Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Hospital

Pali Momi Medical Center

Pali Momi Medical Center was paid $49.28M by Medicaid between Jan 2018 and Dec 2024, across 253 billing codes. Its largest line is 99283, emergency room visit (moderate) — 28% of everything it billed.

33Billing provider infoPALI MOMI MEDICAL CENTER
AIEA, HI 96701
33aNPI1013961408assigned 05/20/2006
28Total paid$49.28M
24GClaims715,392
24DCodes billed253
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other General Acute Care Hospital providers in Hawaii

Rank by total paid#4 of 18
Median peer was paid$10.94M
This provider vs. median4.5×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

$0$500K$1.0M$1.5M2018201920202021202220232024
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
YearClaimsPaid
2018125,173$8.02M
2019131,897$7.80M
202085,647$4.58M
202198,101$6.01M
2022100,364$7.18M
202396,210$7.26M
2024incomplete78,000$8.43M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 28% 31,321 28,525 $14.04M
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 23% 15,841 13,942 $11.20M
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 21% 20,752 18,874 $10.31M
99282 Emergency department visit for the evaluation and management, low to moderate severity 5.5% 7,643 7,232 $2.70M
G0378 Hospital observation service, per hour 5.0% 4,204 2,515 $2.45M
74177 Computed tomography, abdomen and pelvis; with contrast material 4.7% 3,846 3,641 $2.34M
74176 Computed tomography, abdomen and pelvis; without contrast material 2.5% 2,630 2,457 $1.24M
L8699 Prosthetic implant, not otherwise specified 1.3% 745 683 $655K
77067 Screening mammography, bilateral, including computer-aided detection 1.1% 6,076 5,985 $519K
A4649 Surgical supply; miscellaneous <1% 55,548 41,245 $372K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 1,146 1,071 $360K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete <1% 2,051 1,971 $290K
241 more codes
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete <1% 3,189 $233K
77065 Tomosynthesis, mammo <1% 2,615 $215K
77066 Tomosynthesis, mammo <1% 1,971 $214K
76811 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed <1% 1,222 $184K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 2,158 $175K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress <1% 327 $141K
76805 Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation <1% 1,445 $124K
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up <1% 1,413 $95K
76813 <1% 1,327 $92K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour <1% 7,562 $88K
76700 Ultrasound, abdominal, real time with image documentation; complete <1% 1,760 $84K
71250 <1% 809 $78K
93976 <1% 756 $64K
70553 Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences <1% 86 $60K
70450 Computed tomography, head or brain; without contrast material <1% 4,344 $57K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 1,054 $56K
76642 <1% 4,461 $51K
71046 Radiologic examination, chest; 2 views <1% 12,964 $50K
70551 Magnetic resonance imaging, brain; without contrast material <1% 628 $47K
36902 <1% 155 $45K
72100 <1% 1,830 $44K
76770 <1% 835 $40K
96361 Intravenous infusion, hydration; each additional hour <1% 4,885 $40K
71275 Computed tomographic angiography, chest, with contrast material <1% 314 $31K
C9803 Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source <1% 3,089 $30K
96367 <1% 2,989 $29K
96413 Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance <1% 2,373 $29K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 2,025 $28K
36591 <1% 1,780 $26K
76536 <1% 543 $21K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular <1% 11,834 $20K
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report <1% 24,323 $20K
73130 <1% 1,499 $18K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 1,037 $18K
73630 <1% 1,827 $15K
77080 <1% 246 $14K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 17 $13K
73610 <1% 1,571 $13K
76801 <1% 177 $12K
93017 <1% 767 $11K
73030 <1% 1,609 $11K
73560 <1% 966 $10K
73110 <1% 735 $10K
73562 <1% 1,043 $9K
76819 Fetal biophysical profile; without non-stress testing <1% 199 $9K
74183 <1% 13 $9K
76831 <1% 26 $8K
86850 <1% 1,563 $8K
36430 <1% 350 $8K
73502 <1% 315 $7K
72125 Computed tomography, cervical spine; without contrast material <1% 555 $7K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance <1% 11,318 $6K
93971 <1% 272 $5K
94060 <1% 135 $5K
72148 Magnetic resonance imaging, lumbar spine; without contrast material <1% 24 $4K
94726 <1% 38 $4K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 12 $4K
76815 Ultrasound, pregnant uterus, real time with image documentation, limited <1% 123 $3K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 1,024 $3K
96415 <1% 277 $3K
J3490 Unclassified drugs <1% 30,066 $3K
72141 <1% 12 $3K
71045 Radiologic examination, chest; single view <1% 7,164 $2K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 60 $2K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 228 $2K
J0561 Injection, penicillin g benzathine, 100,000 units <1% 12 $2K
73590 <1% 155 $2K
73140 <1% 180 $2K
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 4,579 $2K
73564 <1% 26 $2K
80305 <1% 2,669 $2K
86920 <1% 271 $2K
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 3,042 $2K
96375 Therapeutic injection; each additional sequential IV push <1% 10,050 $1K
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal <1% 536 $1K
87186 <1% 2,685 $1K
80053 Comprehensive metabolic panel <1% 25,017 $1K
74018 <1% 186 $1K
10060 <1% 149 $989.46
72170 <1% 75 $978.40
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 5,631 $761.81
29125 <1% 27 $740.03
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 36,525 $708.75
P9016 Red blood cells, leukocytes reduced, each unit <1% 196 $705.29
84132 <1% 2,334 $704.79
88341 <1% 58 $664.00
83880 <1% 4,023 $630.34
80048 Basic metabolic panel (calcium, ionized) <1% 11,026 $584.33
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 8,506 $502.08
84484 <1% 11,890 $469.16
96523 <1% 28 $451.97
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 1,059 $417.79
A9270 Non-covered item or service <1% 8,267 $405.84
93308 <1% 12 $316.65
74022 <1% 432 $276.69
81025 <1% 7,461 $267.81
73080 <1% 15 $258.44
93246 <1% 16 $238.37
87040 <1% 3,009 $237.85
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 1,070 $180.91
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 854 $166.13
90715 <1% 1,573 $162.55
71101 <1% 70 $161.76
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 5,117 $159.13
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 2,771 $152.93
83690 <1% 8,609 $151.80
76830 Ultrasound, transvaginal <1% 3,110 $127.59
83605 <1% 3,523 $126.56
87086 Culture, bacterial; quantitative colony count, urine <1% 5,085 $123.23
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 9,419 $121.89
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 2,571 $121.13
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 10,392 $117.76
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,716 $107.59
96376 <1% 3,634 $107.53
Q9963 High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml <1% 516 $102.13
84703 <1% 2,954 $101.87
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 8,560 $90.17
A4648 Tissue marker, implantable, any type, each <1% 12 $89.91
J1815 Injection, insulin, per 5 units <1% 818 $86.30
83036 Hemoglobin; glycosylated (A1C) <1% 640 $59.79
J2270 Injection, morphine sulfate, up to 10 mg <1% 4,428 $57.50
84443 Thyroid stimulating hormone (TSH) <1% 999 $56.99
81003 <1% 6,652 $55.43
87077 <1% 3,364 $52.56
36415 Collection of venous blood by venipuncture <1% 24,531 $50.12
81001 <1% 5,747 $49.38
83735 <1% 2,288 $45.72
J1170 Injection, hydromorphone, up to 4 mg <1% 1,984 $44.89
J3370 Injection, vancomycin hcl, 500 mg <1% 830 $40.62
85379 <1% 449 $39.56
J2060 Injection, lorazepam, 2 mg <1% 679 $38.04
85610 <1% 3,475 $36.58
82948 <1% 2,256 $36.28
E0114 Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips <1% 698 $34.00
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 2,848 $32.17
73660 <1% 12 $29.88
A4550 Surgical trays <1% 5,911 $28.80
A4217 Sterile water/saline, 500 ml <1% 1,390 $28.41
85730 <1% 1,146 $28.40
81015 <1% 2,499 $23.07
A4565 Slings <1% 250 $22.80
84702 <1% 83 $20.80
86901 <1% 2,123 $20.67
J8540 Dexamethasone, oral, 0.25 mg <1% 562 $20.28
73070 <1% 14 $18.60
J3010 Injection, fentanyl citrate, 0.1 mg <1% 8,140 $18.51
84145 <1% 37 $17.77
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 2,682 $16.13
J0137 Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg <1% 445 $13.62
J1940 Injection, furosemide, up to 20 mg <1% 1,042 $10.68
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 1,524 $9.97
87070 <1% 553 $7.51
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A <1% 387 $6.99
A6257 Transparent film, sterile, 16 sq. in. or less, each dressing <1% 4,944 $5.88
82550 <1% 204 $4.64
A4215 Needle, sterile, any size, each <1% 15,818 $4.31
A4620 Variable concentration mask <1% 3,567 $4.17
86900 <1% 1,936 $3.27
J1642 Injection, heparin sodium, (heparin lock flush), per 10 units <1% 6,479 $3.02
A6402 Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing <1% 4,031 $3.01
C9113 Injection, pantoprazole sodium, per vial <1% 20 $2.30
A6449 Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard <1% 343 $2.07
J2704 Injection, propofol, 10 mg <1% 5,845 $1.23
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 5,458 $0.55
A6403 Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing <1% 1,349 $0.44
A6446 Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard 0% 370 $0.00
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg 0% 220 $0.00
A4618 Breathing circuits 0% 571 $0.00
J1644 Injection, heparin sodium, per 1000 units 0% 4,191 $0.00
84100 0% 336 $0.00
Q9950 Injection, sulfur hexafluoride lipid microspheres, per ml 0% 330 $0.00
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose 0% 326 $0.00
J7030 Infusion, normal saline solution , 1000 cc 0% 828 $0.00
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 0% 705 $0.00
A6258 Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing 0% 511 $0.00
J0780 Injection, prochlorperazine, up to 10 mg 0% 270 $0.00
C1887 Catheter, guiding (may include infusion/perfusion capability) 0% 151 $0.00
87075 0% 72 $0.00
J0688 Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg 0% 52 $0.00
J0670 Injection, mepivacaine hydrochloride, per 10 ml 0% 94 $0.00
87660 0% 160 $0.00
J1596 Injection, glycopyrrolate, 0.1 mg 0% 215 $0.00
J3475 Injection, magnesium sulfate, per 500 mg 0% 57 $0.00
J1171 Injection, hydromorphone, 0.1 mg 0% 34 $0.00
J2720 Injection, protamine sulfate, per 10 mg 0% 92 $0.00
J2004 Injection, lidocaine hcl with epinephrine, 1 mg 0% 65 $0.00
J0136 Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg 0% 26 $0.00
82565 0% 13 $0.00
94799 0% 83 $0.00
77062 0% 26 $0.00
96160 0% 40 $0.00
58340 0% 14 $0.00
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf 0% 13 $0.00
L1906 Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf 0% 12 $0.00
87634 0% 27 $0.00
Q9969 Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose 0% 986 $0.00
J3471 Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units) 0% 117 $0.00
A7521 Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each 0% 1,192 $0.00
J0690 Injection, cefazolin sodium, 500 mg 0% 3,854 $0.00
J7050 Infusion, normal saline solution, 250 cc 0% 2,184 $0.00
86140 0% 165 $0.00
97162 0% 63 $0.00
A4570 Splint 0% 453 $0.00
A9585 Injection, gadobutrol, 0.1 ml 0% 1,544 $0.00
J2371 Injection, phenylephrine hydrochloride, 20 micrograms 0% 200 $0.00
J0330 Injection, succinylcholine chloride, up to 20 mg 0% 525 $0.00
87088 0% 184 $0.00
C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) 0% 370 $0.00
B4083 Stomach tube - levine type 0% 37 $0.00
77063 Screening digital breast tomosynthesis, bilateral 0% 894 $0.00
A4467 Belt, strap, sleeve, garment, or covering, any type 0% 1,124 $0.00
87081 0% 259 $0.00
88342 0% 212 $0.00
C1769 Guide wire 0% 301 $0.00
C1893 Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away 0% 343 $0.00
87205 0% 39 $0.00
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc 0% 1,203 $0.00
0241U Neonatal screening for hereditary disorders, genomic sequence analysis panel 0% 72 $0.00
88304 0% 111 $0.00
J0500 Injection, dicyclomine hcl, up to 20 mg 0% 250 $0.00
J2785 Injection, regadenoson, 0.1 mg 0% 264 $0.00
12002 0% 14 $0.00
12001 0% 64 $0.00
J2003 Injection, lidocaine hydrochloride, 1 mg 0% 204 $0.00
87510 0% 160 $0.00
87480 0% 160 $0.00
J1630 Injection, haloperidol, up to 5 mg 0% 13 $0.00
J2370 Injection, phenylephrine hcl, up to 1 ml 0% 151 $0.00
J1790 Injection, droperidol, up to 5 mg 0% 46 $0.00
85018 0% 72 $0.00
80320 0% 33 $0.00
A4322 Irrigation syringe, bulb or piston, each 0% 72 $0.00
85651 0% 78 $0.00
A6448 Light compression bandage, elastic, knitted/woven, width less than three inches, per yard 0% 14 $0.00
A6453 Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard 0% 27 $0.00
J7060 5% dextrose/water (500 ml = 1 unit) 0% 33 $0.00
80329 0% 14 $0.00
70486 0% 16 $0.00
J2543 Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) 0% 25 $0.00
80051 0% 14 $0.00
88307 0% 12 $0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialOKABE, DAVID (CFO, SR. VICE PRESIDENT)
Same official

Other billing entities under OKABE, DAVID

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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.