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 Texas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Texas 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. Texas (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.

Shelita Jones (NPI 1881211803)

Field	Value
Entity Type	Individual
Organization	Shelita Jones
Address	2400 Augusta Dr Ste 369
City	Houston
State	TX
ZIP	77057
Taxonomy	Family Nurse Practitioner
NPI Enumerated	June 26, 2020

Payer Source	Total Paid
Medicare	$6.7M
Medicaid	$0

Key Findings

Medicare revenue is highly concentrated in a single HCPCS code: Q4262 accounts for $6.6M of the provider’s $6.7M total Medicare revenue (99.5% of Medicare revenue), and the precomputed top three Medicare codes together account for 99.8% of total Medicare revenue. This means nearly all billed Medicare dollars flow from a narrow set of wound-care/supply-related items rather than a broad mix of E/M or preventive services.

The code mix points to a wound-care and skin-replacement service line: Q4262 (dual layer impax membrane) is the dominant item, supplemented by procedural codes for debridement (11042, 177 claims, $86 avg paid/claim, $15.2K revenue) and skin substitute placement (15271, 89 claims, $103 avg paid/claim, $9.2K revenue). Together these codes indicate the practice is operationally focused on tissue-management procedures and product-based interventions rather than primarily office-based evaluation and management.

This provider is effectively single-payer in scale: lifetime Medicare revenue is $6.7M while there is no Medicaid billing on file. Analysts should treat the entity as Medicare-centric for payer-mix comparisons and benchmarking rather than a mixed Medicaid/Medicare outpatient provider.

Competitive standing for the dominant product code is above typical but not extreme: Q4262 is ranked #21 of 141 providers nationally (86th percentile) with 6.1K claims and an average paid amount of $1087 per claim. That rank indicates a relatively strong national position for this specific code, but the provider is not an outlier labeled as extreme or anomalous for Q4262.

By contrast, the procedural companion codes show only modest peer standing: 11042 ranks #2784 of 10712 providers (74th percentile) and 15271 ranks #395 of 1157 providers (65th percentile). Those percentile placements are described as "typical, unremarkable volume for this code," signaling that beyond the dominant supply code the provider is a modest participant in debridement and skin-substitute procedures compared with national peers.

The provider’s NPI was enumerated on 2020-06-26 (~6 years ago), so the $6.7M in Medicare revenue represents billing activity over roughly that tenure. That timeline provides context for assessing throughput and average annual Medicare revenue when comparing to peers with longer or shorter enrollment histories.

Operationally, the billing pattern (6.1K claims for Q4262 at $1087 avg paid/claim) suggests a volume-and-supply-driven reimbursement model where revenue is sensitive to per-unit/area pricing and claim counts for a single product line. Because one add-on code dominates receipts, changes to coverage, reimbursement rates, or utilization for Q4262 would materially affect reported Medicare revenue.

All top reported codes carry the platform’s characterization of "typical, unremarkable volume" in national comparisons rather than labels like "extreme outlier," which indicates that while the provider is highly concentrated in a single code, its per-code volumes generally fall within expected ranges among peers. This nuance matters for competitive assessment: strong revenue concentration is present, but activity levels are not flagged as atypical across the cited codes.

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	6,100	$1,090	$6.6M
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.	180	$90	$15.2K
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.	90	$100	$9.2K
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…	180	$50	$8.9K
99342	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…	30	$50	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Shelita Jones — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	3	30	1,580	$1,010	$2.5M
11042	208	790	90	$70	$13K
15271	44	120	70	$100	$9.9K
99348	138	780	60	$50	$6K
99342	91	160	30	$50	$3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Richard Park	CA	Internal Medicine Physician	$31.7M	$0
Samuel Jurca	ID	Family Medicine Physician	$24M	$0
Nyrie Austin	NJ	Family Nurse Practitioner	$15.9M	$8.8K
Patrick Black	CA	Physical Therapist	$14M	$0
Owen Ellington	TX	Hematology & Oncology Physician	$11.5M	$0
Joseph Palumbo	WV	Emergency Medicine Physician	$7.9M	$44.3K
Kellie King	TX	Family Nurse Practitioner	$5.3M	$0
Jamie Kate Adoc	CA	Family Nurse Practitioner	$4.7M	$0
Raymond Wawrowski	OH	Physician Assistant	$4.7M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ipseity Diagnostics LLC	TX	Clinical Medical Laboratory	$19.3M	$10.9K
Christopher Tiangco	TX	Nurse Practitioner	$2M	$0
Encompass Laboratory LLC	TX	Clinical Medical Laboratory	$1.1M	$5K
Tamara Liburd	TX	Occupational Therapist	$633.1K	$0
Patricia Salvato	TX	Internal Medicine Physician	$608.7K	$0
Andres Tapia	TX	Clinical Psychologist	$115K	$0
Patricia Elles	TX	Certified Registered Nurse Anesthetist	$80.5K	$0
Nicholas Defilippis	TX	Anesthesiology Physician	$24K	$0

Shelita Jones — Billing Profile & Reimbursement Data

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Shelita Jones — 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