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    OpenPayerNPI Medicare & MedicaidEdwin Herd
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    Edwin Herd — Billing Profile & Reimbursement Data

    NPI 1215985320 · Kailua-kona, HI · Pediatrics Physician

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    Edwin Herd is a pediatrics physician provider located in Kailua-kona, Hawaii. This profile covers 0 Medicare and 18 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationEdwin Herd
    Address78-6831 Ali'i Drive
    CityKailua-kona
    StateHI
    ZIP96740
    TaxonomyPediatrics Physician
    NPI EnumeratedMay 4, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$640.5K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…1,850$90$167.9K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…2,330$60$149.3K
    99391Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…860$110$97K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.720$110$78K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…620$120$73K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.360$110$39.6K
    87426The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…500$40$20.6K
    92551The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.1,670$1$5K
    90460In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.190$20$3.9K
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.110$30$2.9K

    Showing 1–10 of 18

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Hawaii median

    18 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…177710650$90$274.1K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…190690650$90$235.4K
    99391Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…26100210$120$116.7K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…31100210$110$101.4K
    99442N/A546080$130$67.7K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.27110230$90$55.7K
    99394The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.3490180$70$31.4K
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.5390180$10$14.5K
    87426The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…1240170$20$13K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.698090$10$12.5K

    Showing 1–10 of 18

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Edwin Herd, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Adventist Health System-sunbelt, IncFLGeneral Acute Care Hospital$0$173.7M
    Florida Hospital Medical Group IncFLFamily Medicine Physician$0$71.2M
    Adventist Health System Sunbelt, Inc.FLUrgent Care Clinic/Center$0$67.5M
    Adventist Health System-sunbelt, IncFLClinical Medical Laboratory$0$28.2M
    Integris Ambulatory Care CorporationOKFamily Medicine Physician$0$27.5M
    Columbus Regional Health Physicians, LLCINInternal Medicine Physician$0$23.2M
    Florida Hospital Physician Group IncFLFamily Medicine Physician$0$21.4M
    Memorial Health Systems IncFLRehabilitation Hospital Unit$0$17.6M
    Memorial Hospital Flagler IncFLGeneral Acute Care Hospital$0$13.9M
    Florida Hospital Medical Group IncFLDiagnostic Radiology Physician$0$13.1M

    Nearby Providers

    Other providers in the same ZIP code as Edwin Herd, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    West Hawaii Community Health Center, Inc.HIFederally Qualified Health Center (FQHC)$0$46.8M
    S&g Labs Hawaii LLCHIClinical Medical Laboratory$292.7K$15.1M
    Full LifeHIDevelopmentally Disabled Services Day Training Agency$0$11M
    Liberty Dialysis - Hawaii LLCHIEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$9M
    Mf Med IncHIPain Medicine (Anesthesiology) Physician$0$4.3M
    Jennifer LogigianHIDentist$0$1.8M
    Transformation Health NetworkHIUrgent Care Clinic/Center$0$1.7M
    Access Capabilities, IncHICommunity/Behavioral Health Agency$0$1.3M
    Alii Health CenterHIMulti-Specialty Clinic/Center$0$799.9K
    David Kwon Jr DdsHIDentist$0$611.1K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Hawaii Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Hawaii Distribution
    Edwin Herd — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Hawaii