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.

S.sira,m.d.,facog,inc (NPI 1972671642)

Field	Value
Entity Type	Organization
Organization	S.sira,m.d.,facog,inc
Address	79-7266 Mamalahoa Hwy
City	Kealakekua
State	HI
ZIP	96750
Taxonomy	Clinic/Center
NPI Enumerated	December 1, 2006

Payer Source	Total Paid
Medicaid	$140.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 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…	2,000	$60	$117.8K
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…	340	$70	$23.1K

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

S.sira,m.d.,facog,inc — 0 of 2 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

2 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…	194	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…	439	690	650	$90	$235.4K

Nearby Providers

Other providers in the same ZIP code as S.sira,m.d.,facog,inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kona Hospital	HI	General Acute Care Hospital	$0	$22.3M
Affordable Care LLC	HI	Home Health Agency	$0	$1.5M
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$257.6K
Yaser Alsaadi	HI	Dental Clinic/Center	$0	$208.7K
Sound Physicians Of Hawaii Inc	HI	Internal Medicine Physician	$0	$195K
Timothy Kale	HI	Optometrist	$71.7K	$103.7K
Nathan King	HI	Internal Medicine Physician	$116.9K	$45.3K
Bradon Kimura	HI	Family Medicine Physician	$135.6K	$0
Wesley J. Sugai, M.d., Inc.	HI	Pediatrics Physician	$0	$131.6K
Ginelle Sakima Roberts	HI	Pediatric Dentistry	$0	$129.9K

S.sira,m.d.,facog,inc — Billing Profile & Reimbursement Data

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S.sira,m.d.,facog,inc — Billing Profile & Reimbursement Data

Sign up for S.sira,m.d.,facog,inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References