Physician

Edmund B Paloyan, M.D.

According to 2025 Medicare claims, Edmund Paloyan, M.D. (NPI: 1972509081) practices hematology/oncology in the Niles, MI market, with the plurality of this provider's patient population coming from Berrien, MI. This provider's primary affiliated billing organization is LAKELAND MEDICAL PRACTICES (NPI: 1538397120; TIN: 270381199) and primary practice location at 49085-9149. Paloyan is affiliated with the West Michigan Accountable Care Organization, LLC (ACO ID: A4626), participating under the MSSP model.

Paloyan's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 616 traditional Medicare patients, billed 1,766 HCPCS/CPT codes, and received $127,414 in Medicare payments. The top billing code was 99205 (New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more). Part D data shows 3,246 prescription claims across 515 beneficiaries totaling $7,230,757 in drug costs, led by Ibrance (Palbociclib). DME data shows 74 claims. No Open Payments records. 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 declined steadily, from $225,067 to $127,414. In contrast, Part D prescription costs have moved sharply higher in recent years, from $2,075,774 to $7,230,757. For DME billing, this smaller-volume category started with an early spike, then settled into a lower baseline, moving from $19,706 to $1,726.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	666	2,546	$225,067
2016	641	2,384	$201,545
2017	663	2,606	$225,789
2018	655	2,393	$202,365
2019	683	2,762	$230,949
2020	581	2,398	$199,191
2021	566	2,181	$216,388
2022	529	2,014	$149,203
2023	523	1,800	$130,229
2024	616	1,766	$127,414

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	310	2,607	$2,075,774
2016	307	2,447	$2,001,961
2017	372	2,804	$1,947,558
2018	386	2,653	$3,749,816
2019	393	2,642	$5,024,829
2020	360	2,166	$3,815,810
2021	320	1,438	$2,248,023
2022	363	1,834	$3,319,460
2023	425	2,774	$5,884,242
2024	515	3,246	$7,230,757

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	66	324	$37,956
2016	68	259	$40,170
2017	50	191	$21,548
2018	23	151	$18,032
2019	62	186	$22,504
2020	20	76	$5,905
2021	20	56	$5,078
2022	29	37	$6,634
2023	20	28	$2,950
2024	28	74	$8,414

* / # = 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
99205	New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	74	74	$133
99215	Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	27	$111
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$96
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	544	1,557	$69
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	57	68	$48

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Ibrance	Palbociclib	68	1,904	$1,014,697
Pomalyst	Pomalidomide	36	1,008	$881,658
Erleada	Apalutamide	47	1,720	$820,411
Venclexta	Venetoclax	52	1,552	$619,043
Promacta	Eltrombopag Olamine	25	750	$471,706

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
L8030	Breast prosthesis, silicone or equal, without integral adhesive	N	12	12	$5,023
L8000	Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type	N	16	20	$2,191
J8521	Capecitabine, oral, 500 mg	N	N/R	21	$804
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	N	N/R	21	$395

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Edmund B. Paloyan, M.D.?

Tedicare shows public-source Medicare data for Edmund B. Paloyan, M.D. (NPI 1972509081), 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 Edmund B. Paloyan, M.D. have ACO affiliation data?

Edmund B. Paloyan, M.D. is shown with ACO affiliation data for West Michigan Accountable Care Organization, LLC (MSSP, ACO ID A4626).

What billing organization is linked to Edmund B. Paloyan, M.D.?

Edmund B. Paloyan, M.D. is linked to LAKELAND MEDICAL PRACTICES (billing NPI 1538397120) in the available physician profile data.

Does Edmund B. Paloyan, M.D. have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests 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.