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.

Queens University Medical Group (NPI 1891441382)

Key Findings

Field	Value
Entity Type	Organization
Organization	Queens University Medical Group
Address	1301 Punchbowl St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	February 23, 2022

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

This provider is effectively a single‑payer Medicaid billing entity: Total Medicaid revenue is $7.4M and there is no Medicare billing on file. The absence of Medicare activity means analyses and contracting conversations should treat QUEENS UNIVERSITY MEDICAL GROUP primarily as a Medicaid-focused operator in Hawaii.

Medicaid revenue is highly concentrated in a small set of E/M codes: the precomputed top‑three Medicaid codes account for 51.3% of the provider's total Medicaid revenue, led by 99233 ($2M, 29.0%), followed by 99213 ($991.4K, 14.3%) and 99214 ($556.1K, 8.0%). This concentration indicates that a majority of payments flow from high-volume evaluation-and-management services rather than a broad mix of low-revenue procedures.

The code mix indicates a hybrid operation spanning inpatient/observation care, outpatient primary care, urgent care, behavioral health, and significant diagnostic imaging. High-volume inpatient/observation E/M codes such as 99233, 99232, 99223 and discharge code 99239 appear alongside office visit codes 99213/99214, urgent care S9088, psychiatric evaluation 90792, and imaging codes like 74177 and 70450, consistent with a multi‑specialty clinic/center providing both hospital-based and outpatient services.

QUEENS UNIVERSITY MEDICAL GROUP is a dominant statewide player for specific inpatient E/M services: 99233 ranks #2 of 72 (99th percentile; extreme outlier), and related codes show elevated rankings (99223 ranks #3 of 65, 97th percentile; notably above typical; 99232 ranks #4 of 83, 96th percentile; notably above typical). These rankings and labels indicate the provider captures unusually large inpatient/observation volumes in Hawaii compared with peers.

The provider also shows a strong urgent and acute care footprint. S9088 (urgent care) reports 23.1K claims and $323.3K revenue (4.7%) and ranks #2 of 38 (97th percentile; notably above typical), while critical care code 99291 has $280.4K revenue (4.0%) and ranks #7 of 34 (82th percentile; typical, unremarkable volume), signaling material acute-care throughput in addition to scheduled visits.

Diagnostic/imaging throughput materially supports clinical activity: CT abdomen/pelvis with contrast 74177 has 4.9K claims and $325.3K revenue (4.7%) and ranks #6 of 36 (86th percentile; typical, unremarkable), CT head 70450 has 5.1K claims and $132K revenue (1.9%) and ranks #7 of 37 (83th percentile; typical, unremarkable), and echocardiography 93306 contributes $172.7K (2.5%) and ranks #3 of 59 (97th percentile; typical, unremarkable). This mix suggests integrated imaging capacity that supports both inpatient and outpatient demand.

Several codes outside the top three are identified as notably above typical statewide volumes, which reinforces that the provider’s market position is concentrated but multi-faceted: examples include 99203 (ranks #6 of 171, 97th percentile; notably above typical), 90792 (ranks #3 of 44, 95th percentile; notably above typical), and 99239 (ranks #2 of 41, 98th percentile; notably above typical). For network planners and utilization reviewers, these labels flag where the provider’s Medicaid activity materially exceeds typical state volumes.

The NPI was enumerated on 2022-02-23 (~4 years ago), indicating relatively recent formal registration. In combination with the high ranks and the revenue concentration in a few E/M and acute-care codes, this tenure is consistent with a provider that has rapidly scaled Medicaid-facing inpatient and urgent care services in Hawaii; the heavy reliance on a handful of high-volume codes also implies revenue sensitivity to reimbursement or utilization shifts for those services.

Medicaid: Complete Services Breakdown

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

155 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	36,500	$60	$2M
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…	18,360	$50	$991.4K
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…	10,300	$50	$556.1K
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…	12,500	$40	$449.8K
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…	3,300	$100	$340K
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.	4,860	$70	$325.3K
S9088	Services provided in an urgent care center (list in addition to code for service)	23,090	$10	$323.3K
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…	2,300	$120	$280.4K
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…	3,160	$90	$271.9K
99203	The provider sees a new 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 provider…	3,460	$80	$266.7K

Showing 1–10 of 155

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

Queens University Medical Group — 10 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

155 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	6	40	1,050	$510	$1.3M
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.	13	30	770	$430	$536.6K
J0585	Injection, onabotulinumtoxina, 1 unit	7	10	50	$1,110	$350.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	14	30	1,370	$110	$333.9K
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…	7	30	200	$290	$329.1K
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…	16	710	650	$90	$274.1K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	5	10	320	$550	$252.9K
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…	31	690	650	$90	$235.4K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	4	10	130	$410	$218.1K
74174	In this procedure, the provider performs computed tomographic angiography of the abdomen and pelvis with contrast and may take noncontrast images as well. After taking the images, he uses a…	2	10	20	$1,200	$205.7K

Showing 1–10 of 155

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Yusuf Aref	FL	Anesthesiology Physician	$619.8K	$0
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
Linda Gordon	CA	Diagnostic Radiology Physician	$271.9K	$0
Siva Raman	CA	Diagnostic Radiology Physician	$257.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M

Queens University Medical Group — 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