230	$170	$1.6M
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…	1,160	$1,060	$1.2M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11,800	$100	$1.2M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	3,970	$230	$906.1K

Showing 1–10 of 272

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

Hilo Benioff Medical Center — 3 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

272 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3590	Unclassified biologics	4	10	690	$4,180	$8M
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.	5	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.	6	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.	17	40	3,820	$330	$3.3M
G0378	Hospital observation service, per hour	3	10	3,250	$480	$2.3M
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.	1	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.	3	40	1,050	$510	$1.3M
J3490	Unclassified drugs	21	50	160	$200	$740.3K
99281	The provider sees a patient for the lowest level emergency department visit.	1	20	950	$220	$651.2K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	3	10	140	$1,690	$601.5K

Showing 1–10 of 272

Related Providers

Other providers that share a Tax Identification Number (TIN) with Hilo Benioff Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hilo Benioff Medical Center	HI	General Acute Care Hospital	$0	$1.1M
Nathaniel Valin	FL	Cardiovascular Disease Physician	$703.2K	$0
Edward Evans	AZ	Interventional Cardiology Physician	$486.8K	$0
Juliet Seigle	HI	Radiation Oncology Physician	$419.3K	$0
Giselle Baquero Caranama	HI	Interventional Cardiology Physician	$349.8K	$0
Sanjeev Ravipudi	MO	Interventional Cardiology Physician	$348.8K	$0
Patrick Jewell	HI	Radiation Oncology Physician	$266.5K	$0
Jorge Gonzalez	MI	Neurology Physician	$147K	$114.2K
Marvin Chang	TX	Pain Medicine (Anesthesiology) Physician	$228.9K	$0
Taurino Avelar	NV	Nephrology Physician	$218.6K	$2.7K

Nearby Providers

Other providers in the same ZIP code as Hilo Benioff Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$19.3M
Metropacific Group, Corp	HI	Developmentally Disabled Services Day Training Agency	$0	$13.3M
Triple Ace Venture Capital, Corp.	HI	In Home Supportive Care Agency	$0	$10.5M
Whchc - Hawaii Island Community Health Center	HI	Federally Qualified Health Center (FQHC)	$0	$8.1M
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$7.1M
Hilo Urgent Care Center, LLC	HI	Urgent Care Clinic/Center	$0	$6.5M
Alpha Care Hawaii LLC	HI	In Home Supportive Care Agency	$0	$5.9M
Mastercare Inc	HI	In Home Supportive Care Agency	$0	$5.4M
Americare Hawaii Incorporated	HI	In Home Supportive Care Agency	$0	$3.7M
Garret K. Uehara, Dds Inc. Dba	HI	General Practice Dentistry	$0	$3.6M

Hilo Benioff Medical Center — Billing Profile & Reimbursement Data

Sign up for Hilo Benioff Medical Center — Billing Profile & Reimbursement Data policy alerts

Hilo Benioff Medical Center — Billing Profile & Reimbursement Data

Sign up for Hilo Benioff Medical Center — Billing Profile & Reimbursement Data policy alerts

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