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.

Lori Case (NPI 1568113983)

Field	Value
Entity Type	Individual
Organization	Lori Case
Address	533 Lake St
City	Hazlehurst
State	MS
ZIP	39083
Taxonomy	Family Nurse Practitioner
NPI Enumerated	January 18, 2022

Payer Source	Total Paid
Medicare	$4.2M
Medicaid	$0

Key Findings

This provider’s Medicare activity is the sole reported public-payer footprint: Total Medicare revenue is $4.2M and there is no Medicaid billing on file, so the provider effectively operates as a Medicare-only billed entity in these datasets. This single-payer profile should be considered when assessing access and network coverage in Mississippi.

Revenue is extremely concentrated in a narrow set of services: the precomputed top three Medicare codes account for 99.0% of total Medicare revenue, driven primarily by Q4236 (66.8% of Medicare revenue, $2.8M) and Q4205 (31.1% of Medicare revenue, $1.3M), with 11042 contributing a small share (1.0%, $43.7K). That concentration indicates the provider’s financial performance on Medicare is dependent on a very small number of procedure/add-on code lines.

The code mix and descriptions indicate a focused wound-care and skin-substitute service model: Q4236 (Carepatch, per square centimeter) and Q4205 (membrane graft or membrane wrap, per square centimeter) are the dominant revenue drivers, and debridement code 11042 is also reported. Together these codes imply operations centered on application and billing for skin substitutes/membranes and associated debridement procedures rather than broad primary care or multispecialty practice.

Against national peers the provider’s market position for the two highest-revenue skin-substitute codes is modest: Q4236 ranks #25 of 79 providers (69th percentile) and Q4205 ranks #27 of 63 providers (58th percentile), both labeled as typical/unremarkable volumes. Those ranks suggest the provider participates meaningfully in the skin-substitute segment but is not a national outlier or dominant provider for those specific codes.

By contrast, the debridement activity represented by 11042 is a notable outlier: 11042 ranks #507 of 10712 providers nationally (95th percentile) and is described as notably above typical national volume. Although 11042 accounts for only $43.7K (1.0% of Medicare revenue), the high percentile rank signals unusually heavy debridement case volume relative to most providers, which may reflect a procedural focus or referral pattern for wound debridement.

Operational and reimbursement characteristics are consistent with high-volume per-unit billing: Q4236 shows 2.7K claims at an average paid per claim of $1050 and Q4205 shows 1.2K claims at an average paid per claim of $1131. Those claim counts and per-claim payments indicate frequent, per-square-centimeter billing of skin-substitute products or add-on graft materials rather than predominantly time-based E/M visits.

The absence of any Medicaid billing on file can reflect limited or no participation in Medicaid, differential payer contracting, or a patient mix that yields negligible Medicaid claims; regardless, it means risk and revenue are concentrated on Medicare reimbursement policies and coverage decisions. For payers and network planners, that lack of Medicaid activity is a salient factor when evaluating access for Medicaid populations in Hazlehurst, MS.

The provider’s NPI was enumerated on 2022-01-18 (~4 years ago), and in that interval the record shows $4.2M in Medicare revenue concentrated in wound-care and skin-substitute codes. This relatively recent enumeration combined with concentrated high-volume procedural billing suggests a focused, established operational model in a short timeframe rather than a long-standing, broad primary-care panel.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	2,660	$1,050	$2.8M
Q4205	Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)	1,150	$1,130	$1.3M
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.	600	$70	$43.7K
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…	610	$20	$14.6K
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…	140	$90	$13K
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…	30	$130	$3.5K
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.	30	$90	$3K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	30	$70	$2.2K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	50	$50	$2.2K
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…	30	$50	$1.4K

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Mississippi Distribution

Lori Case — 2 of 12 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

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4236	1	20	850	$1,050	$1.2M
Q4205	1	10	750	$1,130	$853.6K
99309	166	210	100	$70	$20.9K
11043	44	50	70	$140	$19.3K
11042	13	140	120	$60	$13.5K
99308	187	260	110	$50	$13K
99349	101	110	60	$80	$10.8K
15271	29	40	70	$80	$6.5K
15275	3	20	60	$90	$6.4K
99348	60	80	60	$50	$4.7K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lori Case, 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
Shannon Weathers	MS	Family Nurse Practitioner	$4.6M	$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
Abbey Ross	MS	Nurse Practitioner	$2.6M	$0
Sarah Sanchez	FL	Family Nurse Practitioner	$2.5M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope Healthcare Staffing Agen Cy	MS	In Home Supportive Care Agency	$0	$12.7M
Copiah County Medical Center	MS	Critical Access Hospital	$0	$9.9M
Compassionate Cares	MS	Personal Care Attendant	$0	$9M
Emma Burns	MS	Attendant Care Provider	$0	$8.3M
Keystone Medical Services Of Ms, Inc	MS	Emergency Medicine Physician	$0	$4.1M
Smile Design Orthodontics, LLC	MS	Dentist	$0	$3.8M
Carol Newton	MS	In Home Supportive Care Agency	$0	$2.5M
Copiah County Medical Center	MS	Family Medicine Physician	$0	$2.4M
Bio-medical Applications Of Mississippi, Inc.	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Chandra Minor	MS	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.4M

Lori Case — 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