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NPI 1134236318 · Newport, VT · Community/Retail Pharmacy
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Kph Healthcare Services, Inc. is a community/retail pharmacy provider located in Newport, Vermont. This profile covers 12 Medicare and 3 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 | 55 Shattuck Hill Rd |
| City | Newport |
| State | VT |
| ZIP | 05855 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | August 24, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $216K |
| Medicaid | $3.1K |
KPH HEALTHCARE SERVICES, INC. presents a community/retail pharmacy billing mix that is heavily immunization- and point-of-care testing–oriented on the Medicare side: the largest Medicare revenues are driven by vaccine and vaccine-administration codes such as 91322, 90662, and 90480, plus testing-related code K1034, indicating routine delivery of COVID and influenza immunizations and self-test distribution alongside typical retail pharmacy services. The presence of multiple influenza and pneumococcal vaccine codes (90662, 90694, 90677, 90686, 90674, G0008, G0009) reinforces that immunizations are a primary service line rather than secondary incidental billing.
Revenue concentration is high for both payers: the precomputed summary shows the top 3 Medicare codes by revenue account for 83.3% of this provider's total Medicare revenue, and the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue. On Medicare the single largest code 91322 itself represents $114.1K (52.7% of Medicare revenue), demonstrating pronounced dependence on a small set of vaccine-related codes for overall Medicare billing.
Payer mix is effectively Medicare-dominant: lifetime Medicare revenue is $216K versus Medicaid revenue of $3.1K, so Medicaid represents a very small share of reported lifetime revenue. This profile indicates the provider operates primarily in the Medicare market and has limited Medicaid billing volume on file.
Despite the concentrated Medicare revenue in vaccination codes, the provider ranks highly on those items nationally: 91322 ranks #107 of 29357 providers, 90662 ranks #235 of 70752, and 90480 ranks #256 of 46950 — each entry is reported in the source as "typical, unremarkable volume," suggesting the clinic achieves strong absolute throughput for common pharmacy-administered vaccines while remaining within expected operational norms for community pharmacies. These high national ranks imply the provider is a notable vaccine administrator relative to peers but not outside the expected activity pattern for a retail immunizer.
Medicaid activity is a distinct outlier in one code: A4253 (blood glucose test strips) accounts for $3.1K and 100.0% of the provider's Medicaid revenue and is labeled an "extreme outlier, far above typical state volume for this code," ranking #1 of 27 in-state. That concentrated Medicaid footprint indicates the provider functions as a statewide focal point for DME/supply dispensing of glucose test strips to Medicaid beneficiaries, even though total Medicaid dollars are small relative to Medicare.
Operational throughput is evident from claim counts on key Medicare items: there are 798 claims each for 91322 and 90480 and 490 claims for 90662, with K1034 at 530 claims, showing recurring, high-volume administration and distribution activity for COVID vaccines and self-test kits. These claim volumes align with a retail pharmacy model that runs regular vaccination clinics and distributes consumer testing supplies, supporting the revenue pattern observed.
The provider’s competitive position is mixed by payer: nationally it appears as a prominent vaccine administrator on Medicare (top percentile ranks on primary vaccine codes) while within Vermont Medicaid it is singularly prominent for A4253. However, Medicaid revenue remains negligible compared with Medicare, so the provider’s market influence is concentrated in Medicare immunization services and Medicaid DME/supplies for glucose testing.
KPH HEALTHCARE SERVICES’ NPI tenure is long-standing: enumerated on 2006-08-24 (~20 years ago). This multi-year presence supports interpretation of the billing pattern as established operational focus (immunizations and diabetes supplies) rather than a transient or newly developed service line.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 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. | 800 | $140 | $114.1K |
| 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… | 490 | $70 | $34.3K |
| 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. | 800 | $40 | $31.9K |
| G0008 | Administration of influenza virus vaccine | 650 | $20 | $11K |
| 90677 | This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the… | 30 | $280 | $7.8K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 530 | $10 | $6.4K |
| 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… | 90 | $70 | $6K |
| 0134A | N/A | 60 | $40 | $2.4K |
| 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… | 50 | $20 | $990 |
| 90674 | This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL… | 30 | $30 | $860 |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
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
Other providers in the same ZIP code as Kph Healthcare Services, Inc., ranked by combined Medicare and Medicaid revenue.
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