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.

Sian Yik Lim (NPI 1992092225)

Field	Value
Entity Type	Individual
Organization	Sian Yik Lim
Address	98-1079 Moanalua Rd Ste 300
City	Aiea
State	HI
ZIP	96701
Taxonomy	Rheumatology Physician
NPI Enumerated	July 7, 2011

Payer Source	Total Paid
Medicare	$316.7K
Medicaid	$0

Key Findings

SIAN YIK LIM is a Rheumatology Physician enumerated on 2011-07-07 (~15 years ago) practicing in AIEA, HI; lifetime Medicare revenue on file is $316.7K and there is no Medicaid billing on file, indicating an effectively single-payer Medicare footprint for the claims available. The absence of any Medicaid billing on file means state Medicaid does not appear in this provider’s payer mix data.

Revenue concentration is highly focused: the precomputed top three Medicare codes account for 90.6% of this provider’s total Medicare revenue, led by J0897 at 64.1%, followed by 99214 at 17.9% and 99213 at 8.5%. This concentration shows most revenue is driven by a single drug administration code plus two office E/M levels.

The top revenue driver, J0897 (Injection, denosumab), shows 11.3K claims with an $18 avg paid/claim generating $203K (64.1% of Medicare revenue), which is reported as a typical, unremarkable volume and ranks #925 of 10057 providers nationally (91th percentile). That pattern — high claim count with a low average paid per claim — is consistent with frequent, low-unit administrations of a medication in office-based settings.

Office evaluation-and-management activity is the second and third largest revenue sources: 99214 has 668 claims and $56.8K revenue (17.9% of Medicare revenue) and is labeled "notably above typical national volume," ranking #28810 of 479517 providers (94th percentile). 99213 has 432 claims and $26.8K revenue (8.5% of Medicare revenue) and is described as typical, unremarkable volume, ranking #34598 of 457151 providers (92th percentile). This mix indicates a practice model combining regular medication administration with substantial mid-level complexity follow-up visits.

Procedure and diagnostic supports are present but secondary to drug and E/M revenue: 20611 (ultrasound-guided arthrocentesis) shows 71 claims and $6.1K (1.9% of Medicare revenue) and is labeled typical, unremarkable volume, while 76882 (limited extremity ultrasound) shows 80 claims and $2.3K (0.7% of Medicare revenue) and is labeled typical, unremarkable volume. These codes confirm point-of-care procedural work (joint injections/arthrocentesis and ultrasound) but together contribute only a small share of total Medicare revenue.

Competitive standing is mixed across codes: for the drug J0897 the provider ranks #925 of 10057 (91th percentile) and is characterized as typical, whereas for 99214 the provider ranks #28810 of 479517 (94th percentile) and is described as notably above typical national volume, suggesting above-average E/M throughput relative to peers but routine participation in denosumab administration. Lower-volume codes such as 99215 (14 claims, $1.9K, 0.6% of revenue) are reported as typical, unremarkable volume (rank #129827 of 145531, 8th percentile), indicating limited high-complexity visit volume.

Operational and risk implications: reliance on a single high-revenue drug code (J0897) plus two E/M codes represents concentration risk — top three codes equal 90.6% of Medicare revenue — and creates exposure to changes in drug utilization or reimbursement. The practice appears established (~15 years of enrollment) and oriented toward office-based medication administration and follow-up care for chronic musculoskeletal or bone-related conditions, with procedural services on the side rather than as primary revenue drivers.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	11,280	$20	$203K
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…	670	$90	$56.8K
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…	430	$60	$26.8K
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…	120	$110	$14K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	70	$90	$6.1K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	230	$10	$2.8K
76882	The provider uses ultrasound for a limited study of one or more nonvascular structures in an extremity. The image appears in real time on a monitor, and a permanent copy is made and documented in the…	80	$30	$2.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	10	$130	$1.9K
20606	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa, typically the temporomandibular, acromioclavicular, wrist, elbow, ankle, or…	20	$60	$1K
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,…	20	$50	$710

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Sian Yik Lim — 2 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	4	20	2,530	$20	$121.5K
99214	67	1,440	100	$80	$15.2K
20611	10	20	50	$80	$11.2K
99215	336	380	40	$120	$11.2K
99213	100	1,460	70	$60	$8.4K
99204	32	630	30	$110	$5.3K
20610	62	60	50	$50	$3.6K
99212	252	310	30	$40	$2.9K
20606	1	10	20	$60	$1K
76882	2	20	30	$30	$960

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sian Yik Lim, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kapiolani Medical Center For Women & Children	HI	Children's Hospital	$0	$102.4M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M
Kapiolani Medical Center For Women & Children	HI	Multi-Specialty Clinic/Center	$0	$3.3M
Straub Clinic & Hospital	HI	Community/Retail Pharmacy	$0	$984.9K
Devy Setyono	HI	Rheumatology Physician	$712.5K	$0
Manas Jain	WA	Urology Physician	$489.2K	$0
Arnold Kop	HI	Internal Medicine Physician	$392.9K	$0
Boyuan Cao	HI	Internal Medicine Physician	$81.1K	$288.1K
Cass Nakasone	HI	Orthopaedic Surgery Physician	$233K	$0

Nearby Providers

Other providers in the same ZIP code as Sian Yik Lim, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Diagnostic Laboratory Services, Inc	HI	Clinical Medical Laboratory	$10.5M	$46M
Pali Momi Medical Center	HI	General Acute Care Hospital	$0	$49.3M
Dlmc, Inc.	HI	Home Health Agency	$0	$39.5M
Usrc Pearlridge, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.7M
International Life Support Inc	HI	Ambulance	$1.2M	$8.6M
Dialysis Newco LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.8M
Pharmacare International, Inc.	HI	Community/Retail Pharmacy	$125.1K	$4.7M
Emergency Medicine Physicians Of Honolulu Pali Momi, LLC	HI	Emergency Medicine Physician	$0	$4.2M
Absolute Care Management Services	HI	Point of Service	$0	$3.2M
Derek B Tom Dds LLC	HI	Pediatric Dentistry	$0	$2.6M

Sian Yik Lim — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References