West Hawaii Community Health Center, INC.
West Hawaii Community Health Center, INC. was paid $300K by Medicaid between Jan 2018 and Jun 2022, across 8 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 43% of everything it billed.
NA'ALEHU, HI 96772
Next to other Federally Qualified Health Center (FQHC) 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 | |
|---|---|---|---|
| 2018 | 621 | $75K | |
| 2019 | 623 | $62K | |
| 2020 | 381 | $49K | |
| 2021 | 720 | $79K | |
| 2022 | 317 | $35K |
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 | 43% | 953 | 876 | $128K |
| 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 | 41% | 785 | 714 | $123K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 9.6% | 670 | 587 | $29K |
| G0511 | Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month | 5.3% | 163 | 162 | $16K |
| 0002A | <1% | 26 | 26 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 12 | 12 | $1K |
| 0001A | <1% | 41 | 41 | $600.00 | |
| 0072A | 0% | 12 | 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.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| West Hawaii Community Health Center, INC. | Kailua-kona, HI | $46.79M |
| WHCHC - Hawaii Island Community Health Center | Hilo, HI | $8.04M |
| West Hawaii Community Health Center, INC. | Hilo, HI | $7.14M |
| West Hawaii Community Health Center, INC. | Pahoa, HI | $1.96M |
| West Hawaii Community Health Center, INC. | Keaau, HI | $1.59M |
| West Hawaii Community Health Center, INC. | Hilo, HI | $554K |
| West Hawaii Community Health Center, INC. | Kailua Kona, HI | $335K |
| West Hawaii Community Health Center, INC. | Pahoa, HI | $284K |
| West Hawaii Community Health Center, INC. | Kealakekua, HI | $258K |
| West Hawaii Community Health Center, INC. | Waikoloa, HI | $7K |
| West Hawaii Community Health Center, INC. | Hilo, HI | $3K |
| West Hawaii Community Health Center INC. | Kealakekua, HI | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.