Physician

Ornette L Gaines, M.D.

According to 2025 Medicare claims, Ornette Gaines, M.D. (NPI: 1386613503) practices family practice in the Fayetteville-Springdale-Rogers, AR market, with the plurality of this provider's patient population coming from Washington, AR. This provider's primary affiliated billing organization is OPTIMAL PAIN AND WELLNESS (NPI: 1487920146; TIN: 26-1468338) and primary practice location at 72703-5251.

Gaines' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 313 traditional Medicare patients, billed 2,715 HCPCS/CPT codes, and received $281,379 in Medicare payments. The top billing code was G0482 (Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms). Part D data shows 10,492 prescription claims across 912 beneficiaries totaling $540,163 in drug costs, led by Xtampza Er (Oxycodone Myristate). DME data shows 24 claims. Open Payments data shows 3 records totaling $56. 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 risen steadily, from $614 to $281,379. Concurrently, Part D prescription costs did not follow a clear longitudinal pattern. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $12,324 to $2,868.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	34	57	$614
2016	279	1,032	$70,802
2017	423	2,981	$278,564
2018	449	3,931	$325,184
2019	679	6,285	$438,234
2020	631	7,551	$444,744
2021	526	4,773	$491,260
2022	402	4,628	$509,253
2023	368	4,064	$430,386
2024	313	2,715	$281,379

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	156	2,852	$181,509
2016	488	4,740	$312,656
2017	706	11,847	$648,104
2018	857	14,031	$820,467
2019	1,364	17,698	$1,057,450
2020	1,339	19,651	$1,042,195
2021	1,190	16,483	$887,725
2022	1,025	14,869	$900,880
2023	1,007	14,869	$857,945
2024	912	10,492	$540,163

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	15	137	$7,708
2016	29	169	$4,533
2017	13	109	$1,772
2018	N/R	34	$370
2019	12	84	$4,495
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	24	$1,416
2024	N/R	24	$1,063

* / # = 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
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms	272	749	$194
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms	68	111	$153
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	281	908	$71
80307	Testing for presence of drug, by chemistry analyzers	287	860	$61
99211	Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	39	39	$14

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xtampza Er	Oxycodone Myristate	200	5,793	$84,587
Hydrocodone-Acetaminophen	Hydrocodone/Acetaminophen	1,726	50,890	$61,356
Movantik	Naloxegol Oxalate	129	4,105	$55,446
Oxycodone-Acetaminophen	Oxycodone Hcl/Acetaminophen	1,272	37,682	$49,293
Oxycodone Hcl	Oxycodone Hcl	2,117	62,838	$44,789

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
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	12	$875
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	Y	N/R	12	$188

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	3	$56	Collegium Pharmaceutical, 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

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FAQ

What Medicare data is available for Ornette L. Gaines, M.D.?

Tedicare shows public-source Medicare data for Ornette L. Gaines, M.D. (NPI 1386613503), 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 Ornette L. Gaines, M.D. have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Ornette L. Gaines, M.D.?

Ornette L. Gaines, M.D. is linked to OPTIMAL PAIN AND WELLNESS (billing NPI 1487920146) in the available physician profile data.

Does Ornette L. Gaines, M.D. have Open Payments data?

Ornette L. Gaines, M.D. has 3 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.