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NPI 1811213523 · Honolulu, HI · Psychiatry Physician
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Koji Iizuka is a psychiatry physician provider located in Honolulu, Hawaii. This profile covers 2 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Koji Iizuka |
| Address | 928 Nuuanu Ave Lowr Level |
| City | Honolulu |
| State | HI |
| ZIP | 96817 |
| Taxonomy | Psychiatry Physician |
| NPI Enumerated | April 20, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $26K |
| Medicare | $14.8K |
This provider shows a Medicaid-tilted payer mix in lifetime revenue: total Medicaid revenue is $26K versus total Medicare revenue of $14.8K, so Medicaid is the larger revenue source on record. Both payers are present rather than a single-payer profile, but the scale of Medicaid receipts is materially larger in absolute dollars.
Revenue is highly concentrated by a small number of outpatient E/M and psychotherapy codes. The precomputed top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, with 99214 representing $9.4K (64.1% of Medicare revenue, 121 claims, $78 avg paid/claim) and 90833 representing $5.3K (35.9% of Medicare revenue, 110 claims, $48 avg paid/claim).
Medicaid revenue is similarly concentrated in the same outpatient visit and psychotherapy add-on codes. The precomputed top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with 99214 at $18.4K (70.8% of Medicaid revenue, 1.3K claims, $14 avg paid/claim) and 90833 at $7.6K (29.2% of Medicaid revenue, 1.5K claims, $5 avg paid/claim), indicating those two code families virtually fully explain Medicaid billing value.
The clinical/service mix points to office-based psychiatry with frequent use of psychotherapy provided in conjunction with evaluation and management visits. The presence of high counts for 99214 (1.3K Medicaid claims, 121 Medicare claims) alongside high counts for the psychotherapy add-on 90833 (1.5K Medicaid claims, 110 Medicare claims) suggests routine combined E/M + psychotherapy sessions are a core operational pattern for both payers.
Payer-specific reimbursement patterns show large differences in per-claim payments between Medicare and Medicaid for the same codes, which has operational and margin implications. For 99214 the avg paid/claim is $78 in Medicare versus $14 in Medicaid, and for 90833 it is $48 in Medicare versus $5 in Medicaid, while several Medicaid-listed codes (99213, Q3014, 90836) show $0 avg paid/claim and 0.0% of Medicaid revenue in the data.
On competitive standing, this provider is a modest participant rather than a dominant player. For Medicare, 99214 ranks #221389 of 479517 (54th percentile) and 90833 ranks #3160 of 7842 (59th percentile), described in our data as "typical, unremarkable volume for this code," indicating unexceptional national volumes. For in-state Medicaid competition, 99214 ranks #234 of 690 (66th percentile) and 90833 ranks #27 of 85 (69th percentile), again labeled "typical, unremarkable volume for this code," which places the provider slightly above median in-state but not among top-volume specialists.
The heavy reliance on the psychotherapy add-on 90833 across both payers (35.9% of Medicare revenue and 29.2% of Medicaid revenue) signals revenue sensitivity to changes in add-on billing policy or utilization. Because combined E/M + psychotherapy is a major revenue driver, any payer-specific policy adjustments or documentation requirements affecting add-on psychotherapy could disproportionately affect this provider's revenue.
This provider has an established presence in the marketplace with NPI enumeration dated 2010-04-20 (~16 years ago), indicating long-tenured billing history. That tenure, combined with the concentrated code mix, suggests a stable, outpatient psychiatry practice model focused on established-patient management and psychotherapy delivered alongside evaluation and management visits.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 120 | $80 | $9.4K |
| 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… | 110 | $50 | $5.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,310 | $10 | $18.4K |
| 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… | 1,510 | $10 | $7.6K |
| 90836 | 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… | 40 | $0 | $0 |
| 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… | 290 | $0 | $0 |
| Q3014 | Telehealth originating site facility fee | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
5 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… | 442 | 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… | 234 | 690 | 650 | $90 | $235.4K |
| 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… | 27 | 90 | 500 | $30 | $56.4K |
| 90836 | 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… | 24 | 30 | 380 | $40 | $41.5K |
| Q3014 | Telehealth originating site facility fee | 26 | 30 | 190 | $20 | $17.5K |
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