Gaines, Alan

Gaines, Alan was paid $67K by Medicaid between Feb 2018 and Dec 2024, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.

33Billing provider infoGAINES, ALAN
CUMBERLAND, RI 02864

33aNPI1841397981assigned 09/20/2006

33bProvider typeAllergy & Immunology Physician

28Total paid$67K

24GClaims2,461

24DCodes billed7

24AFirst – last monthFeb 2018 – Dec 2024

Compared with peers

Next to other Allergy & Immunology Physician providers in Rhode Island

Rank by total paid#1 of 9

Median peer was paid$12K

This provider vs. median5.4×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	132	$6K
2019	211	$7K
2020	273	$8K
2021	491	$12K
2022	362	$10K
2023	486	$11K
2024incomplete	506	$13K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	35%	520	491	$24K
95117		28%	1,600	813	$19K
95004	Percutaneous tests with allergenic extracts, immediate type reaction	21%	189	185	$14K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	6.7%	50	50	$5K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	6.6%	72	72	$4K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	1.2%	15	14	$801.42
94010		<1%	15	14	$227.85

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.