Hospital
Samuel Mahelona Memorial Hospital
Samuel Mahelona Memorial Hospital was paid $7.01M by Medicaid between Jan 2018 and Dec 2024, across 43 billing codes. Its largest line is 99283, emergency room visit (moderate) — 49% of everything it billed.
33Billing provider infoSAMUEL MAHELONA MEMORIAL HOSPITAL
KAPAA, HI 96746
KAPAA, HI 96746
33aNPI1619038536assigned 12/13/2006
33bProvider typeCritical Access Hospital
28Total paid$7.01M
24GClaims38,585
24DCodes billed43
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Critical Access Hospital providers in Hawaii
Rank by total paid#2 of 8
Median peer was paid$4.91M
This provider vs. median1.4×
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 | 5,163 | $924K | |
| 2019 | 5,375 | $908K | |
| 2020 | 3,396 | $727K | |
| 2021 | 4,213 | $781K | |
| 2022 | 6,635 | $1.10M | |
| 2023 | 7,354 | $1.28M | |
| 2024incomplete | 6,449 | $1.29M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 49% | 8,781 | 7,867 | $3.46M |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 23% | 5,773 | 5,228 | $1.59M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 19% | 2,148 | 1,941 | $1.33M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 7.2% | 503 | 428 | $504K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 1,629 | 536 | $69K |
| 74177 | Computed tomography, abdomen and pelvis; with contrast material | <1% | 12 | 12 | $25K |
| 97032 | <1% | 311 | 125 | $22K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 661 | 244 | $12K |
| 87428 | <1% | 1,318 | 1,200 | $3K | |
| 96361 | Intravenous infusion, hydration; each additional hour | <1% | 486 | 437 | $1K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 487 | 461 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 2,521 | 2,218 | $702.90 |
31 more codes
| 81025 | <1% | 671 | $661.97 | |
| 96374 | Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance | <1% | 788 | $331.91 |
| 81002 | <1% | 1,438 | $305.86 | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 1,123 | $297.07 |
| 94640 | Pressurized or nonpressurized inhalation treatment for acute airway obstruction | <1% | 147 | $143.01 |
| 80305 | <1% | 12 | $110.08 | |
| 96375 | Therapeutic injection; each additional sequential IV push | <1% | 375 | $106.62 |
| 80047 | <1% | 1,610 | $83.51 | |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | <1% | 44 | $81.98 |
| Q0162 | Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen | <1% | 191 | $74.82 |
| J7040 | Infusion, normal saline solution, sterile (500 ml = 1 unit) | <1% | 1,342 | $50.41 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 1,447 | $28.39 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | <1% | 1,372 | $27.05 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 126 | $22.28 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 14 | $20.00 |
| 85014 | <1% | 1,606 | $17.62 | |
| J7030 | Infusion, normal saline solution , 1000 cc | <1% | 216 | $13.24 |
| C1751 | Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis) | <1% | 624 | $1.95 |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | 0% | 28 | $0.00 |
| J2001 | Injection, lidocaine hcl for intravenous infusion, 10 mg | 0% | 65 | $0.00 |
| A9270 | Non-covered item or service | 0% | 33 | $0.00 |
| 71045 | Radiologic examination, chest; single view | 0% | 179 | $0.00 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 0% | 118 | $0.00 |
| 97035 | 0% | 63 | $0.00 | |
| 82803 | 0% | 30 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 13 | $0.00 |
| 84484 | 0% | 89 | $0.00 | |
| 83605 | 0% | 30 | $0.00 | |
| J2270 | Injection, morphine sulfate, up to 10 mg | 0% | 41 | $0.00 |
| 71046 | Radiologic examination, chest; 2 views | 0% | 103 | $0.00 |
| 90715 | 0% | 17 | $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 officialLORENZO, RACHELLE (CFO)