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    OpenPayerNPI Medicare & MedicaidPharmcare Usa Of Edison, Inc.
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    Pharmcare Usa Of Edison, Inc. — Billing Profile & Reimbursement Data

    NPI 1194906172 · Edison, NJ · Long Term Care Pharmacy

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    Pharmcare Usa Of Edison, Inc. is a long term care pharmacy provider located in Edison, New Jersey. This profile covers 9 Medicare and 11 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)

    FieldValue
    Entity TypeOrganization
    OrganizationPharmcare Usa Of Edison, Inc.
    Address450 Raritan Center Pkwy Ste C
    CityEdison
    StateNJ
    ZIP08837
    TaxonomyLong Term Care Pharmacy
    NPI EnumeratedNovember 19, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$299.7K
    Medicaid$820

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    9 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    90677This 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…400$280$114K
    90694This 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…930$80$70.8K
    91322This 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.320$140$46.2K
    G0008Administration of influenza virus vaccine940$30$31.9K
    90480The 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–19.320$50$14.5K
    G0009Administration of pneumococcal vaccine430$30$14.4K
    0124AN/A90$40$4.1K
    90732The provider intramuscularly or subcutaneously injects pneumococcal polysaccharide vaccine in an individual two years or older. This vaccine provides protection against meningitis and pneumonia that…20$130$2.8K
    0134AN/A30$40$1.2K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    9 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    913226378080$140$16.8K
    9067721,78020$280$8.5K
    9069431,46070$70$8.4K
    904801511,250120$40$6.4K
    G000864,29050$30$3K
    907324717020$130$2.6K
    0124A3055030$40$2.1K
    0134A25150030$40$1.8K
    G000922,03020$30$910

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

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

    11 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    91322This 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.10$20$290
    90694This 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…150$1$150
    0004AN/A50$1$140
    90480The 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–19.10$10$80
    0003AN/A40$1$70
    0054AN/A40$0$0
    0124AN/A50$0$0
    0134AN/A10$0$0
    90653This code represents an inactivated influenza vaccine product that contains subunits of the virus and an adjuvant to enhance the immune response. The vaccine is administered via separately reportable…30$0$0
    90682This code represents a quadrivalent flu vaccine given by injection into the muscle. The vaccine is made using recombinant DNA technology and contains only a protein from the virus. It does not…20$0$0

    Showing 1–10 of 11

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. New Jersey median

    11 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    90682This code represents a quadrivalent flu vaccine given by injection into the muscle. The vaccine is made using recombinant DNA technology and contains only a protein from the virus. It does not…12715040$30$5.5K
    0004AN/A4610040$30$3K
    0003AN/A247020$20$2.3K
    0134AN/A303050$20$1.3K
    0054AN/A205040$10$1.2K
    0124AN/A257030$10$1.1K
    90480The 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–19.789030$10$820
    G0008Administration of influenza virus vaccine13487050$1$550
    90694This 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…1513040$10$500
    90653This code represents an inactivated influenza vaccine product that contains subunits of the virus and an adjuvant to enhance the immune response. The vaccine is administered via separately reportable…338020$10$370

    Showing 1–10 of 11

    Nearby Providers

    Other providers in the same ZIP code as Pharmcare Usa Of Edison, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    New Jersey Institute For Disabilities IncNJDevelopmentally Disabled Services Day Training Agency$0$132.5M
    Grace Healthcare Services LLCNJCommunity Based Hospice Care Agency$0$42.5M
    Autism Community Services Inc.NJChild Intellectual and/or Developmental Disabilities Respite Care$0$20.3M
    Edison Township Board Of EducationNJLocal Education Agency (LEA)$0$8.7M
    Mohammad QureshiNJSpecialist$6.8M$818.3K
    May Street Surgi Center, LLCNJAmbulatory Surgical Clinic/Center$689.8K$6.2M
    Home Care Services, Inc.NJHome Infusion Therapy Pharmacy$91.8K$1.6M
    Edison Surgery Center LLCNJAmbulatory Surgical Clinic/Center$1.4M$0
    Amjad KhanNJAnatomic Pathology & Clinical Pathology Physician$796K$0
    James BentleyNJAnatomic Pathology & Clinical Pathology Physician$743.1K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. New Jersey Distribution
    Pharmcare Usa Of Edison, Inc. — 4 of 9 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Jersey
    Medicaid Revenue by Year vs. New Jersey Providers
    0 of 5 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. New Jersey Distribution
    Pharmcare Usa Of Edison, Inc. — 0 of 5 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Jersey