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 Oklahoma for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oklahoma 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. Oklahoma (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.

Alexander Raines (NPI 1184850539)

Alexander Raines is a surgery physician provider located in Oklahoma City, Oklahoma. This profile covers 10 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Alexander Raines
Address	920 Sl Young Blvd
City	Oklahoma City
State	OK
ZIP	73104
Taxonomy	Surgery Physician
NPI Enumerated	May 29, 2009

Payer Source	Total Paid
Medicare	$40.3K
Medicaid	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
36561	A central venous access catheter is a device that the physician inserts beneath the skin to draw blood or administer medication/nutrients to the patient. The catheter's tip must terminate in the…	40	$240	$9.6K
49650	The provider performs laparoscopic repair of an initial inguinal hernia.	20	$400	$8.8K
99204	The provider sees a new 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 provider…	60	$120	$7.5K
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…	40	$160	$5.7K
99214	The 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…	30	$90	$2.6K
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…	10	$140	$1.9K
43246	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum to direct the placement of a tube through the skin and abdominal tissues into the…	10	$140	$1.5K
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…	20	$70	$1.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	20	$40	$1K
77001	Report this code as an add–on code to the primary procedure code, such as central venous access devices (CVAD) placement, replacement, or removal, including accessing the vessel, manipulating the…	30	$10	$440

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	4,802	5,560	130	$70	$18.4K
99213	5,014	5,450	80	$50	$8.7K
99215	1,171	1,310	40	$110	$8.2K
36561	5	50	20	$300	$6.6K
99205	243	620	30	$140	$5.8K
99204	841	2,790	40	$100	$5.8K
49650	6	30	20	$290	$5.5K
43246	13	10	10	$140	$2.6K
99212	680	1,100	30	$30	$2.3K
77001	31	70	30	$20	$640

Alexander Raines — Billing Profile & Reimbursement Data

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Alexander Raines — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References