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

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

Michael Nagar (NPI 1588996847)

Field	Value
Entity Type	Individual
Organization	Michael Nagar
Address	211 S Gulph Rd Ste 200
City	King Of Prussia
State	PA
ZIP	19406
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	February 10, 2010

Payer Source	Total Paid
Medicare	$3.8M
Medicaid	$0

Key Findings

This provider’s Medicare billing profile is heavily concentrated in cytology, molecular in-situ hybridization testing, and prostate surgical pathology. The top revenue codes — 88120 (in-situ hybridization), 88112 (liquid-based cytology), and G0416 (prostate needle biopsy surgical pathology) — together account for 90.2% of the provider’s Medicare revenue, indicating a focused service line consistent with anatomic and clinical pathology work.

Revenue concentration is extreme: 88120 accounts for $2.3M (61.0% of Medicare revenue), 88112 accounts for $677.9K (17.9%), and G0416 accounts for $427.4K (11.3%) of the provider’s total Medicare receipts. These three codes alone make up the bulk of the reported $3.8M in Medicare revenue, with the remainder coming from much smaller, dispersed codes.

This provider is effectively single-payer in scale: total Medicare revenue is $3.8M while there is no Medicaid billing on file, which means the practice’s public-payer exposure is concentrated entirely in Medicare and there is no Medicaid revenue stream reported. Operational and financial planning should therefore treat Medicare trends and policy as the primary external driver of volume and revenue.

The provider’s competitive standing on key pathology services is nationally outsized. 88120 ranks #2 of 232 providers (100th percentile; extreme outlier), 88112 ranks #4 of 4868 providers (100th percentile; extreme outlier), and G0416 ranks #4 of 2465 providers (100th percentile; extreme outlier), which signals dominant national volume for these specific tests compared with peers. 88344 also shows elevated national standing at $340K (9.0% of Medicare revenue) and ranks #2 of 1880 providers (100th percentile; extreme outlier), reinforcing prominence in immunostaining services.

While a few codes are extreme outliers, many other pathology codes are reported at unremarkable volumes. For example, 88121 ($16.1K, 0.4% of Medicare revenue) ranks #59 of 104 (43th percentile; typical), 88305 ($9.4K, 0.2%) ranks #11718 of 14580 (20th percentile; typical), and 88342 ($6.3K, 0.2%) ranks #7704 of 11370 (32th percentile; typical). This contrast suggests a highly specialized throughput focused on a narrow set of high-volume tests rather than broad, evenly distributed pathology services.

The claim-level economics vary by test: 88120 shows a high average payment per claim at $580, G0416 averages $336 per claim, and 88112 averages $61 per claim. These differences indicate that a relatively small number of higher-paid molecular and surgical pathology claims drive outsized portions of revenue compared with large-volume, lower-paid cytology claims.

The provider has an established billing history, with NPI enumerated on 2010-02-10 (~16 years ago), which supports interpretation of these patterns as sustained practice behavior rather than a transient reporting artifact. Given the long tenure, the persistent dominance on a small set of high-revenue codes is likely an intentional specialization rather than a new or anomalous activity.

From a business-risk and strategic perspective, the practice’s dependence on a narrow set of codes (top 3 = 90.2% of Medicare revenue) concentrates operational and reimbursement risk: changes to coverage, reimbursement, or clinical guidelines affecting 88120, 88112, or G0416 could materially affect total Medicare revenue. Diversification of service mix or payor sources would be the primary levers to mitigate that concentration, noting that no Medicaid billing is currently on file to provide offsetting volume.

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
88120	The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for manual morphometric analysis, looking at the number and…	3,990	$580	$2.3M
88112	Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in…	11,110	$60	$677.9K
G0416	Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method	1,270	$340	$427.4K
88344	The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	2,100	$160	$340K
88121	The lab analyst performs a technical lab test on a urinary tract specimen using in situ hybridization and three to five molecular probes for computer assisted morphometric analysis, looking at the…	40	$400	$16.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	140	$70	$9.4K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	70	$90	$6.3K

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. Pennsylvania Distribution

Michael Nagar — 4 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88121	7	10	30	$350	$210K
88305	742	620	530	$40	$50.4K
88120	1	10	20	$160	$39.7K
G0416	1	100	20	$200	$9K
88342	514	570	100	$40	$7.3K
88112	2	260	80	$30	$4.6K
88344	1	130	40	$50	$3.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Theranostix Inc	MD	Clinical Medical Laboratory	$5.1M	$5.3M
Rami Sartawi	NY	Vascular & Interventional Radiology Physician	$3.7M	$4.9M
Arizona Gastrointestinal Associates, Plc	AZ	Gastroenterology Physician	$0	$8.3M
P4 Clinical LLC	NJ	Clinical Medical Laboratory	$4.6M	$964K
Ann Anderson	NY	Clinical Pathology/Laboratory Medicine Physician	$5.2M	$0
Zhiming Yang	PA	Anatomic Pathology Physician	$4.5M	$0
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Ari Isaacson	NC	Vascular & Interventional Radiology Physician	$2.8M	$0
Eduard Kagan	NY	Radiation Oncology Physician	$2.1M	$0
Vishesh Agrawal	NY	Radiation Oncology Physician	$2.1M	$13K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Promptcare Companies, Inc.	PA	Oxygen Equipment & Supplies (DME)	$0	$78.5M
Behavior Interventions, Inc	PA	Behavior Analyst	$0	$73.7M
Children's Hospital Of Philadelphia	PA	Durable Medical Equipment & Medical Supplies	$0	$27.6M
Cnnh Therapy LLC	PA	Behavior Analyst	$0	$26.2M
Children's Hospital Of Philadelphia	PA	Home Infusion Agency	$0	$23.1M
Helping Hands Family Pennsylvania LLC	PA	Community/Behavioral Health Agency	$0	$15.8M
Trustees Of The University Of Pennsylvania	PA	Home Infusion Agency	$159.1K	$7.2M
Ambulnz PA, LLC	PA	Ambulance	$3.3M	$3.8M
Quality Life Healthcare LLC	PA	Nursing Care Agency	$0	$6.3M
Wal-mart Stores, Inc.	PA	Optician	$0	$5.7M

Michael Nagar — Billing Profile & Reimbursement Data

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Michael Nagar — Billing Profile & Reimbursement Data

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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