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.

Reis Pediatrics LLC (NPI 1902196314)

Reis Pediatrics LLC is a pediatrics physician provider located in Kailua, Hawaii. This profile covers 0 Medicare and 38 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	Reis Pediatrics LLC
Address	30 Aulike St
City	Kailua
State	HI
ZIP	96734
Taxonomy	Pediatrics Physician
NPI Enumerated	April 19, 2011

Payer Source	Total Paid
Medicaid	$225K
Medicare	$0

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

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	7,530	$10	$105.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	540	$60	$33.1K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	600	$30	$17.3K
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…	990	$20	$15.9K
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.	2,170	$10	$10.9K
99072	The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items…	4,730	$1	$9.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	300	$30	$7.9K
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…	160	$30	$4.7K
99392	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…	150	$30	$4.1K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	80	$40	$3K

Showing 1–10 of 38

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

Reis Pediatrics LLC — 1 of 23 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

38 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…	61	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…	278	690	650	$90	$235.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	143	190	190	$100	$122.8K
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…	60	100	210	$120	$116.7K
99392	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…	68	100	210	$110	$101.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	49	110	230	$90	$55.7K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	8	10	90	$60	$40.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	78	90	180	$70	$31.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	25	40	160	$60	$31K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	97	230	140	$20	$16.1K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Castle Medical Center	HI	General Acute Care Hospital	$0	$37.6M
Hawaii Emergency Physicians Associated Inc	HI	Emergency Medicine Physician	$0	$20.2M
Howard Y Kim Dds Inc	HI	Pediatric Dentistry	$0	$3.3M
Liberty Dialysis - Hawaii LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.1M
Pacific Island Medical, Inc.	HI	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Hawaii Dermatology Centers, Inc	HI	Specialist	$0	$1.4M
Medical Clinic, Inc.	HI	Multi-Specialty Clinic/Center	$0	$1.3M
Kupunaride Corporation	HI	Non-emergency Medical Transport (VAN)	$0	$943.9K
Stuart Lerner, M.d. LLC	HI	Family Medicine Physician	$0	$920.4K
Windward Heart Center LLC	HI	Cardiovascular Disease Physician	$0	$885K

Reis Pediatrics LLC — Billing Profile & Reimbursement Data

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Reis Pediatrics 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

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