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

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

Susan Mugford (NPI 1659732022)

Field	Value
Entity Type	Individual
Organization	Susan Mugford
Address	630 Plantation St
City	Worcester
State	MA
ZIP	01605
Taxonomy	Gerontology Nurse Practitioner
NPI Enumerated	March 14, 2016

Payer Source	Total Paid
Medicare	$49K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	240	$130	$31.6K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	40	$140	$5.6K
G0318	Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary…	230	$20	$5.1K
99349	The 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…	30	$80	$2.7K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	20	$110	$2.5K
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…	20	$50	$970
G0317	Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary…	30	$20	$570

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Susan Mugford — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99310	424	510	80	$110	$15.4K
99350	23	190	60	$120	$14.1K
99349	211	290	60	$80	$12K
99345	23	80	30	$140	$5.2K
99348	200	230	50	$50	$4.9K
G0318	5	30	40	$20	$2.1K
G0317	26	40	50	$20	$1.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Old Colony Hospice Inc	MA	Family Nurse Practitioner	$0	$11.5M
Charles Wolff	MA	Family Medicine Physician	$232.9K	$10.5K
Cassandra Fox	KY	Family Nurse Practitioner	$164.1K	$0
Ericka Harmon	GA	Family Nurse Practitioner	$159.8K	$0
Alexis Beauchesne	MA	Family Nurse Practitioner	$8.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health Systems, Inc	MA	Addiction (Substance Use Disorder) Counselor	$6M	$187.4M
Edward M. Kennedy Community Health Center, Inc	MA	Federally Qualified Health Center (FQHC)	$0	$55.2M
Prestige Adult Foster Care LLC.	MA	In Home Supportive Care Agency	$0	$54.1M
Autism Therapuetic Services LLC	MA	Early Intervention Provider Agency	$0	$23M
Catholic Charities Of The Diocese Of Worcester	MA	Developmentally Disabled Services Day Training Agency	$0	$17.2M
City Home Care, LLC	MA	Home Health Agency	$0	$15.9M
Autism Intervention Specialists	MA	Behavior Analyst	$0	$13.4M
Pinnacle Home Healthcare Services, Inc	MA	Home Health Agency	$0	$13.3M
Adcare Hospital Of Worcester, Inc.	MA	General Acute Care Hospital	$0	$13.2M
The Bridge Of Central Massachusetts, Inc.	MA	Community/Behavioral Health Agency	$0	$5.5M

Susan Mugford — Billing Profile & Reimbursement Data

Sign up for Susan Mugford — Billing Profile & Reimbursement Data policy alerts

Susan Mugford — Billing Profile & Reimbursement Data

Sign up for Susan Mugford — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References