Medicare billing address
CMS Medicare provider billing file
270 Susquehanna Valley Mall Dr Ste 800Selinsgrove, PA 17870
CMS public data · NPI 1194163964
Dr. James D Pagana: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
James D Pagana, MD
Specialty
Credential
MD
NPI
1194163964
Primary source state
PA
Data retrieval date
July 28, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubFamily PracticeState-specialty hubSelinsgrove, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for James D Pagana, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Selinsgrove, PA 17870
FAMILY PRACTICE CENTER PC
CMS Doctors & Clinicians file
1 Dock Hill RdMiddleburg, PA 17842
FAMILY PRACTICE CENTER PC
CMS Doctors & Clinicians file
21 Susquehanna Valley Mall DrSuite A
Selinsgrove, PA 17870
FAMILY PRACTICE CENTER PC
CMS Doctors & Clinicians file
270 Susquehanna Valley Mall DrSelinsgrove, PA 17870
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 361 Medicare beneficiaries and 3,368 total services. The average beneficiary age was 77, and the average HCC risk score was 1.5.
Total Medicare allowed amount
$253,074.44
Total Medicare payment amount
$191,915.13
Medicare beneficiaries
361
Total services
3,368
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Chronic kidney disease
52%
CMS beneficiary-panel share
Diabetes
35%
CMS beneficiary-panel share
Mood disorders
35%
CMS beneficiary-panel share
Depression
32%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 745 | $70.32 |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 528 | $101.56 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 301 | $120.16 |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 301 | $59.41 |
| Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 181 | $45.32 |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 112 | $121.42 |
| Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 103 | $72.60 |
| Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 98 | $15.52 |
| Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 64 | $170.72 |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | 57 | $38.10 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1194163964. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did James D Pagana, MD prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Atorvastatin Calcium | Atorvastatin Calcium | 699 | 1,402.9 | $14,125.75 |
| 2 | Levothyroxine Sodium | Levothyroxine Sodium | 459 | 754.1 | $5,108.78 |
| 3 | Omeprazole | Omeprazole | 306 | 492.3 | $7,756.68 |
| 4 | Gabapentin | Gabapentin | 305 | 357.7 | $4,948.01 |
| 5 | Eliquis | Apixaban | 298 | 364 | $144,979.00 |
| 6 | Losartan Potassium | Losartan Potassium | 274 | 564 | $4,179.50 |
| 7 | Amlodipine Besylate | Amlodipine Besylate | 271 | 507 | $3,148.79 |
| 8 | Metoprolol Tartrate | Metoprolol Tartrate | 258 | 360 | $2,058.90 |
| 9 | Lisinopril | Lisinopril | 250 | 579.6 | $2,209.82 |
| 10 | Metoprolol Succinate | Metoprolol Succinate | 247 | 448 | $3,251.37 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Medical school
Pennsylvania State University College Of Medicine
Graduation year
2013
Group/practice field
Family Practice Center Pc
Telehealth reported
Yes
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 28, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 24 records for this NPI · retrieved July 28, 2026
- Doctors and Clinicians National Downloadable File · 5 records for this NPI · retrieved July 28, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 28, 2026
- Medicare Part D Prescribers - by Provider and Drug · 169 records for this NPI · retrieved July 28, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.