Physician

Kumar Rai, MD

According to 2025 Medicare claims, Kumar Rai, MD (NPI: 1134428980) practices general surgery in the Beckley, WV market, with the plurality of this provider's patient population coming from Raleigh, WV. This provider's primary affiliated billing organization is APPALACHIAN REGIONAL HEALTHCARE, INC (NPI: 1477510162; TIN: 520795508) and primary practice location at 25801-3142. Rai is affiliated with the Main Street Rural Health Sycamore ACO LLC (ACO ID: A5403), participating under the MSSP model.

Rai's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 319 traditional Medicare patients, billed 965 HCPCS/CPT codes, and received $93,649 in Medicare payments. The top billing code was 99222 (Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes). Part D data shows 125 prescription claims across 48 beneficiaries totaling $15,443 in drug costs, led by Clopidogrel (Clopidogrel Bisulfate). DME data shows 36 claims. Open Payments data shows 1 records totaling $40. 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 started with an early spike, then settled into a lower baseline, moving from $180,745 to $93,649. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $24,897 and ending at $15,443. For DME billing, reported payments started with an early spike, then settled into a lower baseline, moving from $24,298 to $4,429.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	362	1,445	$180,745
2016	984	3,863	$426,372
2017	583	2,274	$293,902
2018	447	1,475	$229,551
2019	296	1,327	$161,382
2020	304	950	$117,628
2021	279	827	$90,444
2022	329	955	$107,273
2023	323	879	$90,557
2024	319	965	$93,649

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	156	336	$24,897
2016	186	377	$16,093
2017	153	355	$22,428
2018	132	266	$19,373
2019	63	170	$9,947
2020	62	185	$17,695
2021	66	152	$12,883
2022	68	217	$18,726
2023	63	176	$21,170
2024	48	125	$15,443

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	24	$17,084
2016	70	184	$48,673
2017	N/R	45	$6,866
2018	36	99	$18,738
2019	N/R	68	$19,142
2020	N/R	26	$2,366
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	36	$2,586
2024	N/R	36	$2,596

* / # = 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
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	125	131	$98
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$93
36556	Insertion of non-tunneled central venous tube for infusion (5 years or older)	60	62	$67
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	94	115	$58
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	96	155	$38

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Clopidogrel	Clopidogrel Bisulfate	54	3,180	$497
Acetaminophen-Codeine	Acetaminophen With Codeine	15	99	$52
Cephalexin	Cephalexin	18	120	$52

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
A4414	Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each	N	N/R	12	$1,155
A4425	Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each	N	N/R	12	$802
A4385	Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each	N	N/R	12	$640

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	1	$40	Ethicon US, LLC
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

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FAQ

What Medicare data is available for Kumar Rai, MD?

Tedicare shows public-source Medicare data for Kumar Rai, MD (NPI 1134428980), 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 Kumar Rai, MD have ACO affiliation data?

Kumar Rai, MD is shown with ACO affiliation data for Main Street Rural Health Sycamore ACO LLC (MSSP, ACO ID A5403).

What billing organization is linked to Kumar Rai, MD?

Kumar Rai, MD is linked to APPALACHIAN REGIONAL HEALTHCARE, INC (billing NPI 1477510162) in the available physician profile data.

Does Kumar Rai, MD have Open Payments data?

Kumar Rai, MD has 1 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.