Clinic
Transformation Health Network
Transformation Health Network was paid $1.68M by Medicaid between Jan 2018 and Dec 2024, across 21 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 33% of everything it billed.
33Billing provider infoTRANSFORMATION HEALTH NETWORK
KAILUA KONA, HI 96740
KAILUA KONA, HI 96740
33aNPI1144621285assigned 09/09/2014
33bProvider typeUrgent Care Clinic/Center
28Total paid$1.68M
24GClaims45,822
24DCodes billed21
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in Hawaii
Rank by total paid#6 of 26
Median peer was paid$103K
This provider vs. median16×
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
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
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 7,274 | $242K | |
| 2019 | 9,704 | $329K | |
| 2020 | 5,569 | $193K | |
| 2021 | 8,988 | $312K | |
| 2022 | 6,656 | $253K | |
| 2023 | 4,962 | $215K | |
| 2024incomplete | 2,669 | $140K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 33% | 10,743 | 9,629 | $554K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 22% | 5,198 | 4,917 | $375K |
| S9088 | Services provided in an urgent care center (list in addition to code for service) | 19% | 19,293 | 17,260 | $325K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 17% | 4,164 | 3,768 | $294K |
| 87428 | 2.0% | 737 | 643 | $34K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.7% | 273 | 255 | $28K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.4% | 672 | 589 | $23K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 1.2% | 380 | 376 | $20K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 925 | 436 | $12K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 577 | 535 | $7K |
| 81002 | <1% | 1,549 | 1,398 | $4K | |
| 81025 | <1% | 211 | 199 | $2K |
9 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 101 | $1K |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 173 | $1K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 32 | $861.01 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 81 | $776.02 |
| 90715 | <1% | 27 | $522.13 | |
| 81003 | <1% | 146 | $314.63 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 27 | $298.02 |
| J7620 | Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme | <1% | 306 | $66.05 |
| J7611 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg | <1% | 207 | $7.07 |
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 officialDE CARVALHO, ELISHA (GROUP PRACTICE MANAGER)
| Provider | Location | Paid |
|---|---|---|
| Transformation Health Network | Kailua Kona, HI | $17K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.