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    OpenPayerNPI Medicare & MedicaidRobin Mcdonald
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    Robin Mcdonald — Billing Profile & Reimbursement Data

    NPI 1407227549 · Tupelo, MS · Family Nurse Practitioner

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    Robin Mcdonald is a family nurse practitioner provider located in Tupelo, Mississippi. This profile covers 33 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationRobin Mcdonald
    Address1211 South Gloster
    CityTupelo
    StateMS
    ZIP38801
    TaxonomyFamily Nurse Practitioner
    NPI EnumeratedOctober 15, 2015

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$1.3M
    Medicaid$0

    Key Findings

    This provider’s revenue profile is effectively single‑payer: total Medicare revenue is $1.3M and there is no Medicaid billing on file. The absence of any Medicaid activity on record means analyses should treat this entity as Medicare‑dependent rather than a mixed‑payer practice.

    Revenue is highly concentrated in a very small set of procedures: the precomputed top‑3 Medicare codes account for 74.9% of the provider’s total Medicare revenue. Those top three codes are J3304 (51.9%), 99214 (13.0%), and 64640 (10.0%), indicating most dollars flow from a focused set of services.

    The code mix and volumes point to an injection/interventional pain and musculoskeletal practice model: J3304 (triamcinolone extended‑release) appears as the single largest revenue driver with 52.4K claims and $680.6K revenue, while 64640 (neurolysis) contributes 1.5K claims and $130.8K. Combined with high volumes for hyaluronan (J7318) and intra‑articular/arthrocentesis work, the practice is delivering a high throughput of injection‑based procedures.

    Routine office E/M work also contributes meaningfully but is secondary to procedures: 99214 shows 2.5K claims and $171.1K revenue, indicating frequent moderate‑complexity established‑patient visits that likely accompany procedural care. This mix (high procedural revenue plus substantial 99214 volume) suggests visits are often procedure‑driven rather than exclusively longitudinal primary care.

    Competitively the provider is a national outlier on several key codes: J3304 ranks #1 of 1181 providers nationally (100th percentile; extreme outlier), 64640 ranks #1 of 619 providers nationally (100th percentile; extreme outlier), and 99214 ranks #555 of 479517 providers nationally (100th percentile; extreme outlier). Those ranks indicate this provider operates at volumes far above typical national peers for its highest‑revenue services and is a dominant player for those specific procedures.

    Additional procedure and imaging codes reinforce a high procedural throughput: 20611 (ultrasound‑guided arthrocentesis) reports 1.8K claims and $111.5K revenue and ranks #9 of 8465 providers nationally (100th percentile; extreme outlier), while knee X‑ray 73564 shows 877 claims and $22.8K revenue and ranks #27 of 20494 providers nationally (100th percentile; extreme outlier). The combined pattern of high ranks across both interventional and imaging codes describes a clinic workflow built around diagnosis and injection‑based treatment.

    The heavy concentration of revenue in a few high‑volume injectable and interventional codes (top 3 = 74.9%) together with sole reliance on Medicare (no Medicaid billing) creates operational and payer exposure: changes in utilization, coverage policy, or reimbursement for J3304, 64640, or related injection codes could materially affect revenue. For payer negotiations and utilization management, these specific codes and their unusually high volumes should be prioritized for audit, network planning, or medical review.

    The provider has an established presence with NPI enumerated 2015-10-15 (~11 years ago), supporting a stable multi‑year operational footprint. Given the specialty‑weighted code mix and the provider’s outsized national ranks on key procedures, this appears to be a focused interventional/musculoskeletal practice rather than a general primary‑care panel.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    33 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg52,350$10$680.6K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…2,480$70$171.1K
    64640Neurolysis is the destruction of nerves responsible for carrying pain information. The destruction includes the use of chemical, heat, or radiofrequency techniques.1,490$90$130.8K
    20611In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…1,800$60$111.5K
    J7318Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg9,240$10$46.2K
    99213The provider sees an established 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…740$50$36.8K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.880$30$22.8K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…460$40$20.1K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…230$90$19.6K
    73502In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…510$20$12.2K

    Showing 1–10 of 33

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 33 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    33 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J33041303,090$10$69.4K
    99214134,110170$70$21.9K
    64640110100$90$21.5K
    J73181201,560$10$13.2K
    992231,1571,22050$120$10.4K
    992131944,000100$50$10.3K
    2061117090$70$10.1K
    99204522,15040$100$5.8K
    206102543060$40$5.8K
    992032461,48030$60$3.5K

    Showing 1–10 of 33

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Specialty Orthopedic Group Of Mississippi PLLCMSOrthopaedic Surgery Physician$0$1.3M
    Rowland RobersonMSOrthopaedic Surgery Physician$585.6K$0
    Tyler MarksMSOrthopaedic Hand Surgery Physician$527.4K$0
    Matthew MillerMSOrthopaedic Surgery Physician$488.5K$0
    William SeelyTNInterventional Pain Medicine Physician$409K$0
    Phillip SandiferMSOrthopaedic Surgery Physician$376.3K$0
    Douglas TuckerMSAnesthesiology Physician$352K$0
    Taylor MathisMSOrthopaedic Surgery Physician$286.9K$0
    Richard RaineyMSSports Medicine (Orthopaedic Surgery) Physician$274.1K$0
    Jeremy SmithermanMSPain Medicine Physician$256.1K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    North Mississippi Medical Center, Inc.MSGeneral Acute Care Hospital$0$117.7M
    North Mississippi Medical Clinics IncMSInternal Medicine Physician$0$16.9M
    Happy Smiles Dentistry - Tupelo LLCMSGeneral Practice Dentistry$0$16.2M
    North Mississippi Ambulatory Surgery Center LLCMSAmbulatory Surgical Clinic/Center$1.5M$7.1M
    Relias Emergency Medicine Specialists Of Tupelo LLCMSEmergency Medicine Physician$0$8.4M
    Sog Surgery Center LLCMSAmbulatory Surgical Clinic/Center$7.5M$480
    Prescribed Pediatric Extended Care, IncMSMedically Fragile Infants and Children Day Care$0$7.2M
    Kare-in-home Hospice Of North Mississippi, LLCMSCommunity Based Hospice Care Agency$0$5M
    North Mississippi Allergy And Asthma Center PLLCMSAllergy & Immunology Physician$0$4.3M
    Sanders Clinic For Women PAMSObstetrics & Gynecology Physician$0$3.8M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Mississippi Distribution
    Robin Mcdonald — 14 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Mississippi