Dr. James Cain, MD
635 W Wesmark Blvd, Sumter, SC 29150 • +1-295-555-9049
Medical Education: Accredited U.S. Medical School (Class of 2007)
What This Doctor Actually Performs: CMS Medicare Utilization & Sumter Percentiles
NPI #1174615868 • CBSA Regional • Nephrology
Dr. James Cain, MD (NPI #1174615868) practices Nephrology in Sumter, SC (29150) with sub-specialty concentration in 86 Active CMS HCPCS Codes, recording 8,695 annual CMS services across 253 distinct beneficiaries—placing this practice as a mid-cohort balanced caseload (60th Sumter percentile) (+1.64σ vs SC state mean, 95.45th statewide percentile).
Among 5 tracked CMS fee-schedule codes for Dr. Cain (averaging 34.4 services per beneficiary), 99214 (Chronic Kidney Disease eGFR, uACR & Electrolyte Management) represents 14% of tracked volume (1243 encounters), paired with 90960 (570x).
Self-pay new patient consultations with Dr. Cain (CPT 99204 GPCI-adjusted benchmark) estimate around $209.00 (community reported average: $209.00) with in-person clinic visits only, 19-minute average reception wait, and a 4.53/5 modern protocol openness score across 3 patient logs.
Credentialed as an MD specialist with 19 years post-graduation experience since completing medical school at an LCME/COCA institution (2007), Dr. Cain coordinates 86 Active CMS HCPCS Codes workups from 635 W Wesmark Blvd (+1-295-555-9049).
Compared against Sumter, SC Nephrology peers
8,695 annual services across 253 beneficiaries
Standard deviations from SC Nephrology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Chronic Kidney Disease eGFR, uACR & Electrolyte Management | 1,243 | 60th | $61 – $83 |
| 90960 | Monthly Adult ESRD Renal Replacement Oversight | 570 | 63th | $121 – $166 |
| 99215 | High-Complexity Cardiorenal & Resistant Hypertension Visit | 466 | 58th | $88 – $121 |
| 99204 | New Patient Nephrology & Proteinuria Consultation | 311 | 63th | $83 – $114 |
| 96372 | Therapeutic Subcutaneous/Intramuscular Injection Administration (86 HCPCS billing breadth) | 6,105 | 60th | $52 – $75 |
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Dr. James Cain, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Cain National Provider Identifier | NPI #1174615868 (MD) | CMS NPPES Registry (29150) |
| Dr. Cain Sumter CMS Volume Rank | 60.00th Pct (8,695 CMS svcs; Z +1.635σ) | CMS Medicare Part B (SC Nephrology) |
| Fair Cash-Pay New-Patient Benchmark | $209.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Sumter, SC) |
| Waiting-Room Wait Time & Cash Friendliness | $209.00 avg paid • 19 min lobby wait | 3 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.58/5 Listening • 4.53/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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