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NPI 1245249614 · Boscobel, WI · Community/Retail Pharmacy
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Boscobel Pharmacy, Inc is a community/retail pharmacy provider located in Boscobel, Wisconsin. This profile covers 12 Medicare and 18 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 | Boscobel Pharmacy, Inc |
| Address | 1028 Wisconsin Ave |
| City | Boscobel |
| State | WI |
| ZIP | 53805 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | August 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $106.8K |
| Medicaid | $104.7K |
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. | 310 | $140 | $42.5K |
| 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… | 320 | $80 | $24.3K |
| 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. | 340 | $40 | $13.1K |
| G0008 | Administration of influenza virus vaccine | 340 | $30 | $9.9K |
| 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… | 20 | $280 | $5.7K |
| 91320 | This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL. | 40 | $130 | $4.9K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 220 | $10 | $2.6K |
| 0124A | N/A | 40 | $40 | $1.5K |
| 0134A | N/A | 20 | $40 | $940 |
| G0009 | Administration of pneumococcal vaccine | 20 | $30 | $670 |
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
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 91322 | 73 | 750 | 70 | $140 | $17.5K |
| 91320 | 343 | 580 | 50 | $130 | $14.3K |
| K1034 | 389 | 510 | 520 | $10 | $8K |
| 90677 | 402 | 1,080 | 20 | $280 | $6.5K |
| 90694 | 28 | 1,020 | 50 | $70 | $5.9K |
| 90480 | 122 | 1,210 | 70 | $30 | $4.5K |
| G0008 | 117 | 2,540 | 40 | $30 | $2.4K |
| M0201 | 9 | 10 | 40 | $30 | $1.8K |
| 0124A | 120 | 420 | 20 | $40 | $1.7K |
| 0134A | 177 | 310 | 30 | $40 | $1.5K |
Showing 1–10 of 12
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.
18 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99606 | The pharmacist provides a 15–minute, in–person, patient–specific medication evaluation for an established patient based on factors such as the patient’s history and medication list. | 1,530 | $40 | $67.1K |
| 0001A | N/A | 300 | $20 | $7.1K |
| 0002A | N/A | 170 | $40 | $6.1K |
| 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… | 220 | $30 | $6K |
| 99605 | The pharmacist provides a 15–minute, in–person, patient–specific medication evaluation for a new patient based on factors such as the patient’s history and medication list. | 80 | $70 | $5.7K |
| S9430 | Pharmacy compounding and dispensing services | 120 | $30 | $3.1K |
| 90679 | This code represents a prefusion F (preF) vaccine product administered into the muscle to protect against respiratory syncytial virus. It includes an adjuvant, an ingredient that helps create a… | 20 | $100 | $2.1K |
| 0004A | N/A | 50 | $40 | $1.9K |
| 90678 | This code represents a bivalent prefusion F vaccine product administered into the muscle to protect against respiratory syncytial virus. | 30 | $60 | $1.5K |
| 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. | 10 | $120 | $1.5K |
Showing 1–10 of 18
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
18 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A4670 | Automatic blood pressure monitor | 5 | 10 | 30 | $60 | $30.5K |
| 99605 | The pharmacist provides a 15–minute, in–person, patient–specific medication evaluation for a new patient based on factors such as the patient’s history and medication list. | 18 | 40 | 70 | $60 | $15.4K |
| 99606 | The pharmacist provides a 15–minute, in–person, patient–specific medication evaluation for an established patient based on factors such as the patient’s history and medication list. | 1 | 30 | 50 | $40 | $10K |
| 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. | 127 | 130 | 30 | $80 | $8K |
| 0002A | N/A | 169 | 430 | 120 | $30 | $7.2K |
| 0001A | N/A | 115 | 460 | 120 | $30 | $7K |
| S9430 | Pharmacy compounding and dispensing services | 15 | 30 | 130 | $30 | $6.7K |
| 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… | 227 | 910 | 80 | $10 | $6.4K |
| 0071A | N/A | 122 | 180 | 40 | $30 | $2.9K |
| 0072A | N/A | 111 | 160 | 40 | $30 | $2.7K |
Showing 1–10 of 18
Other providers in the same ZIP code as Boscobel Pharmacy, Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Memorial Hospital Of Boscobel | WI | Critical Access Hospital | $0 | $5.4M |
| Grant Williams | WI | Chiropractor | $20.5K | $213.9K |
| Poul-erik Transo | WI | Audiologist | $16.6K | $42.7K |
| Jonathan Demory | WI | Emergency Medicine Physician | $28.8K | $560 |
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