Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Hawaii (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Thomas Edholm (NPI 1285678953)

Field	Value
Entity Type	Individual
Organization	Thomas Edholm
Address	Kona Community Hosptial
City	Kealakekua
State	HI
ZIP	96750
Taxonomy	Emergency Medical Services (Emergency Medicine) Physician
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicare	$54.3K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	220	$140	$29.9K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	140	$90	$12.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	70	$170	$12K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Hawaii Distribution

Thomas Edholm — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	13	190	100	$130	$14.5K
99291	77	280	40	$170	$10.4K
99284	13	210	50	$90	$5.3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cep America - California	CA	Emergency Medicine Physician	$0	$59.7M
Cep America - California	CA	Emergency Medicine Physician	$0	$32.7M
Cep America - California	CA	Emergency Medicine Physician	$0	$31.8M
Cep America - California	CA	Emergency Medicine Physician	$0	$26.1M
Cep America, LLC	ID	Emergency Medicine Physician	$0	$3.9M
Brian Tyson	CA	Family Medicine Physician	$709.7K	$0
Michael Maloney	CA	Diagnostic Radiology Physician	$190.6K	$481.9K
Scott Dlugos	CA	Emergency Medicine Physician	$459.8K	$0
Eddie Lares	CA	Emergency Medicine Physician	$353.5K	$0
Brian Doane	IL	Emergency Medicine Physician	$153K	$159K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kona Hospital	HI	General Acute Care Hospital	$0	$22.3M
Affordable Care LLC	HI	Home Health Agency	$0	$1.5M
West Hawaii Community Health Center, Inc.	HI	Federally Qualified Health Center (FQHC)	$0	$257.6K
Yaser Alsaadi	HI	Dental Clinic/Center	$0	$208.7K
Sound Physicians Of Hawaii Inc	HI	Internal Medicine Physician	$0	$195K
Timothy Kale	HI	Optometrist	$71.7K	$103.7K
Nathan King	HI	Internal Medicine Physician	$116.9K	$45.3K
S.sira,m.d.,facog,inc	HI	Clinic/Center	$0	$140.9K
Bradon Kimura	HI	Family Medicine Physician	$135.6K	$0
Wesley J. Sugai, M.d., Inc.	HI	Pediatrics Physician	$0	$131.6K

Thomas Edholm — Billing Profile & Reimbursement Data

Sign up for Thomas Edholm — Billing Profile & Reimbursement Data policy alerts

Thomas Edholm — Billing Profile & Reimbursement Data

Sign up for Thomas Edholm — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References