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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Peter Pogacar (NPI 1275502635)

Field	Value
Entity Type	Individual
Organization	Peter Pogacar
Address	1377 S County Trl
City	East Greenwich
State	RI
ZIP	02818
Taxonomy	Pediatrics Physician
NPI Enumerated	March 16, 2006

Payer Source	Total Paid
Medicaid	$321.8K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,940	$70	$141.6K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,440	$60	$84.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	230	$90	$20.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	230	$90	$20K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	850	$20	$18.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	210	$40	$7.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	230	$20	$5.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	40	$90	$4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	40	$90	$3.1K
0241U	N/A	40	$80	$2.9K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

Peter Pogacar — 1 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0241U	N/A	18	20	80	$150	$83.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	188	1,730	220	$70	$75.2K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	399	2,050	300	$50	$72.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	84	90	90	$60	$67.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	43	160	90	$110	$54.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	150	190	160	$90	$39.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	67	190	110	$90	$32K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	89	140	90	$90	$29.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	164	500	90	$50	$24.9K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	77	240	440	$30	$22.5K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Egp Inc	RI	Pediatrics Physician	$0	$708.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joanne Lewis	RI	Pediatric Dentistry	$0	$2.1M
Healthy Babies, Happy Moms Inc.	RI	Customized Equipment (DME)	$0	$1.5M
Daniel Collins	RI	Family Medicine Physician	$24.4K	$902.1K
Sargent Rehabilitation Center, Inc.	RI	Comprehensive Outpatient Rehabilitation Facility (CORF)	$0	$819.5K
Bayside Endoscopy Center LLC	RI	Ambulatory Surgical Clinic/Center	$650.4K	$0
Robert Gianfrocco	RI	Emergency Medicine Physician	$14.7K	$633.9K
Joseph Wyllie	RI	Cardiovascular Disease Physician	$110.6K	$537.2K
Nathaniel Jellinek	RI	MOHS-Micrographic Surgery Physician	$638.1K	$0
Natasha Bica	RI	Family Medicine Physician	$0	$606.3K
Julia Baltz	RI	Dermatology Physician	$529.7K	$0

Peter Pogacar — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References