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NPI 1558321190 · Herrin, IL · Gastroenterology Physician
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Mack Mccain is a gastroenterology physician provider located in Herrin, Illinois. This profile covers 14 Medicare and 13 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)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Mack Mccain |
| Address | 404 Lincoln Dr |
| City | Herrin |
| State | IL |
| ZIP | 62948 |
| Taxonomy | Gastroenterology Physician |
| NPI Enumerated | March 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $702.2K |
| Medicare | $92.3K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 100 | $200 | $19.8K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 170 | $80 | $13.2K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 150 | $80 | $12.9K |
| 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… | 130 | $70 | $8.4K |
| 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… | 100 | $70 | $6.3K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 40 | $140 | $6K |
| 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… | 60 | $100 | $5.7K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 30 | $180 | $5.6K |
| 45390 | The provider performs flexible colonoscopy along with excision of mucous membrane tissue using an endoscope. | 10 | $270 | $3.5K |
| 43235 | The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing. | 40 | $90 | $3.4K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
14 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 45385 | 169 | 640 | 60 | $270 | $23.4K |
| 45380 | 77 | 670 | 50 | $160 | $12.7K |
| 99232 | 3,253 | 7,960 | 90 | $60 | $12.4K |
| G0105 | 127 | 310 | 30 | $260 | $10K |
| 43239 | 72 | 680 | 70 | $110 | $9.6K |
| 99213 | 7,320 | 17,390 | 70 | $60 | $8.8K |
| 45390 | 30 | 40 | 20 | $330 | $6.5K |
| 91110 | 4 | 40 | 20 | $310 | $6.2K |
| 99222 | 1,571 | 5,730 | 30 | $100 | $5.3K |
| 45378 | 50 | 340 | 20 | $180 | $5.1K |
Showing 1–10 of 14
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 2,360 | $160 | $381.7K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 1,320 | $120 | $153.2K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 450 | $210 | $93.6K |
| 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… | 550 | $40 | $24.4K |
| 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… | 730 | $20 | $17.4K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 90 | $140 | $11.8K |
| 99203 | The provider sees a new 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 provider… | 160 | $40 | $6.2K |
| 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… | 250 | $20 | $5.1K |
| 43450 | The provider passes long thin tubular devices of increasing diameter to dilate, or widen, a stricture in the patient’s esophagus to improve swallowing. | 80 | $40 | $3.1K |
| 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,… | 120 | $20 | $2.7K |
Showing 1–10 of 13
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
13 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 4 | 300 | 70 | $180 | $50.5K |
| 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… | 5,484 | 14,680 | 300 | $50 | $48.7K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 17 | 40 | 50 | $200 | $42.3K |
| 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… | 4,602 | 14,190 | 280 | $20 | $38.9K |
| 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… | 2,216 | 4,800 | 210 | $30 | $29.3K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 7 | 90 | 40 | $220 | $26.8K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 4 | 120 | 50 | $140 | $25K |
| 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… | 1,733 | 2,800 | 60 | $80 | $17.7K |
| 99203 | The provider sees a new 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 provider… | 1,095 | 3,270 | 80 | $40 | $11.1K |
| 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,… | 1,463 | 3,330 | 90 | $10 | $7.4K |
Showing 1–10 of 13
Other providers in the same ZIP code as Mack Mccain, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Southern Illinois Medical Services, Nfp | IL | Rural Health Clinic/Center | $0 | $9.2M |
| Southern Illinois Hospital Services | IL | General Acute Care Hospital | $0 | $5.4M |
| Southern Orthopedic Associates Sc | IL | Orthopaedic Surgery Physician | $0 | $3.2M |
| Ted Van Acker | IL | Dermatology Physician | $1.4M | $320.7K |
| Derek Kenneaster | IL | Dermatology Physician | $229.5K | $343.5K |
| Terrence Glennon | IL | Physical Medicine & Rehabilitation Physician | $149.4K | $311.3K |
| Southern Illinois Orthopedic Center,llc | IL | Ambulatory Surgical Clinic/Center | $446.3K | $0 |
| Gerri Dyer | IL | Nurse Practitioner | $175.1K | $109.5K |
| Steven Young | IL | Orthopaedic Surgery Physician | $189.8K | $90.7K |
| Shanda Swagler | IL | Family Nurse Practitioner | $166.3K | $106.7K |
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