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.

Edward Shen (NPI 1609861822)

Key Findings

Field	Value
Entity Type	Individual
Organization	Edward Shen
Address	1380 Lusitana St
City	Honolulu
State	HI
ZIP	96813
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	September 14, 2005

Payer Source	Total Paid
Medicare	$305.3K
Medicaid	$0

EDWARD SHEN is a Cardiovascular Disease Physician in HONOLULU, HI whose Medicare billing totals $305.3K in lifetime revenue and who has no Medicaid billing on file; his NPI was enumerated on 2005-09-14 (~21 years ago), indicating long-standing enrollment. The absence of any Medicaid revenue makes this effectively a Medicare-only billing profile at the scale shown.

Revenue concentration is notable: the top three Medicare codes are 93306 ($63.8K, 20.9% of Medicare revenue), 93925 ($41.1K, 13.5%), and 99215 ($37.5K, 12.3%), and those top three codes together account for 46.6% of this provider's total Medicare revenue. This indicates nearly half of Medicare receipts derive from a small set of diagnostic imaging and high-complexity E/M services.

The code mix points to an imaging- and vascular-diagnostics–focused cardiology practice: high-revenue anatomic/functional echocardiography (93306) and multiple duplex ultrasound arterial/venous codes (93925, 93978, 93979, 93880, 93970) dominate the list. Coupled with substantial high-level office visits (99215) this suggests a clinic model that integrates diagnostic vascular imaging with complex outpatient cardiovascular management rather than a procedure-only interventional practice.

Several codes show above-typical or outlier national standing for volume. In particular 93979 is an extreme outlier, far above typical national volume for this code (rank #10 of 914, 99th percentile), while 93925 ranks #488 of 10098 (95th percentile) and 93978 ranks #156 of 4075 (96th percentile), indicating unusually high activity in lower-extremity and aorta/iliac duplex studies relative to peers. These rankings imply a locally differentiated capability or referral concentration for specific vascular studies.

Office visit behavior is skewed to high-complexity encounters: 99215 appears frequently (270 claims, $37.5K; ranks #7107 of 145531, 95th percentile, described as notably above typical national volume) alongside lower-level visits like 99213 and 99214. This pattern supports a practice managing complex, high-acuity cardiovascular patients in the outpatient setting and generating a meaningful share of revenue from E/M services.

Cardiac device and remote monitoring services are present but represent smaller revenue streams: device follow-up/adjustment codes such as 93280 ($3.8K, 1.2%), 93282 ($2.8K, 0.9%), 93283 ($2.7K, 0.9%) and monitoring codes like 93295 ($476, 0.2%) and 99453 ($306, 0.1%) are reported. These items indicate capability to manage pacemakers/ICDs and participate in remote physiologic monitoring programs, supplementing the core imaging and clinic visit mix rather than dominating revenue.

Payer-mix implications are straightforward: with $305.3K in Medicare revenue and no Medicaid billing on file, the provider’s financial exposure and referral footprint are concentrated in Medicare beneficiaries. Analysts should treat reimbursement patterns, utilization, and potential growth or risk scenarios primarily through the Medicare lens rather than dual-payer dynamics.

From a competitive standpoint, the provider is a modest but specialized participant nationally: several vascular imaging codes place him in high percentiles (including an extreme outlier for 93979), while common imaging codes like 93306 and arterial studies show typical to strong volumes (93306 at the 76th percentile; 93925 at the 95th). This constellation suggests a niche strength in vascular ultrasound diagnostics within his service area while overall Medicare revenue remains modest in absolute terms at $305.3K.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	400	$160	$63.8K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	190	$220	$41.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	270	$140	$37.5K
93979	The provider performs a limited study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts, or performs the study on only one side. He uses duplex Doppler ultrasound…	400	$80	$32.5K
93978	The provider performs a complete study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts using duplex Doppler ultrasound scanning. He performs the study to assess…	190	$160	$30.1K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	190	$160	$29.5K
99213	The 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…	270	$70	$18.8K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	90	$170	$15.1K
93224	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the…	170	$60	$9.6K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	50	$170	$9K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Queens Medical Center	HI	General Acute Care Hospital	$0	$200M
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
State Of Hawaii Dept. Of Health Adult Mental Health Division	HI	Community/Behavioral Health Agency	$0	$29.3M
Positive Behavior Supports Corporation	HI	Community/Behavioral Health Agency	$0	$26.4M
Easter Seals Hawaii	HI	Developmentally Disabled Services Day Training Agency	$0	$16.8M
The Emergency Group, Inc.	HI	Emergency Medicine Physician	$0	$15M
Hawaii Dental Group, Inc.	HI	General Practice Dentistry	$0	$12.4M
The Queen's Medical Center	HI	General Acute Care Hospital	$0	$10.3M
Hawaii Home Care Inc	HI	Nursing Care Agency	$0	$9.3M
Evergreen Adult Day Care	HI	Adult Day Care Clinic/Center	$0	$8.9M

Edward Shen — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	13	60	190	$90	$22.8K
93978	4	20	130	$130	$19K
93925	5	30	40	$180	$16.6K
99214	1,118	1,440	100	$80	$15.2K
99215	31	380	40	$120	$11.2K
93979	1	10	60	$80	$11K
93880	6	40	50	$110	$9.2K
99213	228	1,460	70	$60	$8.4K
93224	1	10	90	$60	$5.3K
99205	35	200	20	$160	$5.1K