Physician

Dustin Alan Pagoria, M.D.

According to 2025 Medicare claims, Dustin Pagoria, M.D. (NPI: 1427291236) practices urology in the Milwaukee-Waukesha, WI market, with the plurality of this provider's patient population coming from Waukesha, WI. This provider's primary affiliated billing organization is UROLOGY ASSOCIATES LTD SC (NPI: 1316035637; TIN: 391092759) and primary practice location at 53188-3403. Pagoria is affiliated with the ProHealth Solutions, LLC (ACO ID: A4979), participating under the MSSP model.

Pagoria's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 352 traditional Medicare patients, billed 2,816 HCPCS/CPT codes, and received $129,814 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 1,128 prescription claims across 318 beneficiaries totaling $502,702 in drug costs, led by Xtandi (Enzalutamide). DME data shows 31 claims. Open Payments data shows 9 records totaling $383. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved up and down with repeated peaks and valleys, starting at $93,535 and ending at $129,814. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $114,981 to $502,702. In contrast, DME billing represents a smaller volume and fell sharply in recent years, from $279 to $99.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	293	1,743	$93,535
2016	469	2,450	$136,622
2017	407	2,443	$114,113
2018	391	2,096	$101,926
2019	284	983	$55,785
2020	219	569	$42,964
2021	246	716	$53,022
2022	193	1,318	$46,230
2023	235	4,355	$236,340
2024	352	2,816	$129,814

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	242	1,286	$114,981
2016	340	1,733	$132,214
2017	352	1,789	$139,509
2018	338	1,782	$139,345
2019	286	1,146	$87,648
2020	196	611	$58,255
2021	248	868	$74,752
2022	220	605	$48,200
2023	229	660	$54,002
2024	318	1,128	$502,702

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	21	$4,664
2016	N/R	75	$7,250
2017	N/R	173	$20,133
2018	N/R	186	$23,508
2019	N/R	234	$25,776
2020	N/R	126	$6,651
2021	N/R	13	$4,229
2022	N/R	12	$35
2023	N/R	31	$5,421
2024	N/R	31	$5,146

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	73	73	$115
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	103	129	$91
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	182	225	$61
51798	Ultrasound measurement of bladder capacity after voiding	137	166	$8
81003	Automated urinalysis test	222	319	$2

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xtandi	Enzalutamide	27	810	$383,262
Myrbetriq	Mirabegron	59	3,788	$56,675
Tamsulosin Hcl	Tamsulosin Hcl	353	22,962	$3,866
Finasteride	Finasteride	199	16,720	$2,113
Methenamine Hippurate	Methenamine Hippurate	24	1,080	$1,599

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	N	N/R	20	$5,048
A4332	Lubricant, individual sterile packet, each	N	N/R	11	$99

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	9	$383	UROGEN PHARMA, INC.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Dustin Alan Pagoria, M.D.?

Tedicare shows public-source Medicare data for Dustin Alan Pagoria, M.D. (NPI 1427291236), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Dustin Alan Pagoria, M.D. have ACO affiliation data?

Dustin Alan Pagoria, M.D. is shown with ACO affiliation data for ProHealth Solutions, LLC (MSSP, ACO ID A4979).

What billing organization is linked to Dustin Alan Pagoria, M.D.?

Dustin Alan Pagoria, M.D. is linked to UROLOGY ASSOCIATES LTD SC (billing NPI 1316035637) in the available physician profile data.

Does Dustin Alan Pagoria, M.D. have Open Payments data?

Dustin Alan Pagoria, M.D. has 9 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.