MARK COX, M.D.
Ophthalmology Physician in SEDALIA, Missouri. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: MARK COX, M.D. reported a CMS MIPS final score of 97.8502 out of 100, above the 83.1 national average, and filed 524 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
MARK COX, M.D. practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).
MARK COX, M.D. at a glance
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Missouri
How Ophthalmology Physician compares to other specialties among Missouri providers
Ophthalmology Physician share within Missouri
Ophthalmology Physician is one of the more visible NUCC categories in Missouri
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
MARK COX, M.D.'s 2023 MIPS final score plotted against the Ophthalmology Physician national average
- MIPS Final Score
- 97.8502/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Ophthalmology Physician) — 97.8502/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Cost dim CMS Cost category
- Specialty volume Ophthalmology Physician US NPIs
97.8502/100 MIPS final score — 14.8 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Ophthalmology Physician. Quality dim: 95.7812. Cost dim: 98.459.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
MARK COX, M.D. is a Ophthalmology Physician provider practicing in SEDALIA, Missouri, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: M.D.. NPI: 1265437990. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.
MARK COX, M.D. appears in the CMS NPPES registry as a Ophthalmology Physician provider holding M.D. credentials at 3400 W 10TH ST, SEDALIA, MO, 65301, with a listed phone of (660) 827-1120. NPI 1265437990 was issued on 06/17/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what COX most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 524 prescription claims written by this provider, covering 169 Medicare beneficiaries and totaling roughly $74K in drug spend, split 36% brand-name and 64% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 97.8502/100 for the 2023 performance year (Quality 95.7812, Cost 98.459), compared with the national average of 83.1.
Ophthalmology Physician is a mid-sized specialty nationwide, with 22,090 enrolled providers across 56 states and an average of 1,420 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1265437990 |
|---|---|
| Specialty | Ophthalmology Physician |
| Credentials | M.D. |
| Gender | Male |
| NPI Issued | 06/17/2005 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm MARK COX, M.D.'s current license status, disciplinary history, and board certifications with the Missouri Board of Registration for the Healing Arts in Missouri before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Brand vs generic prescribing mix · Above average
36% brand-name claims vs 64% generic, on 524 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 751
- Total Day Supply
- 20,847
- Brand vs Generic
- 36% brand / 64% generic
- Brand Drug Cost
- $65K
- Generic Drug Cost
- $9K
Patient Demographics
- Average Patient Age
- 77.6 years
- Avg HCC Risk Score
- 1.28
- Gender Split
- 63% female / 37% male
- Age Distribution
- <65: 11, 65-74: 49, 75-84: 74, 85+: 35
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Latanoprost | 205 |
| Lumigan Bimatoprost | 63 |
| Brimonidine Tartrate | 46 |
| Timolol Maleate | 43 |
| Restasis Cyclosporine | 31 |
| Dorzolamide-Timolol Dorzolamide Hcl/Timolol Maleat | 25 |
| Acetazolamide | 24 |
| Dorzolamide Hcl | 17 |
| Prednisolone Acetate | 17 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Ophthalmology Physician Overview
How MARK COX, M.D. fits within the Ophthalmology Physician landscape nationally.
MARK COX, M.D.'s 524 claims are below the specialty average of 1,420.
Nearby Ophthalmology Physician Providers in Missouri
Other clinicians with the same primary specialty enrolled in Missouri, drawn from the same CMS NPPES roster as COX.
Compare Ophthalmology Physician nationally: see state-by-state distribution →
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Frequently Asked Questions
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology