Kaiser Foundation Health Plan
Kaiser Foundation Health Plan was paid $248K by Medicaid between May 2019 and Sep 2024, across 7 billing codes. Its largest line is 45380, Colonoscopy, flexible; with biopsy, single or multiple — 38% of everything it billed.
HONOLULU, HI 96819
Next to other Ambulatory Surgical Clinic/Center providers in Hawaii
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 30 | $5K | |
| 2020 | 41 | $6K | |
| 2022 | 27 | $29K | |
| 2023 | 154 | $123K | |
| 2024incomplete | 100 | $85K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 38% | 88 | 88 | $95K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 29% | 95 | 95 | $71K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 27% | 85 | 83 | $67K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | 2.2% | 27 | 27 | $5K |
| 99152 | 1.6% | 17 | 16 | $4K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 1.3% | 13 | 13 | $3K |
| 99153 | Mod sedat endo service >5yrs | <1% | 27 | 26 | $1K |
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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Kaiser Foundation Health Plan INC | Honolulu, HI | $7.37M |
| Village of Brookfield | Brookfield, IL | $1.54M |
| Medtech Laboratory Services LLC | Cypress, TX | $852K |
| Kaiser Foundation Health Plan INC | Kapolei, HI | $631K |
| Kaiser Foundation Health Plan INC | Honolulu, HI | $499K |
| City of Canton | Canton, OH | $326K |
| Kaiser Foundation Health Plan INC | Waipahu, HI | $246K |
| Vegas Hospital Care LLC | Las Vegas, NV | $54K |
| Kaiser Foundation Health Plan INC | Kaneohe, HI | $28K |
| Kaiser Foundation Health Plan INC | Lahaina, HI | $8K |
| Kaiser Foundation Health Plan INC | Wailuku, HI | $4K |
| Kaiser Foundation Health Plan INC | Kihei, HI | $3K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.