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PROVIDER PROFILE · NPI 1114080017

James RainsMD

OphthalmologyBessemer, ALI
CROSS-REFERENCE

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ProviderScore
OIG/SAM exclusion screening, sanctions history
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QUALITY · MIPS · 2024
Final MIPS score
84.7
Quality
79.8
Cost
70.9
Improvement activities
40.0
Promoting interop.
98.0
Payment adjustment
0.41%
Group
PRESCRIBING · PART D · 2024
Total Rx claims
706
Beneficiaries
—
Total drug cost
$21K
Distinct drugs
8
Brand share
19.8%
Top prescribed drugs
Latanoprost381 claims
Dorzolamide Hcl/Timolol Maleat104 claims
Timolol Maleate78 claims
Brimonidine Tartrate44 claims
Dorzolamide Hcl44 claims
REFERRAL NETWORK

Where James Rains's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 3 inbound referrers · 6 outbound destinations.

Receives referrals from
Inbound — who sends patients here
PhysicianPatientsVisits
Laboratory Corporation Of America Holdings
Clinical Laboratory · Birmingham, AL
1825
Harini Doppalapudi
Internal Medicine · Bessemer, AL
1326
UNIVERSITY OF ALABAMA AT BIRMINGHAM1119
Refers patients to
Outbound — where patients go next
PhysicianPatientsVisits
MEDICAL WEST HOSPITAL AUTHORITY, AN AFFILIATE OF UAB HEALTH SYSTEM81149
UNIVERSITY OF ALABAMA AT BIRMINGHAM1524
Harini Doppalapudi
Internal Medicine · Bessemer, AL
1430
CUTLER, JEFFREY1112
Laboratory Corporation Of America Holdings
Clinical Laboratory · Birmingham, AL
1111
Quest Diagnostics Clinical Laboratories Inc
Clinical Laboratory · Tucker, GA
1121
Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.
MEDICARE UTILIZATION · PART B · 2024
Total beneficiaries
217
Unique beneficiaries
—
Total services
223
Distinct HCPCS
5
Medicare payment
$14K
Peer benchmark
Q1
Q2
Q3
Q4
Q5
Total Medicare services vs. 191 Ophthalmology providers in AL — bottom quintile (cohort median 1,895).
INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024
No data available for this provider in 2024.