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

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

Shalini Gough (NPI 1902001753)

Field	Value
Entity Type	Individual
Organization	Shalini Gough
Address	119 Neurology Way
City	Milford
State	DE
ZIP	19963
Taxonomy	Family Medicine Physician
NPI Enumerated	June 20, 2007

Payer Source	Total Paid
Medicare	$31.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	150	$100	$15.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	70	$150	$10.3K
G0316	Prolonged hospital inpatient or observation care 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…	90	$30	$2.4K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	20	$60	$1.5K
99498	The provider or other healthcare professional performs advanced care planning beyond an initial 30 minutes. The provider discusses and shares planning for the future health care needs of the patient…	20	$60	$1.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10	$70	$940

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Shalini Gough — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	149	500	80	$90	$15.4K
99232	707	730	120	$60	$14.2K
99223	183	500	50	$130	$10.4K
99497	66	110	40	$50	$4.5K
G0316	3	10	30	$20	$1.2K
99498	3	10	20	$50	$1.1K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Newton-wellesley Hospital	MA	General Acute Care Hospital	$0	$36.3M
Moussa Mansour	MA	Clinical Cardiac Electrophysiology Physician	$406K	$0
Sunil Kapur	MA	Cardiovascular Disease Physician	$283.8K	$0
Leon Ptaszek	MA	Clinical Cardiac Electrophysiology Physician	$275.4K	$0
Stefanos Parpos	MA	Cardiovascular Disease Physician	$231.3K	$830
Giulia Sheftel	MA	Specialist	$203K	$200
Walter Mutter	MA	Nephrology Physician	$189.8K	$0
Z Liu	RI	Diagnostic Radiology Physician	$140.3K	$31.5K
Sophie Wells	MA	Cardiovascular Disease Physician	$167.7K	$670
Imad Bahhady	MA	Pulmonary Disease Physician	$165.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$39.5M
Banyan Delaware LLC	DE	Substance Abuse Rehabilitation Facility	$0	$30.9M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$28.5M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$19.3M
Delaware Pediatric Dentistry	DE	Pediatric Dentistry	$0	$18.1M
Kent-sussex Industries	DE	Developmentally Disabled Services Day Training Agency	$0	$11.7M
Nurses 'n Kids Of Milford, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$9.5M
Prn Staffers Inc	DE	Home Health Agency	$0	$7.6M
People's Place Ii, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.9M
Bayhealth Medical Center, Inc.	DE	Clinic/Center	$0	$3.7M

Shalini Gough — Billing Profile & Reimbursement Data

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Shalini Gough — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References