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NPI 1376741355 · Oxford, MS · Family Medicine Physician
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Christopher Cummins is a family medicine physician provider located in Oxford, Mississippi. This profile covers 3 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Christopher Cummins |
| Address | 406 Galleria Dr |
| City | Oxford |
| State | MS |
| ZIP | 38655 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | July 11, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.9M |
| Medicaid | $630 |
This profile is overwhelmingly Medicare-driven: total Medicare revenue is $1.9M while total Medicaid revenue is $628, so Medicare makes up the vast majority of billed revenue and the provider functions effectively as a Medicare-focused biller. The Medicaid total is negligible in scale compared with Medicare, indicating this entity is effectively single-payer in economic impact despite some Medicaid activity on file.
Revenue concentration on Medicare is extreme: the precomputed top-3 Medicare codes account for 100.0% of this provider's total Medicare revenue, with a single code, K1034, representing 90.0% of Medicare revenue. That concentration implies the provider’s Medicare business is dominated by a narrow service line rather than a broad mix of primary care E/M visits.
Business/service-line implication from code mix: K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use) accounts for $1.7M of Medicare revenue across 142.3K claims and drives the bulk of activity, while 99442 and 99441 (telephone E/M codes) together represent the remainder of Medicare billings. This pattern suggests an operational model focused on high-volume distribution or processing of self-administered COVID-19 tests supplemented by telephonic evaluation services rather than traditional face-to-face outpatient primary-care visits.
Competitive standing on Medicare for specific codes is unusually strong: K1034 ranks #150 of 30143 providers nationally and is described as “notably above typical national volume for this code,” while 99442 ranks #6 of 21242 providers nationally and is labeled an “extreme outlier.” 99441 also appears as an “extreme outlier” (rank #90 of 10645); collectively these positions indicate the provider is a major national participant for these specific services rather than a typical small-volume local clinic.
Medicaid billing is minimal and concentrated: the Medicaid top code list shows K1034 with 230 claims and $690 revenue listed as 100.0% of this provider's total Medicaid revenue, and several other listed Medicaid codes show $0 average paid/claim. Note there is a small data inconsistency between the lifetime Medicaid total ($628) and the Medicaid code-level revenue ($690 for K1034 reported as 100.0%), suggesting a rounding or reporting discrepancy in the source files.
Statistical outlier characterization: both 99442 and 99441 are flagged as “extreme outlier” volumes nationally on Medicare, while K1034 is flagged as “notably above typical national volume.” Those plain-English labels indicate these code-level volumes are well outside typical peer activity patterns and merit attention when assessing utilization and operational focus.
Tenure and legitimacy of the billing record: the NPI was enumerated on 2007-07-11 (~19 years ago), indicating the provider has a long-standing enrollment in federal programs. That tenure combined with concentrated, high-volume code activity suggests an established operational workflow around the services billed rather than a newly launched practice.
Operational risk and reimbursement notes for payers: because 100.0% of Medicare revenue is tied to three codes (with K1034 alone at 90.0%) and Medicaid revenue is both tiny and concentrated, any changes in reimbursement policy for K1034 or telephone E/M codes (99442/99441) would materially affect this provider’s revenue. Payers evaluating contract terms or audits should therefore focus on those specific codes and on reconciling the small Medicaid revenue discrepancy noted above.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 142,320 | $10 | $1.7M |
| 99442 | N/A | 3,480 | $50 | $177.2K |
| 99441 | N/A | 450 | $30 | $12.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
3 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 2 | 210 | 300 | $10 | $37.5K |
| 99442 | 1 | 80 | 20 | $50 | $3.9K |
| 99441 | 1 | 50 | 30 | $30 | $1.5K |
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 230 | $1 | $690 |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 10 | $0 | $0 |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 220 | $0 | $0 |
| 99441 | N/A | 10 | $0 | $0 |
| 99442 | N/A | 350 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Mississippi providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Mississippi median
5 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 249 | 680 | 100 | $50 | $34.8K |
| 99202 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider… | 291 | 300 | 70 | $50 | $15.9K |
| 99442 | N/A | 14 | 100 | 50 | $20 | $4.5K |
| 99441 | N/A | 100 | 100 | 50 | $20 | $2.1K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 2 | 10 | 230 | $1 | $570 |
Other providers in the same ZIP code as Christopher Cummins, ranked by combined Medicare and Medicaid revenue.
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