Physician

Adam C Protain, MD

According to 2025 Medicare claims, Adam Protain, MD (NPI: 1083879803) practices nephrology in the Kahului-Wailuku, HI market, with the plurality of this provider's patient population coming from Maui, HI. This provider's primary affiliated billing organization is NORTHWEST RENAL CLINIC, INC. (NPI: 1528036662; TIN: 930751490) and primary practice location at 96793-2443. Protain is affiliated with the QCIPN (ACO ID: A4614), participating under the MSSP model.

Protain's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 256 traditional Medicare patients, billed 2,629 HCPCS/CPT codes, and received $205,586 in Medicare payments. The top billing code was 90960 (Dialysis services, 4 or more physician visits per month (20 years or older)). Part D data shows 1,463 prescription claims across 235 beneficiaries totaling $638,029 in drug costs, led by Xphozah (Tenapanor Hcl). DME data shows 258 claims. Open Payments data shows 9 records totaling $188. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved up and down with repeated peaks and valleys, starting at $127,956 and ending at $205,586. Concurrently, Part D prescription costs have moved from a lower plateau to a higher plateau, from $49,753 to $638,029. In contrast, DME billing represents a smaller volume and changed little.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	382	8,502	$127,956
2016	356	6,003	$132,336
2017	381	24,948	$317,554
2018	332	13,171	$311,279
2019	310	8,405	$239,584
2020	362	1,652	$120,532
2021	264	2,195	$170,129
2022	313	2,964	$228,430
2023	274	2,601	$216,616
2024	256	2,629	$205,586

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	147	918	$49,753
2016	232	1,662	$186,577
2017	207	1,814	$232,199
2018	194	1,515	$162,281
2019	188	1,491	$163,159
2020	237	1,479	$195,193
2021	231	1,225	$395,860
2022	246	1,507	$504,345
2023	249	1,749	$608,433
2024	235	1,463	$638,029

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	140	$9,687
2018	N/R	240	$14,398
2019	11	361	$19,223
2020	38	392	$23,134
2021	N/R	272	$10,592
2022	N/R	217	$4,578
2023	N/R	270	$5,319
2024	N/R	258	$3,991

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
90960	Dialysis services, 4 or more physician visits per month (20 years or older)	47	388	$280
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	56	64	$94
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	66	167	$91
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	86	226	$60
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	62	147	$13

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xphozah	Tenapanor Hcl	34	1,740	$165,860
Farxiga	Dapagliflozin Propanediol	53	4,410	$77,980
Ozempic	Semaglutide	77	2,902	$77,269
Velphoro	Sucroferric Oxyhydroxide	13	570	$61,735
Jardiance	Empagliflozin	38	2,480	$45,694

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
Q0512	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	N	N/R	79	$903
J7507	Tacrolimus, immediate release, oral, 1 mg	N	N/R	72	$812
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	N	N/R	45	$790
J7517	Mycophenolate mofetil, oral, 250 mg	N	N/R	27	$745
J7518	Mycophenolic acid, oral, 180 mg	N	N/R	24	$733

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	9	$188	Ardelyx, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

Explore More Providers

FAQ

What Medicare data is available for Adam C. Protain, MD?

Tedicare shows public-source Medicare data for Adam C. Protain, MD (NPI 1083879803), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Adam C. Protain, MD have ACO affiliation data?

Adam C. Protain, MD is shown with ACO affiliation data for QCIPN (MSSP, ACO ID A4614).

What billing organization is linked to Adam C. Protain, MD?

Adam C. Protain, MD is linked to NORTHWEST RENAL CLINIC, INC. (billing NPI 1528036662) in the available physician profile data.

Does Adam C. Protain, MD have Open Payments data?

Adam C. Protain, MD has 9 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.