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    v1.0.28
    OpenPayerNPI Medicare & MedicaidPaul Pongor
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    Paul Pongor — Billing Profile & Reimbursement Data

    NPI 1770585705 · Marlboro, MA · Specialist

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    Paul Pongor is a specialist provider located in Marlboro, Massachusetts. This profile covers 18 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationPaul Pongor
    Address65 Fremont St
    CityMarlboro
    StateMA
    ZIP01752
    TaxonomySpecialist
    NPI EnumeratedAugust 10, 2005

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$143.1K
    Medicaid$3.3K

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    18 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…610$100$62.9K
    99203The provider sees a new 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 provider…200$90$18.3K
    27130In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…10$1,110$14.4K
    27446In this procedure, the provider reconstructs the diseased or damaged medial or lateral compartment of the knee along with the femoral condyles and tibial plateaus to relieve pain and improve the…10$990$13.9K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…170$50$9.2K
    99213The 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…80$80$6.1K
    73502In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other…100$40$4.2K
    73564In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.80$40$3.1K
    99233The 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…20$100$1.9K
    73030This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.60$30$1.9K

    Showing 1–10 of 18

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    18 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    2713016819030$880$33.3K
    2744661010$850$16.2K
    9921476215,410110$80$15.6K
    992333,6904,17070$100$12.6K
    992136,35713,70070$60$8.8K
    2061020398060$50$5.8K
    992031314,29030$80$4.1K
    7356419953050$20$2K
    7356232267050$20$1.7K
    7350223079060$20$1.6K

    Showing 1–10 of 18

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    1 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…40$90$3.3K

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Massachusetts median

    1 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99214The 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…3,8525,040200$70$209.5K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Quest Diagnostics LLCMAClinical Medical Laboratory$27.2M$209.7M
    Quest Diagnostics Massachusetts LLCMAClinical Medical Laboratory$27.8M$199.9M
    Lifeline Systems CompanyMAPersonal Emergency Response Attendant$0$76.4M
    Baypath Elder Services, IncMACase Management Agency$0$49.6M
    Advocates, Inc.MAMental Health Clinic/Center (Including Community Mental Health Center)$0$48.9M
    Option Care Enterprises IncMAHome Infusion Therapy Pharmacy$0$37M
    Umass Memorial Medical Center, Inc.MAGeneral Acute Care Hospital$0$26.7M
    Brookhaven Hospice LLCMACommunity Based Hospice Care Agency$0$15.3M
    Adult Day Health, Inc.MAAdult Day Care Clinic/Center$0$12.9M
    Community Ems, Inc.MALand Ambulance$921.3K$4M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Massachusetts Distribution
    Paul Pongor — 2 of 18 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts
    Medicaid Revenue by Year vs. Massachusetts Providers
    0 of 2 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Massachusetts Distribution
    Paul Pongor — 0 of 1 code billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts