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

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

Donald Cain (NPI 1609296730)

Field	Value
Entity Type	Individual
Organization	Donald Cain
Address	2003 Bluegrass Cir
City	Cheyenne
State	WY
ZIP	82009
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	April 16, 2014

Payer Source	Total Paid
Medicare	$396.9K
Medicaid	$0

Key Findings

This NPI is a Diagnostic Radiology physician with a procedure mix dominated by advanced cross-sectional imaging; the top revenue-generating codes are 78815 (PET/CT) at $53.8K (16.9% of Medicare revenue), 74177 (CT abdomen/pelvis w/ contrast) at $24.6K (7.7%), and 70553 (brain MRI w/ and w/o contrast) at $24.5K (7.7%). The presence of both PET/CT (78815 and supply code A9552) and multiple high-volume CT and MRI codes indicates an operation that offers both oncologic/metabolic imaging and routine diagnostic CT/MRI services.

Revenue is somewhat concentrated in a small set of studies: the precomputed top three Medicare codes account for 32.3% of this provider's total Medicare revenue, within a lifetime Medicare revenue pool of $396.9K. Those three codes alone (78815, 74177, 70553) together form roughly one-third of billed Medicare revenue, signaling reliance on a limited number of high-yield imaging services.

Payer mix is effectively single-payer at the claim level: total Medicare revenue is $396.9K while there is no Medicaid billing on file, so the provider operates with Medicare as the principal public payer. The absence of Medicaid activity suggests this profile should be interpreted primarily through a Medicare lens rather than as a balanced dual-payer practice.

Competitive standing across codes is generally modest-to-typical nationally rather than dominant: 78815 ranks #2372 of 6566 providers (64th percentile; typical, unremarkable volume), 74177 ranks #3372 of 23621 (86th percentile; typical, unremarkable volume), and 70553 ranks #2022 of 11271 (82th percentile; typical, unremarkable volume). Most high-revenue CPTs are in mid-to-upper percentiles but do not show national dominance; the provider appears to be a steady, regionally available radiology service rather than a major national center for any single modality.

There is one standout statistical signal: 71275 (CTA chest) ranks #1024 of 19107 providers (95th percentile; notably above typical national volume) and generates $12.9K (4.1% of Medicare revenue). This suggests relatively high activity in vascular chest imaging compared with peers, which may reflect either specialized referral patterns for CTA or local clinical demand for advanced chest vascular studies.

Procedure volume details indicate a broad mix of screening and diagnostic imaging: high-volume screening and plain radiography include 77067 mammography (200 claims, $22.6K, 7.1%) and 71046 chest radiographs (559 claims, $6.7K, 2.1%), while large CT volumes include 70450 head CT (493 claims, $16.3K, 5.1%) and multiple abdomen/pelvis CT codes (74177, 74176, 74178). This combination of screening mammography, plain films, CT, MRI, and PET-related billing points to a full-service diagnostic imaging practice serving both routine and higher-acuity studies.

MRI and PET modality presence is material: MRI brain/brainstem 70553 accounts for $24.5K (7.7%), MRI lumbar 72148 accounts for $17.1K (5.4%), and PET-related supply A9552 accounts for $9.6K (3.0%). The mix of MRI and PET items supports the earlier observation that the practice is equipped to perform cross-sectional and metabolic imaging, not just plain radiography or basic CT.

The provider has an established tenure on the Medicare roster, with NPI enumeration dated 2014-04-16 (~12 years ago), indicating a stable multi-year presence. That tenure, combined with consistent billing across a range of radiology modalities, suggests an ongoing local role in imaging services rather than a recent entrant or transient biller.

Medicare: Complete Services Breakdown

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

86 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	90	$630	$53.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	270	$90	$24.6K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	150	$160	$24.4K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	200	$110	$22.6K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	150	$120	$17.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	490	$30	$16.3K
74178	The provider performs computed tomography of the abdomen and pelvis without contrast material in one or both body regions followed by contrast material in one or both body regions and additional…	50	$270	$14.2K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	160	$90	$14K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	200	$70	$12.9K
72197	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the pelvis first without using contrast and again after injecting contrast material.	40	$260	$11.3K

Showing 1–10 of 86

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 86 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

Donald Cain — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

86 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
78815	6	10	50	$650	$75K
A9552	6	10	70	$260	$29.5K
77067	23	40	210	$80	$23.8K
74177	5	40	150	$80	$12.5K
77063	22	40	200	$40	$10.9K
70553	1	30	60	$130	$7.8K
72197	3	10	20	$190	$6.3K
71250	9	30	100	$50	$6K
72148	5	50	40	$90	$6K
73218	2	10	30	$200	$5.9K

Showing 1–10 of 86

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Jefferson Radiology, PC	CT	Diagnostic Radiology Physician	$0	$14M
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Prema Abraham	SD	Retina Specialist (Ophthalmology) Physician	$7.1M	$0
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Mitchell Goff	UT	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Brittney Statler	CO	Ophthalmology Physician	$3.7M	$0
Arthur Korotkin	CO	Ophthalmology Physician	$3.7M	$0
Richard Kinsey	TN	Anatomic Pathology & Clinical Pathology Physician	$3.3M	$147.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry LLC	WY	Pediatric Dentistry	$0	$8M
Emg Cheyenne Sh LLC	WY	Assisted Living Facility	$0	$5.8M
Liv In-home Counseling & Care Management, LLC	WY	Primary Care Clinic/Center	$0	$5.7M
Lucy Russell	WY	Developmentally Disabled Services Day Training Agency	$0	$5.4M
Pediatric Dentistry LLC	WY	Pediatric Dentistry	$0	$4.1M
Bridges Of Wyoming, Inc	WY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$2.2M
Renee Dreher	WY	Clinical Social Worker	$0	$817.9K
Breanna Barnes	WY	Pediatric Dentistry	$0	$794.4K
College Drive Urgent Care LLC	WY	Urgent Care Clinic/Center	$0	$770.4K
Sandra Surbrugg	WY	Dermatology Physician	$664.9K	$0

Donald Cain — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References