Managed care
Kaiser Foundation Health Plan INC
Kaiser Foundation Health Plan INC was paid $7.37M by Medicaid between Jan 2018 and Dec 2024, across 76 billing codes. Its largest line is 90837, psychotherapy session, about an hour — 28% of everything it billed.
33Billing provider infoKAISER FOUNDATION HEALTH PLAN INC
HONOLULU, HI 96813
HONOLULU, HI 96813
33aNPI1407862030assigned 08/01/2006
33bProvider typeHealth Maintenance Organization
28Total paid$7.37M
24GClaims112,592
24DCodes billed76
24AFirst – last monthJan 2018 – Dec 2024
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official ADAMS, JAMES controls 12+ related entities in our dataset. Read more
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 | 20,093 | $1.89M | |
| 2019 | 20,026 | $2.08M | |
| 2020 | 15,509 | $541K | |
| 2021 | 14,025 | $691K | |
| 2022 | 26,249 | $881K | |
| 2023 | 9,979 | $645K | |
| 2024incomplete | 6,711 | $638K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 28% | 7,837 | 6,343 | $2.05M |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | 22% | 12,875 | 9,278 | $1.61M |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 8.7% | 5,372 | 4,651 | $643K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 6.8% | 2,499 | 2,047 | $503K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 3.9% | 10,564 | 9,939 | $287K |
| 81001 | 2.9% | 15,336 | 14,562 | $217K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.2% | 1,531 | 1,292 | $162K |
| 98968 | 2.2% | 2,208 | 1,841 | $161K | |
| 81025 | 1.8% | 4,594 | 4,497 | $134K | |
| 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 | 1.8% | 513 | 437 | $131K |
| 80051 | 1.7% | 4,458 | 4,244 | $128K | |
| 82565 | 1.6% | 6,584 | 6,273 | $116K |
64 more codes
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.6% | 1,909 | $115K |
| 92523 | 1.4% | 179 | $106K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.0% | 966 | $74K |
| 97161 | <1% | 438 | $70K | |
| 85027 | <1% | 3,244 | $62K | |
| 97530 | Therapeutic activities, direct patient contact, each 15 minutes | <1% | 177 | $62K |
| 84460 | <1% | 3,180 | $58K | |
| 84450 | <1% | 2,864 | $50K | |
| 0241U | Neonatal screening for hereditary disorders, genomic sequence analysis panel | <1% | 830 | $50K |
| 85610 | <1% | 3,285 | $49K | |
| 92557 | <1% | 571 | $44K | |
| 99213 | Doctor's office visit, returning patient (routine) | <1% | 269 | $42K |
| 84520 | <1% | 3,207 | $41K | |
| 82247 | <1% | 1,785 | $38K | |
| 92567 | <1% | 1,078 | $38K | |
| 82947 | <1% | 2,597 | $33K | |
| 84075 | <1% | 1,594 | $28K | |
| 84484 | <1% | 594 | $28K | |
| 83690 | <1% | 1,089 | $25K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 62 | $20K |
| 92593 | <1% | 195 | $14K | |
| 88720 | <1% | 1,305 | $14K | |
| 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 | <1% | 142 | $13K |
| 99199 | Unlisted special service, procedure or report | <1% | 524 | $13K |
| 81003 | <1% | 1,552 | $12K | |
| 81002 | <1% | 916 | $12K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 29 | $9K |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 69 | $8K |
| 99386 | <1% | 25 | $8K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 53 | $8K |
| 81000 | <1% | 558 | $7K | |
| 99441 | <1% | 160 | $7K | |
| 97150 | Therapeutic procedure(s), group (2 or more individuals) | <1% | 149 | $7K |
| 98962 | <1% | 50 | $6K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 16 | $5K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 54 | $5K |
| 85652 | <1% | 458 | $5K | |
| 99443 | <1% | 56 | $5K | |
| 85007 | <1% | 627 | $5K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 219 | $4K |
| 85730 | <1% | 253 | $4K | |
| 77080 | <1% | 63 | $3K | |
| 97165 | <1% | 15 | $3K | |
| 99078 | <1% | 30 | $2K | |
| 82150 | <1% | 68 | $2K | |
| 99350 | Prolong home eval add 15m | <1% | 36 | $2K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 46 | $2K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 60 | $2K |
| 97804 | <1% | 12 | $2K | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 14 | $1K |
| 92558 | <1% | 49 | $1K | |
| 90686 | <1% | 164 | $787.50 | |
| 99442 | <1% | 12 | $730.87 | |
| 85379 | <1% | 85 | $728.04 | |
| 98966 | <1% | 18 | $588.00 | |
| 99417 | Prolong home eval add 15m | <1% | 15 | $496.00 |
| 85018 | <1% | 28 | $461.50 | |
| 85014 | <1% | 28 | $461.50 | |
| S9999 | Sales tax | <1% | 20 | $32.27 |
| 99385 | 0% | 44 | $0.00 | |
| 99205 | Prolong outpt/office vis | 0% | 12 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 48 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 13 | $0.00 |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 0% | 13 | $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 officialADAMS, JAMES (EXECUTIVE DIRECTOR, FINANCE LEADER)
| Provider | Location | Paid |
|---|---|---|
| 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 | Honolulu, HI | $248K |
| 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.