Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Mississippi for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Mississippi only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Mississippi (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Abbey Ross (NPI 1083085260)

Field	Value
Entity Type	Individual
Organization	Abbey Ross
Address	236 Pierce Rd
City	Florence
State	MS
ZIP	39073
Taxonomy	Nurse Practitioner
NPI Enumerated	October 13, 2015

Payer Source	Total Paid
Medicare	$2.6M
Medicaid	$0

Key Findings

Provider ABBEY ROSS has billed $2.6M in Medicare revenue and has no Medicaid billing on file, making her practice effectively single-payer (Medicare) in the available claims data. Her NPI was enumerated 2015-10-13 (~11 years ago), indicating roughly a decade of billing history to support these volumes.

Revenue is highly concentrated in three add-on wound product codes: the precomputed top 3 Medicare codes account for 96.4% of this provider's total Medicare revenue. Those codes are Q4205 ($1.1M revenue, 954 claims, $1131 avg paid/claim), Q4217 ($772.6K revenue, 910 claims, $849 avg paid/claim), and Q4236 ($617.4K revenue, 588 claims, $1050 avg paid/claim), which together dominate the payer mix.

The code mix (Q4205, Q4217, Q4236) points to a wound-care and skin-substitute product orientation: all three codes are per-square-centimeter add-on charges for membrane grafts or similar biologic wound products, suggesting the provider’s revenue model emphasizes selling/applying per-area wound products rather than high-volume E/M primary care. Ancillary debridement and skin substitute procedure codes (for example 11042 at $38.4K and 15271 at $9.8K) are present but account for a small share of Medicare revenue, indicating these services support the primary wound-product activity rather than replacing it.

Despite large absolute dollars tied to the three wound-product codes, ABBEY ROSS is a modest national participant on those specific items: Q4205 ranks #33 of 63 providers nationally (48th percentile) and is described as "typical, unremarkable volume for this code," Q4217 ranks #42 of 65 (36th percentile, "typical, unremarkable volume for this code"), and Q4236 ranks #65 of 79 (18th percentile, "typical, unremarkable volume for this code"). These ranks indicate the provider does not appear to be a dominant national supplier of these products, but rather operates at a typical to below-typical volume relative to listed peers.

Several lower-revenue Medicare codes reflect a service footprint that includes wound debridement and facility/home visits: 11042 (534 claims, $38.4K, 1.5% of Medicare revenue), 11043 (71 claims, $9.9K, 0.4%), 99348 (168 claims, $7.7K, 0.3%), and 99349 (95 claims, $6.9K, 0.3%). Each of these codes is labeled in the file as "typical, unremarkable volume for this code," supporting an operational profile that pairs product-based wound care with occasional procedural debridement and E/M visits in home or nursing settings rather than high-volume longitudinal primary care.

The absence of any Medicaid billing on file means competitive and payer-mix analysis must treat this provider as essentially Medicare-only in the dataset; there are no in-state Medicaid code comparisons to assess. This single-payer concentration increases the sensitivity of the provider's topline to Medicare reimbursement and utilization patterns for the three dominant add-on wound-product codes.

From a business perspective, the combination of per-square-centimeter add-on codes as primary revenue drivers plus supporting debridement and facility/home visit codes suggests a specialized wound-care operation that likely bills product application per wound area. Given the top-3 concentration (96.4% of Medicare revenue), payer or coding policy changes that affect Q4205, Q4217, or Q4236 would materially impact the practice’s Medicare revenue.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4205	Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)	950	$1,130	$1.1M
Q4217	Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure)	910	$850	$772.6K
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	590	$1,050	$617.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	530	$70	$38.4K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	70	$140	$9.9K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	110	$90	$9.8K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	170	$50	$7.7K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	100	$70	$6.9K
11045	The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately…	180	$20	$4.2K
15275	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…	40	$100	$4K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Mississippi Distribution

Abbey Ross — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4217	5	10	1,130	$980	$1.6M
Q4236	12	20	850	$1,050	$1.2M
Q4205	3	10	750	$1,130	$853.6K
99309	160	210	100	$70	$20.9K
11043	25	50	70	$140	$19.3K
11042	17	140	120	$60	$13.5K
99308	183	260	110	$50	$13K
99349	47	110	60	$80	$10.8K
15271	9	40	70	$80	$6.5K
15275	17	20	60	$90	$6.4K

Showing 1–10 of 17

Related Providers

Other providers that share a Tax Identification Number (TIN) with Abbey Ross, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Strategic Solutions-panola Medical Center LLC	MS	Rural Acute Care Hospital	$0	$17.6M
Scott Martin	MS	Family Medicine Physician	$9M	$0
Strategic Solutions-panola Medical Center LLC	MS	Rural Health Clinic/Center	$0	$6.7M
Greenwood Leflore Hospital	MS	Rural Health Clinic/Center	$0	$4.7M
Shannon Weathers	MS	Family Nurse Practitioner	$4.6M	$0
Lori Case	MS	Family Nurse Practitioner	$4.2M	$0
Strategic Solutions-panola Medical Center LLC	MS	Rural Health Clinic/Center	$0	$4M
Amy Shuptrine	TX	Nurse Practitioner	$3.7M	$0
Chelsea Cockrell	MS	Family Nurse Practitioner	$3M	$0
Anna Gordon	MS	Nurse Practitioner	$2.9M	$0

Nearby Providers

Other providers in the same ZIP code as Abbey Ross, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compassionate Homemaker And Respite Care Services, LLC	MS	In Home Supportive Care Agency	$0	$6.8M
Helping Hands Homemaker Agency,inc.	MS	In Home Supportive Care Agency	$0	$6.1M
Faith And Friends Healthcare Staffing LLC	MS	Nursing Care Agency	$0	$4.8M
Martin Health Care, LLC	MS	Family Medicine Physician	$0	$3.1M
Inco-med LLC	MS	Durable Medical Equipment & Medical Supplies	$0	$2.6M
Roderick Shields	MS	Family Medicine Physician	$160.6K	$0
Derek Puckett	MS	Physical Therapist	$149.3K	$0
Brian Hendley	MS	Physical Therapist	$141.6K	$0
Jamie Brewer	MS	Family Nurse Practitioner	$109.3K	$0
Jessalynn Thurman	MS	Family Nurse Practitioner	$97.4K	$0

Abbey Ross — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References