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 1962584060)

Hilo Benioff Medical Center is a general acute care hospital provider located in Hilo, Hawaii. This profile covers 0 Medicare and 50 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	Hilo Benioff Medical Center
Address	1190 Waianuenue Ave
City	Hilo
State	HI
ZIP	96720
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 19, 2006

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

50 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…	13,630	$30	$422.6K
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…	4,680	$40	$196.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	2,470	$30	$81.6K
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…	2,210	$30	$59.5K
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…	660	$80	$50.7K
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…	790	$60	$46.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	880	$40	$37K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	550	$60	$33.9K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	440	$60	$25.5K
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…	290	$80	$24.2K

Showing 1–10 of 50

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

50 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	29	30	2,660	$330	$1.5M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	32	70	370	$150	$457.3K
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…	33	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…	29	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…	78	690	650	$90	$235.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	8	60	650	$110	$152.2K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	2	10	1,080	$120	$131.4K
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…	54	70	520	$50	$125.4K
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,…	144	190	190	$100	$122.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	36	80	320	$100	$119.2K

Showing 1–10 of 50

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hilo Benioff Medical Center	HI	General Acute Care Hospital	$0	$51.2M
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

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

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Hilo Benioff Medical Center — 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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