Loading...
NPI 1043317969 · Byers, CO · Community/Retail Pharmacy
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Benzer Co 1 LLC is a community/retail pharmacy provider located in Byers, Colorado. This profile covers 3 Medicare and 16 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 | Benzer Co 1 LLC |
| Address | 568 Us Hwy 36 |
| City | Byers |
| State | CO |
| ZIP | 80103 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | September 20, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $52.9M |
| Medicare | $3K |
Payer mix is heavily skewed toward Medicaid: lifetime Medicaid revenue is $52.9M compared with total Medicare revenue of $3K, so the provider is effectively a Medicaid-focused operation in scale and dollars. Medicare activity is negligible relative to Medicaid and does not meaningfully contribute to the provider’s overall revenue profile.
Medicaid revenue is highly concentrated in diabetes-related DME and supplies: the top three Medicaid codes A9274, K0553, and A4239 together account for 87.9% of the provider’s Medicaid revenue. Individually these codes generate $22.3M (A9274, 42.1%), $12.2M (K0553, 23.1%), and $12M (A4239, 22.7%), indicating the bulk of Medicaid dollars flow through ambulatory insulin delivery systems and continuous glucose monitor (CGM) supplies.
Competitive standing in-state is dominant for core diabetes supply lines: the provider ranks #1 in-state for A9274 and K0553 and also ranks #1 of 13 providers for A4239, where it is labeled an extreme outlier and far above typical state volume. Those #1 rankings and the extreme outlier status for A4239 indicate this entity is a primary supplier/distributor for Medicaid-funded CGM and insulin delivery products in Colorado.
Operational profile is consistent with a Community/Retail Pharmacy that has specialized into DME/supply distribution for diabetes management: large claim volumes such as 64.5K claims for A4239, 19.5K claims for K0553, and 12.8K claims for A9274 reinforce a fulfillment/distribution model focused on sensors, supplies, and external ambulatory insulin delivery systems rather than high-volume traditional pharmacy dispensing.
Medicare business is narrow and centered on influenza vaccination: the top three Medicare codes (90662, 90694, and G0008) account for 100.0% of the provider’s Medicare revenue and together produce only $3K in lifetime Medicare revenue. National rank/percentile positions for those codes (e.g., 90662 at the 10th percentile, 90694 at the 5th percentile, G0008 at the 35th percentile) indicate modest, routine vaccine administration volumes versus peers.
Although Medicaid revenue is concentrated, the provider also bills for adjacent diabetes-related supplies and equipment at smaller levels: A9276 ($1.9M, 3.7%) ranks #3 of 4 in-state (33th percentile; typical, unremarkable volume), A4230 ($1.4M, 2.6%) ranks #2 of 2 in-state (0th percentile; typical, unremarkable volume), and E0784 ($1M, 1.9%) ranks #2 of 2 in-state (0th percentile; typical, unremarkable volume). These line items show the business supports a broader supply ecosystem (sensors, infusion sets, infusion pumps) beyond its three revenue leaders.
Tenure on file is long-standing: the NPI was enumerated on 2006-09-20 (~20 years ago), which aligns with the scale and market penetration implied by multi-year, high-volume Medicaid billing for diabetes DME and supplies.
The concentrated Medicaid footprint presents both leverage and concentration risk: payer negotiations and operational resilience will be driven by a small set of high-value codes (A9274, K0553, A4239 account for 87.9% of Medicaid revenue), so changes in coverage, pricing, or supplier relationships for CGM and insulin delivery products could materially affect revenue while also giving the provider bargaining leverage as a dominant in-state supplier for those items.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 20 | $70 | $1.1K |
| 90694 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL… | 10 | $80 | $990 |
| G0008 | Administration of influenza virus vaccine | 30 | $30 | $960 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 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.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | 12,770 | $1,740 | $22.3M |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 19,460 | $630 | $12.2M |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 64,480 | $190 | $12M |
| A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | 1,940 | $1,000 | $1.9M |
| A4230 | Infusion set for external insulin pump, non needle cannula type | 2,520 | $550 | $1.4M |
| E0784 | External ambulatory infusion pump, insulin | 290 | $3,610 | $1M |
| K0554 | Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system | 3,750 | $210 | $772.1K |
| A9277 | Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | 1,860 | $240 | $452.6K |
| A4232 | Syringe with needle for external insulin pump, sterile, 3 cc | 2,520 | $160 | $393K |
| E2103 | Non‑adjunctive, non‑implanted continuous glucose monitor or receiver | 1,720 | $160 | $275.7K |
Showing 1–10 of 16
How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Colorado median
16 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A9274 | External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories | 1 | 10 | 6,470 | $1,730 | $11.2M |
| K0553 | Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 1 | 10 | 2,620 | $520 | $3.2M |
| A9276 | Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply | 3 | 10 | 3,920 | $450 | $1.6M |
| A4230 | Infusion set for external insulin pump, non needle cannula type | 2 | 10 | 7,360 | $180 | $1.3M |
| E0784 | External ambulatory infusion pump, insulin | 2 | 10 | 870 | $1,350 | $1.2M |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | 1 | 10 | 70 | $180 | $1M |
| A9277 | Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system | 1 | 10 | 1,380 | $430 | $641.4K |
| K0554 | Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system | 1 | 10 | 2,060 | $200 | $404.4K |
| A4232 | Syringe with needle for external insulin pump, sterile, 3 cc | 2 | 10 | 7,380 | $50 | $382.3K |
| A5120 | Skin barrier, wipes or swabs, each | 10 | 20 | 1,090 | $20 | $127.5K |
Showing 1–10 of 16
Other providers in the same ZIP code as Benzer Co 1 LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Dragonfly Supportive Services LLC | CO | Developmentally Disabled Services Day Training Agency | $0 | $4M |
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.