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NPI 1013203074 · Barton, VT · Community/Retail Pharmacy
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Kph Healthcare Services, Inc. is a community/retail pharmacy provider located in Barton, Vermont. This profile covers 5 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)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Kph Healthcare Services, Inc. |
| Address | 16 Church St |
| City | Barton |
| State | VT |
| ZIP | 05822 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | June 28, 2011 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $163.6K |
| Medicaid | $0 |
KPH HEALTHCARE SERVICES, INC. functions as a community/retail pharmacy with a clear focus on vaccine administration: its top Medicare codes are vaccine products and vaccine administration (91322, 90662, 90480, and G0008), indicating the operation is primarily delivering immunizations rather than broad clinical services. The mix of COVID-19 vaccine product codes (91322, 90480) and influenza vaccine codes (90662, 90686, G0008) points to a workflow centered on point-of-care vaccine dispensing and on-site administration.
Revenue concentration is extreme within Medicare: the provider reports $163.6K in total Medicare revenue and the precomputed top-3 Medicare codes account for 94.0% of that Medicare revenue. Those top three contributors are 91322 (601 claims, $143 avg paid/claim, $85.9K revenue; 52.4% of Medicare revenue), 90662 (613 claims, $72 avg paid/claim, $44.1K revenue; 26.9% of Medicare revenue), and 90480 (601 claims, $40 avg paid/claim, $24K revenue; 14.7% of Medicare revenue), underscoring a very narrow service-line concentration.
Payer mix is effectively single-payer: the record shows $163.6K in lifetime Medicare revenue versus $0 in lifetime Medicaid revenue, indicating no billed Medicaid activity on file and a business model that, at least in the claims data, relies exclusively on Medicare vaccination reimbursement. This lack of Medicaid billing materially limits exposure to that payer segment and concentrates payment risk on Medicare policies and seasonal demand.
On competitive standing for the top vaccine codes, the provider ranks highly by volume but the dataset characterizes those counts as routine: 91322 ranks #245 of 29357 (99th percentile; typical, unremarkable volume for this code), 90662 ranks #116 of 70752 (100th percentile; typical, unremarkable volume for this code), and 90480 ranks #661 of 46950 (99th percentile; typical, unremarkable volume for this code). In plain terms, KPH is among the higher-volume national billers for these specific vaccine codes but the supplied labels indicate these volumes are consistent with many other pharmacies that bill these immunization codes.
Claim-level and pricing detail reinforce a vaccine-centric revenue model and product-price differentiation: 91322 shows 601 claims at $143 avg paid/claim generating $85.9K, while 90662 shows 613 claims at $72 avg paid/claim generating $44.1K, and 90480 shows 601 claims at $40 avg paid/claim generating $24K. Lower-revenue administration/other vaccine codes (G0008: 633 claims, $15 avg paid/claim, $9.5K revenue; 90686: 18 claims, $22 avg paid/claim, $396 revenue) further show that product reimbursement (not just administration) drives the bulk of dollars.
The provider has an established NPI tenure (enumerated 2011-06-28 (~15 years ago)), which combined with repeated claim counts for core vaccine codes suggests sustained, ongoing immunization activity rather than a short-term campaign. This longevity supports interpreting the billing pattern as an operational focus rather than a transient spike.
From a business risk and competitive implication perspective, the combination of a modest total Medicare revenue base ($163.6K) and extreme concentration in three vaccine codes (94.0% of Medicare revenue) means KPH is sensitive to changes in Medicare vaccine reimbursement, supply availability, and seasonal flu/COVID demand. Although the provider appears among higher-volume national billers for certain vaccine codes by rank, the absolute revenue scale is limited and the absence of Medicaid billing further narrows diversification opportunities.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 91322 | This code represents a SARS–CoV–2 vaccine product administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 50 mcg/0.5 mL. | 600 | $140 | $85.9K |
| 90662 | This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection… | 610 | $70 | $44.1K |
| 90480 | The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19. | 600 | $40 | $24K |
| G0008 | Administration of influenza virus vaccine | 630 | $20 | $9.5K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 20 | $20 | $400 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 80 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 13 | 30 | 50 | $1 | $220 |
Other providers in the same ZIP code as Kph Healthcare Services, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| North Country Hospital & Health Center Inc | VT | Rural Health Clinic/Center | $0 | $1M |
| Maria Fatigati | VT | Geriatric Medicine (Internal Medicine) Physician | $30.9K | $0 |
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