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

Why is the Medicaid comparison limited to Hawaii 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. Hawaii (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.

Value Drug Ltd (NPI 1265418891)

Field	Value
Entity Type	Organization
Organization	Value Drug Ltd
Address	3375 Koapaka St
City	Honolulu
State	HI
ZIP	96819
Taxonomy	Pharmacy
NPI Enumerated	December 15, 2005

Payer Source	Total Paid
Medicaid	$21.7M
Medicare	$0

Key Findings

VALUE DRUG LTD is effectively a Medicaid-focused pharmacy: it reports no Medicare revenue on file and $21.7M in lifetime Medicaid revenue, making its operations materially concentrated in the state Medicaid market rather than in traditional Medicare channels. The absence of Medicare billing indicates payer mix is effectively single-payer (Medicaid) for the claims in this dataset.

Revenue concentration is substantial within a small set of services: the precomputed top three Medicaid codes account for 47.0% of the provider’s total Medicaid revenue. The leading individual code by revenue is J3590 (Unclassified biologics) with $3.8M (18.9% of Medicaid revenue), followed by J3490 ($3.1M, 15.3%) and S9342 ($2.6M, 12.8%), indicating that biologics, unclassified drug billing, and enteral nutrition home-therapy services drive nearly half of Medicaid receipts.

The code mix implies a specialty pharmacy/home infusion and enteral nutrition focus: high volumes and rank dominance in S9342, multiple enteral formula codes (B4161, B4149, B4150, B4160, B4154, B4035), and home-infusion service codes (99601, S9500, S9379) suggest VALUE DRUG LTD operates a business centered on home therapy support, enteral supplies, and specialty drug administration rather than a conventional retail dispensing model. This pattern aligns with per-diem service billing and high-unit enteral formula billing.

VALUE DRUG LTD’s state competitive standing is frequently dominant for many product and service lines: it ranks #1 of state providers for S9342, B4161, J0585, 99601, S9500, B4149, S9341, B4150, B4160, S9379 and several incontinence and enteral supply codes, with many of those listing a 100th-percentile or labeled “notably above typical” state volume. These ranks indicate the provider is a major or leading supplier in Hawaii for home infusion, enteral nutrition, and related supplies.

There are clear statistical outliers in specific codes indicating above-typical state volume: J0585 (onabotulinumtoxina) and 99601 (home infusion visit) both rank #1 in-state with descriptions of “notably above typical state volume,” and multiple incontinence supply codes (T4527, T4526, T4528, T4541, T4522) also show 100th-percentile rankings and are described as “notably above typical state volume.” These labels point to specialties or supply contracts that generate materially higher utilization relative to peers.

At the same time, some high-revenue codes show more modest state positions: J3590 (J3590 – Unclassified biologics) is $3.8M and ranks #2 of 4 providers in-state at the 67th percentile, and J3490 is $3.1M and ranks #8 of 49 providers at the 85th percentile. Those placements suggest that while biologics and unclassified drug billing are large revenue contributors, competition for those categories exists and VALUE DRUG LTD is not universally dominant across all drug billing lines.

The provider has long tenure in the NPI registry, enumerated on 2005-12-15 (~21 years ago), which supports the observed breadth of service lines and its capacity to establish market presence in Hawaii. This longevity is consistent with the scale and number of specialized codes where it leads in-state.

Operationally, the mix of many per-diem home therapy codes and high claim counts for items like incontinence products and enteral feeding supplies (for example, T4541 with 14.5K claims and T4527 with 5.2K claims) implies a high-volume supply and recurring service model that likely depends on ongoing beneficiary enrollment and durable service contracts with Medicaid. Persistent high claim counts across supplies and per-diem services point to stable recurring revenue streams tied to chronic care and home-based therapy populations.

Medicaid: Complete Services Breakdown

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

60 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3590	Unclassified biologics	1,180	$3,270	$3.8M
J3490	Unclassified drugs	8,290	$380	$3.1M
S9342	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	8,370	$310	$2.6M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	2,800	$600	$1.7M
J0585	Injection, onabotulinumtoxina, 1 unit	1,330	$1,170	$1.6M
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.	9,940	$120	$1.2M
S9500	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and…	2,370	$320	$750K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1,450	$400	$577.5K
S9341	Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	1,690	$310	$521.9K
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	5,200	$100	$514.4K

Showing 1–10 of 60

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Hawaii Distribution

Value Drug Ltd — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3590	Unclassified biologics	2	10	690	$4,180	$8M
S9342	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	1	10	8,370	$310	$2.6M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	2	10	1,570	$930	$1.5M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	1	10	2,300	$420	$967.4K
S9500	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and…	1	10	2,370	$320	$750.3K
J3490	Unclassified drugs	8	50	160	$200	$740.3K
A9276	Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply	4	10	40	$330	$528.3K
S9341	Home therapy; enteral nutrition via gravity; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	1	10	1,690	$310	$522.4K
A9274	External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories	4	10	500	$520	$402.8K
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.	1	10	60	$120	$361.4K

Showing 1–10 of 60

Related Providers

Other providers that share a Tax Identification Number (TIN) with Value Drug Ltd, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pharmacare International, Inc.	HI	Community/Retail Pharmacy	$125.1K	$4.7M
Value Drug Ltd	HI	Pharmacy	$0	$746.9K
Kapiolani Medical Center For Women & Children	HI	Community/Retail Pharmacy	$0	$153.7K

Nearby Providers

Other providers in the same ZIP code as Value Drug Ltd, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	HI	General Acute Care Hospital	$0	$76.5M
Hawaii Permanente Medical Group Inc	HI	Health Maintenance Organization	$0	$75.8M
Procare Pharmacy, L.L.C.	HI	Specialty Pharmacy	$0	$41.8M
Care Hawaii, Inc.	HI	Community/Behavioral Health Agency	$0	$11.8M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$10M
Hawaii Life Flight, LLC	HI	Air Ambulance	$636.1K	$8.5M
City And County Of Honolulu	HI	Land Ambulance	$3.3M	$5.3M
Keiki Dental Specialists	HI	Pediatric Dentistry	$0	$5.7M
Kokua Kalihi Valley Comprehensive Family Services	HI	Federally Qualified Health Center (FQHC)	$0	$2M
Imua Medical Equipment And Supplies,llc	HI	Durable Medical Equipment & Medical Supplies	$0	$1.7M

Value Drug Ltd — 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