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.

Hawaii Nephrologists LLC (NPI 1871909549)

Hawaii Nephrologists LLC is a nephrology physician provider located in Waipahu, Hawaii. This profile covers 0 Medicare and 11 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	Hawaii Nephrologists LLC
Address	94-229 Waipahu Depot St Ste 101
City	Waipahu
State	HI
ZIP	96797
Taxonomy	Nephrology Physician
NPI Enumerated	July 2, 2014

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	4,360	$110	$471K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7,660	$50	$352.2K
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…	4,790	$50	$239.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,010	$80	$81.4K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	180	$100	$18.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	150	$60	$9.6K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	90	$80	$7.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	100	$40	$3.5K
99204	The 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…	50	$60	$3.4K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	380	$10	$2.7K

Showing 1–10 of 11

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

Hawaii Nephrologists LLC — 0 of 11 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

11 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…	633	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…	74	690	650	$90	$235.4K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2	10	1,120	$100	$190.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	70	520	$50	$125.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	58	80	290	$30	$75.5K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	8	10	190	$90	$75.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9	70	130	$90	$45.7K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	11	20	420	$70	$32.8K
99204	The 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…	96	170	70	$90	$23.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	12	30	130	$70	$20.2K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preferred Home & Community Based Services, Inc.	HI	Developmentally Disabled Services Day Training Agency	$0	$66.9M
Bayada Home Care	HI	Developmentally Disabled Services Day Training Agency	$0	$33.3M
Hawaii Health Services, Inc.	HI	Home Health Agency	$0	$29.4M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$19.4M
Dsi Waipahu, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.7M
Blue Water Resources	HI	Case Management Agency	$0	$5.7M
Family Services Of Oahu,llc	HI	Developmentally Disabled Services Day Training Agency	$0	$4.9M
Loving Care Health Provider, Inc.	HI	In Home Supportive Care Agency	$0	$4.2M
Leeward Pedodontix, LLC	HI	Pediatric Dentistry	$0	$4.1M
Metropacific Group, Corp	HI	In Home Supportive Care Agency	$0	$2.8M

Hawaii Nephrologists LLC — Billing Profile & Reimbursement Data

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Hawaii Nephrologists LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valerie Tan	HI	Nephrology Physician	$148.2K	$0
Wei Boon Ooi	HI	Nephrology Physician	$140.4K	$0
Arie Olivo Ganz	HI	Nephrology Physician	$122.6K	$0
Rafal Ciecierski	HI	Nephrology Physician	$76.9K	$3.3K