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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Paul Musco (NPI 1063579886)

Field	Value
Entity Type	Individual
Organization	Paul Musco
Address	103 Boulder Point Drive
City	Plymouth
State	NH
ZIP	03264
Taxonomy	Ophthalmology Physician
NPI Enumerated	January 2, 2007

Payer Source	Total Paid
Medicare	$337K
Medicaid	$0

Key Findings

This provider has a modest Medicare revenue footprint of $337K and no Medicaid billing on file, so the practice is effectively single-payer (Medicare) in the available claims data; the top three Medicare codes account for 61.2% of that Medicare revenue, signaling concentrated revenue drivers. The NPI was enumerated 2007-01-02 (~19 years ago), indicating a long-tenured clinician with an established Medicare billing history.

The code mix indicates an ophthalmology practice structured around high-volume office exams and retinal care: 92014 (943 claims, $78 avg paid/claim, $73.6K revenue; 21.7% of Medicare revenue), 92012 (684 claims, $61 avg paid/claim, $41.7K revenue; 12.3%), and high-volume retinal imaging 92250 (1.1K claims, $25 avg paid/claim, $27.4K revenue; 8.1%) together reflect routine comprehensive and follow-up eye care combined with significant diagnostic imaging capacity. Injectables also contribute materially to revenue via J0178 (99 claims, $695 avg paid/claim, $68.8K revenue; 20.3%) and J2777 (2.2K claims, $29 avg paid/claim, $64.7K revenue; 19.1%), signaling provision of intravitreal therapies alongside exam and imaging services.

Revenue concentration is high: the precomputed top-3 share (61.2%) shows reliance on a small set of services—primarily comprehensive exams and retina therapeutics—for the bulk of Medicare receipts, which has implications for sensitivity to reimbursement or utilization shifts for those specific codes. Given total Medicare revenue of $337K, payers should expect that changes to coverage or utilization patterns for these codes would meaningfully affect the provider’s revenue base.

Competitive standing is mixed across service lines: 92014 ranks #1882 of 35415 (95th percentile) and 92012 ranks #1049 of 17177 (94th percentile), both described as notably above typical national volume, and 92250 ranks #194 of 25087 (99th percentile) as an extreme outlier—together these positions indicate a locally dominant volume for office exams and fundus photography. By contrast, retina drug administration ranks are low nationally (J0178 at #2999 of 3204, 6th percentile; J2777 at #1943 of 2039, 5th percentile), suggesting the provider’s use of high-cost injectables is not unusually large relative to national peers despite meaningful dollar contribution.

Several specific codes are identified as statistical outliers or notably above typical volume: 92250 is labeled an "extreme outlier" (99th percentile), while 92014 and 92012 are "notably above typical national volume" (95th and 94th percentiles respectively). Other common ophthalmology codes (for example 92134, 92083, 66821) are described as typical or unremarkable volume, reinforcing that elevated activity is concentrated in exams and fundus photography rather than across every ancillary service.

Operational detail from claim counts supports a busy clinic throughput for routine care: 92014 (943 claims) and 92012 (684 claims) point to sustained encounter volume for established patients, while 92250 (1.1K claims) confirms heavy use of fundus photography; these volumes align with the provider’s high national percentiles for those imaging and exam codes. For payers assessing network capacity, these counts suggest reliable availability of in-office diagnostic imaging services.

The injectable portfolio contributes sizeable revenue dollars despite lower national rank: J0178 generates $68.8K (20.3% of Medicare revenue) from 99 claims and J2777 generates $64.7K (19.1%) from 2.2K claims, indicating that while the practice is not a high-ranking national injector by percentile, these therapies are important to the practice’s revenue mix and should be considered in medical management and contracting discussions. Payers should note the juxtaposition of strong imaging/exam volume with a meaningful, if not nationally dominant, injectable drug revenue stream.

From a payer strategy perspective, this provider represents an established Medicare-focused ophthalmology practice with concentrated revenue drivers and specialized imaging capacity; absence of Medicaid billing suggests limited participation in Medicaid networks or none on file, so Medicaid plans should verify network access locally while Medicare Advantage plans should consider aligning reimbursement and utilization management with the provider’s high-volume exam and imaging services.

Medicare: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	940	$80	$73.6K
J0178	Injection, aflibercept, 1 mg	100	$700	$68.8K
J2777	Injection, faricimab‑svoa, 0.1 mg	2,230	$30	$64.7K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	680	$60	$41.7K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	1,100	$30	$27.4K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	170	$90	$14.6K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	130	$90	$10.8K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	320	$30	$9.1K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	170	$40	$7K
66821	The provider removes the haziness from the capsule of the eye using a laser for a patient with a secondary membranous cataract.	30	$230	$6.8K

Showing 1–10 of 20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 20 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Paul Musco — 7 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

20 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2777	9	10	13,440	$30	$563.5K
J0178	11	10	590	$680	$549.1K
67028	13	20	600	$90	$67K
92014	10	210	170	$80	$21.2K
66821	34	40	60	$250	$19.4K
92012	3	70	60	$60	$8.2K
92136	36	50	200	$30	$6K
92134	17	170	60	$30	$5.2K
92004	9	180	40	$90	$5K
92083	30	170	60	$40	$4.3K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Speare Memorial Hospital	NH	Critical Access Hospital	$0	$9.2M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$6.4M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$1.1M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$817.5K
Jason Desmarais	NH	Orthopaedic Surgery Physician	$267.4K	$0
Lance Klingler	NH	Orthopaedic Hand Surgery Physician	$211.1K	$0
Jamie Kim	NH	Clinical Cardiac Electrophysiology Physician	$210.6K	$0
Omar Hyder	RI	Interventional Cardiology Physician	$130.2K	$73.8K
Sean Burns	NH	Orthopaedic Surgery Physician	$199.7K	$0
Vercin Ephrem	NH	Internal Medicine Physician	$192.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mount Prospect Academy, Inc.	NH	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$76.6M
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$5.5M
Speare Health Ventures, Inc.	NH	Urgent Care Clinic/Center	$0	$388.4K
Pemi Baker Regional School District	NH	Local Education Agency (LEA)	$0	$318K
Plymouth School District	NH	Local Education Agency (LEA)	$0	$312.5K
Pemi-baker Hospice & Home Health	NH	Home Health Agency	$0	$298.5K
Growing Roots LLC	NH	Clinical Psychologist	$0	$244.3K
Cvs Manchester Nh, LLC	NH	Pharmacy	$185.7K	$0
John Eppolito	NH	Emergency Medicine Physician	$70.1K	$93K
Town Of Plymouth	NH	Land Ambulance	$95.4K	$20K

Paul Musco — Billing Profile & Reimbursement Data

Sign up for Paul Musco — Billing Profile & Reimbursement Data policy alerts

Paul Musco — Billing Profile & Reimbursement Data

Sign up for Paul Musco — Billing Profile & Reimbursement Data policy alerts

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