Providers
All 11 in CA
HAKU KEVIN KAHOANO, M.D.
NPI 1073714937, individual, Jamestown, CA, General Practice
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99213 ($267 per patient-month) sit in the top 5% of every provider billing that code.
score 54 of 100, rank 8007, $264K at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2018 | More hours than a day holds at a conservative unit price | 2.0 | 36.1 | 24.1 | 33.7 | 120 | 1 | 99213 99214 | $54K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HAKU KEVIN KAHOANO, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | May 29, 2007, last updated May 18, 2015 |
| Practice location | 18144 SECO ST, MATHIESEN MEMORIAL HEALTH CLINIC, Jamestown, CA 95327-9737, 209-984-4824 |
| Mailing address | 201 HIGHLAND RIDGE DR, Manhattan, KS 66503-2428 |
| Specialties | Internal Medicine (207R00000X, license MD-14815 HI) General Practice (208D00000X, primary, license MD-14815 HI) Family Medicine, Adult Medicine (207QA0505X, license MD-14815 HI) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $532K | 50% | $129 | $60 (top 5% from $133) | 94th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $109K | 10% | $267 | $44 (top 5% from $110) | 99th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $87K | 8% | $89 | $45 (top 5% from $110) | 91st percentile | |
| T1015 | Medicaid service code | $82K | 8% | $657 | $182 (top 5% from $488) | 97th percentile | |
| 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 | $28K | 3% | $87 | $75 (top 5% from $185) | 70th percentile | |
| 83970 | Parathormone (parathyroid hormone) level | $24K | 2% | $51 | $1.29 (top 5% from $43) | 97th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $18K | 2% | $43 | $32 (top 5% from $49) | 84th percentile | |
| 82306 | Vitamin d-3 level | $17K | 2% | $36 | $20 (top 5% from $40) | 92nd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 209 | 80 | $16K | $225 | $117 | 1.9x | 2.3x (90th percentile 3.8x) |
| 80307 | Testing for presence of drug, by chemistry analyzers | 79 | 32 | $5K | $120 | $61 | 2.0x | 3.2x (90th percentile 7.6x) |
| 83970 | Parathormone (parathyroid hormone) level | 44 | 31 | $2K | $85 | $40 | 2.1x | 3.0x (90th percentile 5.1x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 13 | 13 | $2K | $210 | $121 | 1.7x | 2.3x (90th percentile 4.1x) |
| 82306 | Vitamin d-3 level | 41 | 31 | $1K | $61 | $29 | 2.1x | 2.9x (90th percentile 5.3x) |
| 80053 | Blood test, comprehensive group of blood chemicals | 59 | 33 | $601 | $18 | $10 | 1.8x | 3.7x (90th percentile 7.4x) |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 77 | 47 | $579 | $14 | $8 | 1.9x | 3.8x (90th percentile 7.1x) |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 44 | 31 | $577 | $28 | $13 | 2.1x | 3.5x (90th percentile 6.9x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
11 providers in Tuolumne County, CA carry an indicator in the public record, with $3.9M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 3. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | ADULT MEDICINE SPECIALISTS, INC Sonora, CA, ranked 369 | $2K |
|
| 3 | WESTERN HEALTH RESOURCES Sonora, CA, ranked 1436 | $43K |
|
| 3 | SONORA COMMUNITY HOSPITAL Sonora, CA, ranked 3082 | $0 |
|
| 3 | WESTERN HEALTH RESOURCES Sonora, CA, ranked 6493 | $0 |
|
| 4 | ROBERT REINA Sonora, CA, ranked 7656 | $2.2M |
|
| 4 | RANDOLPH ROXAS Tuolumne, CA, ranked 8015 | $231K |
|
| 5 | RALPH RETHERFORD Sonora, CA, ranked 10327 | $359K |
|
| 5 | ALEJANDRO ABARCA Sonora, CA, ranked 10373 | $231K |
|
Recent enforcement in CA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.