Gurung, Sushma

Gurung, Sushma was paid $1.16M by Medicaid between Jan 2019 and Mar 2023, across 12 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 91% of everything it billed.

33Billing provider infoGURUNG, SUSHMA
SPRINGFIELD, MA 01103

33aNPI1043563653assigned 10/19/2012

33bProvider typeFamily Nurse Practitioner

28Total paid$1.16M

24GClaims8,846

24DCodes billed12

24AFirst – last monthJan 2019 – Mar 2023

Compared with peers

Next to other Family Nurse Practitioner providers in Massachusetts

Rank by total paid#3 of 327

Median peer was paid$5K

This provider vs. median217×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2019	2,232	$250K
2020	2,466	$337K
2021	2,146	$265K
2022	1,643	$261K
2023	359	$50K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	91%	6,064	5,725	$1.05M
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	3.3%	218	217	$39K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	3.2%	491	490	$37K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	<1%	1,082	1,080	$10K
90686		<1%	501	501	$10K
90750		<1%	87	87	$7K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	158	158	$3K
90715		<1%	70	70	$2K
87880	Infectious agent antigen detection by immunoassay; Streptococcus, group A	<1%	87	87	$1K
87804	Infectious agent antigen detection by immunoassay; Influenza, each type	<1%	17	17	$212.58
81002		<1%	27	27	$70.30
91300		0%	44	44	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.