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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Rusty Cain (NPI 1811908270)

Field	Value
Entity Type	Individual
Organization	Rusty Cain
Address	1228 Country Club Rd
City	Fairmont
State	WV
ZIP	26554
Taxonomy	Foot Surgery Podiatrist
NPI Enumerated	August 11, 2006

Payer Source	Total Paid
Medicare	$41K
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
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…	350	$60	$21.9K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	70	$90	$6K
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…	70	$70	$5K
11720	The provider surgically debrides (debulks or removes) 1 to 5 abnormal, diseased, or infected nails.	170	$20	$3.6K
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…	20	$100	$1.7K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	50	$30	$1.2K
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…	10	$100	$1.1K
11719	The provider performs trimming of one or more normally developed nails of the fingers or toes.	60	$10	$620

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. West Virginia Distribution

Rusty Cain — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
11042	42	60	90	$70	$13.6K
99214	2,711	2,740	100	$70	$11.8K
11721	59	60	240	$30	$9.6K
99213	269	2,860	80	$50	$7.5K
11720	21	40	190	$20	$6.3K
99222	809	1,080	30	$100	$4.5K
99203	149	940	30	$60	$2.8K
11719	10	20	130	$10	$1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monongahela Valley Association Of Health Centers, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$16.6M
Alecto Healthcare Services Fairmont LLC	WV	General Acute Care Hospital	$0	$11.7M
Radiological Physician Associates Inc	WV	Diagnostic Radiology Physician	$0	$11.1M
Bbc Rehab, Pc,inc	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$10.5M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$8.8M
Marion County Rescue Squad Inc	WV	Land Ambulance	$833K	$7.6M
Family Service Of Marion & Harrison Counties Inc	WV	Community/Behavioral Health Agency	$0	$5.5M
Essential Needs Homecare	WV	In Home Supportive Care Agency	$0	$4.7M
Yale Academy LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M
Youth Academy, LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M

Rusty Cain — Billing Profile & Reimbursement Data

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Rusty Cain — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References