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 Puerto Rico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Walgreen Co (NPI 1245520634)

Field	Value
Entity Type	Organization
Organization	Walgreen Co
Address	Los Prados Shopping Center
City	Caguas
State	PR
ZIP	00727
Taxonomy	Pharmacy
NPI Enumerated	April 19, 2011

Payer Source	Total Paid
Medicare	$131.8K
Medicaid	$0

Key Findings

WALGREEN CO in CAGUAS, PR is listed with a Pharmacy taxonomy and was enumerated (registered) on 2011-04-19 (~15 years ago). Its reported lifetime Medicare revenue is $131.8K and there is no Medicaid billing on file, indicating the dataset captures only Medicare activity for this NPI.

Revenue for Medicare is extremely concentrated: the precomputed top-3 Medicare codes account for 100.0% of this provider's total Medicare revenue, with K1034 alone reported as 98.7% of Medicare revenue. The remaining Medicare revenue is split across 90694 (0.8%) and G0008 (0.6%), demonstrating a narrow service mix driving nearly all billings.

The coded services point to a retail pharmacy operational footprint focused on point-of-care testing and occasional immunizations: K1034 is for provision of nonprescription, self-administered COVID-19 tests, while 90694 and G0008 relate to influenza vaccine products and vaccine administration. This mix suggests primary business activity is distribution/provision of FDA-authorized COVID-19 self-tests with limited ancillary vaccine administration.

Claims and payment details reinforce the concentration in test provision: the provider reported 11.1K claims for K1034 with a $12 avg paid/claim and $132.9K revenue, versus 15 claims for 90694 at $71 avg paid/claim generating $1.1K revenue, and 24 claims for G0008 at $31 avg paid/claim generating $744 revenue. These figures show high claim volume at a low per-claim payment for K1034 and very limited claim activity for flu vaccine codes.

Competitive standing for the principal code is mixed: K1034 ranks #302 of 30143 providers nationally (99th percentile) but is described in the source as "typical, unremarkable volume for this code," which suggests the provider is near the top of the national distribution by rank while the supplied characterization treats the activity as consistent with peer retail pharmacy behavior. The influenza-related codes rank lower—90694 at #45896 of 51679 (9th percentile) and G0008 at #87228 of 119096 (25th percentile)—both also labeled "typical, unremarkable volume," indicating modest participation on those services.

Payer mix is effectively single-payer in the available data: Medicare is the only payer with recorded revenue ($131.8K) and Medicaid shows none on file. For analysts this means state Medicaid exposure is absent in the claims feed for this NPI and contracting or utilization analyses should treat the provider as Medicare-dominant in the dataset.

Operational and seasonal interpretation: the very small share of revenue from influenza vaccine product and administration codes (90694 and G0008 combined account for 1.4% of Medicare revenue as reported per-code percentages) suggests vaccination is a secondary activity relative to COVID-19 test distribution. The low counts for vaccine claims (15 and 24 claims respectively) imply occasional immunization services rather than a sustained vaccination program at this location.

Given the extreme concentration on K1034, analysts should monitor dependency risk if public demand or reimbursement for nonprescription self-tests changes; the provider’s Medicare revenue stream is highly sensitive to activity and reimbursement for that single code. Routine checks against expected retail pharmacy behavior and periodic re-evaluation of code mix are advised to detect meaningful shifts in service profile or payer exposure.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
K1034	Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count	11,080	$10	$132.9K
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…	20	$70	$1.1K
G0008	Administration of influenza virus vaccine	20	$30	$740

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Walgreen Co — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
K1034	5	140	3,110	$10	$43.2K
90694	64	80	30	$70	$3.3K
G0008	75	120	30	$30	$1.6K

Nearby Providers

Other providers in the same ZIP code as Walgreen Co, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amp Services Incorporated	PR	Health Service Clinic/Center	$0	$1.6M
Laboratorio Clinico Sharem	PR	Clinical Medical Laboratory	$0	$1.1M
Scr Empresas Visuales, Psc	PR	Eyewear Supplier	$0	$667K
Manuel Ortiz Bustillo	PR	General Practice Physician	$15K	$626.9K
Primary Internal Med LLC	PR	Internal Medicine Physician	$0	$633.8K
Mario Sanchez-pares	PR	Physical Medicine & Rehabilitation Physician	$4.2K	$622.3K
Walgreen Co	PR	Pharmacy	$89.9K	$0

Walgreen Co — Billing Profile & Reimbursement Data

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Walgreen Co — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References