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    OpenPayerNPI Medicare & MedicaidAdraine Cox
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    Adraine Cox — Billing Profile & Reimbursement Data

    NPI 1992346076 · Flowood, MS · Nurse Practitioner

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    Adraine Cox is a nurse practitioner provider located in Flowood, Mississippi. This profile covers 9 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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    Progress1 / 9

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAdraine Cox
    Address778 Liberty Rd
    CityFlowood
    StateMS
    ZIP39232
    TaxonomyNurse Practitioner
    NPI EnumeratedSeptember 30, 2019

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

    Payer SourceTotal Paid
    Medicare$1.2M
    Medicaid$0

    Key Findings

    ADRAINE COX is a Nurse Practitioner based in FLOWOOD, MS with an NPI enumerated on 2019-09-30 (~7 years ago). Her lifetime Medicare revenue on file is $1.2M and there is no Medicaid billing on file, so the available claims data reflect a Medicare-centric practice profile rather than a mixed payer footprint.

    Revenue is highly concentrated in a single CPT/HCPCS line item: Q4236 accounts for $1.1M of Medicare revenue (93.2% of the provider's Medicare total) from 1K claims at an average paid/claim of $1050. The precomputed top-3 codes together account for 97.7% of Medicare revenue, with 11043 contributing $40K (3.4%) and 99349 contributing $13.2K (1.1%).

    The code mix points squarely to wound-care and skin-substitute services as the core business line: Q4236 (Carepatch, per square centimeter) and 15271 (skin substitute up to 25 cm2) dominate the revenue picture, while debridement codes 11043 and 11046 are present at meaningful volumes. Home-based and facility visit E/M codes (for example 99349, 99348, 99344, and 99307) also appear in the top codes, indicating some delivery of wound care in home or long-term care settings rather than exclusively in-office procedures.

    Payer mix is effectively single-payer in the available data: Medicare $1.2M versus no Medicaid billing on file. That concentration implies commercial or state payer negotiations and risk-sharing arrangements will be driven primarily by Medicare performance and utilization patterns rather than Medicaid dynamics.

    Competitive standing on the principal code shows modest national presence rather than dominance: Q4236 ranks #51 of 79 providers nationally (36th percentile; typical, unremarkable volume), while 11043 ranks #373 of 2062 (82th percentile; typical, unremarkable volume) and 99349 ranks #4882 of 14284 (66th percentile; typical, unremarkable volume). Across these top codes the provider’s volumes are characterized in the source data as typical or unremarkable rather than extreme outliers, so the practice appears as a specialized but not market-leading national participant for these services.

    Although most revenue is concentrated in Q4236, smaller procedure and supply codes are billed alongside it: 11046 ($9.6K, 0.8%), 15271 ($8.8K, 0.8%), and 99348 ($4K, 0.3%) show that debridement, skin-substitute application, and longer home visits are part of the care pathway. These ancillary codes indicate a bundled wound-care workflow (debridement + dressing/skin substitute + follow-up/home-based E/M) where ancillary items represent modest but consistent additional Medicare revenue.

    There are no statistical flags in the provided descriptions indicating extreme outlier behavior; each top code is labeled as typical or unremarkable in national comparisons. The principal operational risk from these data is revenue concentration—with $1.1M tied to Q4236—meaning changes in reimbursement, coding policy, or utilization for that code would have outsized effects on this provider’s Medicare revenue stream.

    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.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    Q4236Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)1,040$1,050$1.1M
    11043The 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…290$140$40K
    99349The 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…170$80$13.2K
    11046The provider uses surgical instruments to remove the dead tissue from the muscle and/or fascia, as well as the subcutaneous tissue layer, epidermis, and dermis if needed. She performs this service at…210$50$9.6K
    15271The 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 cm2.100$90$8.8K
    99348The 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…90$50$4K
    99344The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider spends at least…30$90$2.2K
    99307The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…40$30$900
    29581The provider applies a layered bandage to the lower leg, ankle, and foot, to treat venous stasis ulcers and venous insufficiency, the failure of the blood veins immediately below the skin. A…30$30$810

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    Q4236820850$1,050$1.2M
    1104345070$140$19.3K
    11046820160$50$13.8K
    993492511060$80$10.8K
    2958181070$70$10.2K
    15271114070$80$6.5K
    99348278060$50$4.7K
    993079613080$20$4.2K
    99344133020$90$2.1K

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Strategic Solutions-panola Medical Center LLCMSRural Acute Care Hospital$0$17.6M
    Scott MartinMSFamily Medicine Physician$9M$0
    Strategic Solutions-panola Medical Center LLCMSRural Health Clinic/Center$0$6.7M
    Shannon WeathersMSFamily Nurse Practitioner$4.6M$0
    Lori CaseMSFamily Nurse Practitioner$4.2M$0
    Strategic Solutions-panola Medical Center LLCMSRural Health Clinic/Center$0$4M
    Amy ShuptrineTXNurse Practitioner$3.7M$0
    Chelsea CockrellMSFamily Nurse Practitioner$3M$0
    Anna GordonMSNurse Practitioner$2.9M$0
    Abbey RossMSNurse Practitioner$2.6M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Rem East LLCMSCommunity/Behavioral Health Agency$0$97M
    Love And Faith Personal Care And Respite ServicesMSHome Health Agency$0$24.3M
    M-d Medical Services, Inc.MSParenteral & Enteral Nutrition Supplies (DME)$0$18M
    River Oaks Hospital LLCMSGeneral Acute Care Hospital$0$16.6M
    National Seating & Mobility, Inc.MSDurable Medical Equipment & Medical Supplies$0$12.5M
    Madison Physician Surgery Center, LLCMSAmbulatory Surgical Clinic/Center$12.3M$30.3K
    Mobility Medical IncMSOxygen Equipment & Supplies (DME)$0$10.4M
    Prescribed Pediatric Extended Care, IncMSMedically Fragile Infants and Children Day Care$0$9.5M
    Women's Health Associates, PLLCMSObstetrics & Gynecology Physician$0$9.4M
    Rem East LLCMSDevelopmentally Disabled Services Day Training Agency$0$7.8M

    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
    Adraine Cox — 0 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Mississippi