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

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

Matthew Gaines (NPI 1205802667)

Field	Value
Entity Type	Individual
Organization	Matthew Gaines
Address	1613 N Mckenzie St
City	Foley
State	AL
ZIP	36535
Taxonomy	Hospitalist Physician
NPI Enumerated	February 27, 2006

Payer Source	Total Paid
Medicare	$100.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	280	$80	$23.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	320	$60	$19.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	170	$90	$15.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	100	$130	$12.5K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	130	$90	$11.7K
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	$160	$10.9K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	110	$60	$6.1K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	10	$110	$1.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Matthew Gaines — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	384	1,860	80	$90	$13.4K
99232	288	2,530	100	$60	$13.3K
99291	227	910	40	$160	$10.6K
99223	295	2,140	40	$130	$8.1K
99239	32	780	60	$90	$6.3K
99222	73	1,590	30	$90	$4.2K
99235	6	10	20	$120	$3.9K
99238	44	720	30	$60	$2.7K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ashland Hospital Corporation	KY	General Acute Care Hospital	$0	$222.9M
Mississippi Baptist Medical Center, Inc.	MS	General Acute Care Hospital	$0	$42M
King's Daughters Medical Center	MS	General Acute Care Hospital	$0	$32.2M
Kdmc Physician Clinics LLC	MS	Multi-Specialty Clinic/Center	$0	$9.2M
State Of Mississippi - University Of Mississippi Medical Center	MS	Critical Access Hospital	$0	$7.5M
Flowood River Oaks Hma Medical Group, LLC	MS	Internal Medicine Physician	$0	$2.8M
Foley Clinic Corp	AL	Family Medicine Physician	$0	$2M
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Mississippi Hma Hospitalists, LLC	MS	Hospitalist Physician	$0	$1.3M
Reuben Stone	MS	Cardiovascular Disease Physician	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gary A. Eberly, Md PC	AL	Pediatrics Physician	$0	$5.5M
South Baldwin Childrens Center PC	AL	Pediatrics Physician	$0	$4.6M
Foley Hospital Company LLC	AL	General Acute Care Hospital	$0	$4.5M
Sea Smiles, LLC	AL	Pediatric Dentistry	$0	$2.1M
Foley Emergency Physicians, LLC	AL	Emergency Medicine Physician	$0	$1.6M
South Baldwin Dental Associates	AL	General Practice Dentistry	$0	$1.6M
Emerald Sands Medical Center	AL	Primary Care Clinic/Center	$0	$1.2M
Gulf Coast Counseling Services	AL	Addiction (Substance Use Disorder) Counselor	$0	$1.1M
Samuel Townsley	AL	General Practice Dentistry	$0	$848.8K
Med-trans Corporation	AL	Air Ambulance	$423.5K	$49K

Matthew Gaines — Billing Profile & Reimbursement Data

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Matthew Gaines — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References