Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Illinois for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Illinois only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Illinois (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Caremark, L.L.C. (NPI 1134100134)

Field	Value
Entity Type	Organization
Organization	Caremark, L.L.C.
Address	800 Biermann Ct
City	Mt Prospect
State	IL
ZIP	60056
Taxonomy	Specialty Pharmacy
NPI Enumerated	November 8, 2005

Payer Source	Total Paid
Medicaid	$34.1M
Medicare	$0

Key Findings

CAREMARK, L.L.C. has no Medicare billing on file and $34.1M in lifetime Medicaid revenue, so its publicly visible billing footprint in this dataset is effectively single-payer and concentrated in Medicaid. Analysts should treat Medicaid performance as the primary lens for assessing this entity’s scale and payer exposure.

Revenue is highly concentrated: the top three Medicaid codes 90378, J2357, and J1726 together account for 55.7% of the provider’s Medicaid revenue. Those three codes individually show 90378 with 3.1K claims, $2745 avg paid/claim and $8.4M revenue, J2357 with 2.8K claims, $2455 avg paid/claim and $6.8M revenue, and J1726 with 1.7K claims, $2251 avg paid/claim and $3.8M revenue.

The code mix indicates a specialty pharmacy/specialty-injectable operation focused on high-cost biologics and immune products: 90378 (immunoglobulin), J2357 (omalizumab), J1726 (hydroxyprogesterone caproate) and additional specialty agents like J3285 (treprostinil) and J3357 (ustekinumab) drive most revenue. Presence of infusion-related supply codes (A4222, A4221) and home infusion visit codes (99601, 99602) also suggests the provider delivers or supports outpatient/home infusion and injection services rather than primarily dispensing low-cost retail drugs.

CAREMARK appears competitively strong statewide on multiple high-revenue items: several top codes are ranked #1 in-state (for example, 90378 is #1 of 2 providers in-state with a 100th percentile label of "typical, unremarkable volume", J2357 is #1 of 3 providers in-state at the 100th percentile, and J1726 is #1 of 1 provider in-state but with no peer volume comparison available). The provider is also an extreme outlier on specific product lines: J7307 (etonogestrel implant) and J0585 (onabotulinumtoxinA) are both described as "extreme outlier, far above typical state volume for this code," indicating outsized state-level volume in those items.

Several high-cost biologics show a low-claim/high-dollar pattern: J3357 reports 154 claims with a $13760 avg paid/claim generating $2.1M in revenue, and other agents (J2357, J1726, J3285) have average paid per claim in the low-thousands. This mix underscores reliance on a small number of expensive specialty doses rather than high-volume, low-cost pharmacy items.

Operational indicators support a distributive and home-infusion service model: A4222 (infusion supplies) has 1.6K claims and $399.7K revenue, 99601 has 755 claims and $154.8K revenue, and K0455 (infusion pump) has 529 claims. Those counts, together with the high claim volumes for injectable biologics, are consistent with a specialty pharmacy that provides device/supply support and in-home administration or care coordination.

Although many top lines are state-dominant, several codes report "no state peer volume comparison available" (for example, J1726, J3285, J3357 and others that are listed as #1 of 1 providers), which means competitive interpretation should be cautious: while the provider is the sole reported in-state supplier for some agents, the dataset lacks broader peer volume context for those items. Analysts should flag these single-provider code entries for follow-up if benchmarking or network decisions require fuller market context.

CAREMARK’s NPI was enumerated on 2005-11-08 (~21 years ago), indicating a long-established billing history in the dataset; combined with multiple #1 in-state ranks and several extreme outlier code labels, this tenure aligns with a sustained, specialized market presence in Illinois Medicaid specialty drug delivery.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90378	Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…	3,060	$2,750	$8.4M
J2357	Injection, omalizumab, 5 mg	2,780	$2,460	$6.8M
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	1,670	$2,250	$3.8M
J3285	Injection, treprostinil, 1 mg	1,910	$1,850	$3.5M
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	2,620	$980	$2.6M
J3357	Ustekinumab, for subcutaneous injection, 1 mg	150	$13,760	$2.1M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	2,060	$800	$1.6M
J2182	Injection, mepolizumab, 1 mg	450	$2,880	$1.3M
J0585	Injection, onabotulinumtoxina, 1 unit	970	$1,170	$1.1M
J1559	Injection, immune globulin (hizentra), 100 mg	390	$2,460	$959K

Showing 1–10 of 30

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.

Claims Volume vs. Illinois Distribution

Caremark, L.L.C. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90378	Immunoglobulin is a very complex protein that is produced by certain cells in the body to protect it from various types of infections and produce passive immunity. RSV–IgIM (respiratory syncytial…	1	10	1,540	$2,730	$4.2M
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	1	10	1,670	$2,250	$3.8M
J3285	Injection, treprostinil, 1 mg	1	10	1,910	$1,850	$3.5M
J2357	Injection, omalizumab, 5 mg	1	10	1,530	$2,120	$3.1M
J3357	Ustekinumab, for subcutaneous injection, 1 mg	1	10	150	$13,760	$2.1M
J2182	Injection, mepolizumab, 1 mg	2	10	540	$2,470	$1.3M
J1559	Injection, immune globulin (hizentra), 100 mg	1	10	390	$2,460	$958.9K
J0517	Injection, benralizumab, 1 mg	1	10	100	$4,440	$457.6K
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	1	10	120	$830	$372.2K
99601	The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for up to the first two hours of a visit.	2	10	2,400	$120	$284.1K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Caremark, L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Procare Pharmacy Direct, LLC.	PA	Specialty Pharmacy	$8.3M	$227.3M
Caremark, L.L.C.	CA	Specialty Pharmacy	$13.4M	$19.9M
Caremark, L.L.C.	FL	Specialty Pharmacy	$1.1M	$7.3M
Caremark L.L.C.	KS	Pharmacy	$0	$2.5M
Caremark Puerto Rico Specialty	PR	Specialty Pharmacy	$0	$1.8M

Nearby Providers

Other providers in the same ZIP code as Caremark, L.L.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Village Of Mt Prospect	IL	Land Ambulance	$577.3K	$5.1M
Better Care Home Health Inc	IL	Home Health Agency	$0	$5.2M
Weil Foot And Ankle Institute LLC	IL	Clinical Medical Laboratory	$689.1K	$159.8K
Sasikala Paidi	IL	Hematology & Oncology Physician	$341.6K	$141.8K
Aleksandra Raykher	IL	Internal Medicine Physician	$408.4K	$56.1K
Evgueni Minev	IL	Nephrology Physician	$323.3K	$116.4K
Northshore Imaging Services Inc	IL	Mobile Mammography Clinic/Center	$375.9K	$14.1K
Carmen Garcia	IL	Podiatrist	$298.6K	$8.5K
Jeffrey Norris	IL	Urology Physician	$291.2K	$0
Manish Tanna	IL	Nephrology Physician	$253.7K	$27.1K

Caremark, L.L.C. — Billing Profile & Reimbursement Data

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Caremark, L.L.C. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References