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NPI 1295145605 · Pasadena, TX · Community/Retail Pharmacy
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Bayshore Health Mart, Inc. is a community/retail pharmacy provider located in Pasadena, Texas. This profile covers 1 Medicare and 1 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 | Bayshore Health Mart, Inc. |
| Address | 3315 Burke Rd Ste 100 |
| City | Pasadena |
| State | TX |
| ZIP | 77504 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | May 7, 2014 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $5.4M |
| Medicaid | $380 |
BAYSHORE HEALTH MART, INC. presents as a community/retail pharmacy operation that, based on its top code K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use), appears to be primarily engaged in distribution or provision of FDA-authorized nonprescription COVID-19 self-tests rather than advanced clinical services. The taxonomy and the code mix are consistent with high-volume retail test provisioning in a pharmacy setting rather than diversified clinical procedures.
Revenue is extremely concentrated in a single service line: the precomputed top-3 Medicare codes account for 100.0% of this provider's Medicare revenue and the precomputed top-3 Medicaid codes account for 100.0% of its Medicaid revenue, with K1034 representing the entirety of reported revenue in both payers. This indicates the provider’s billing profile is effectively single-code dependent across both Medicare and Medicaid.
The payer mix is highly skewed toward Medicare in scale: the provider reported $5.4M in total Medicare revenue versus $382 in total Medicaid revenue, making it effectively a Medicare-driven billing profile with negligible Medicaid revenue on file. Operationally, this suggests exposure to Medicare payment and policy shifts for the K1034 benefit while Medicaid factors have minimal immediate revenue impact.
On Medicare K1034 the provider is a national outlier: it reported 446.9K claims and $5.4M revenue for K1034 (average paid $12 per claim) and ranks #85 of 30143 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). This ranking and volume position BAYSHORE as a dominant national participant specifically for K1034 activity, indicating unusually large scale in distributing or billing for nonprescription COVID-19 self-tests to the Medicare program.
By contrast, the provider’s Medicaid activity for the same code is modest and unremarkable: it reported 191 claims and $382 revenue for K1034 (average paid $2 per claim) and ranks #46 of 77 providers in-state (41th percentile; typical, unremarkable volume for this code). Within the state Medicaid peer set BAYSHORE does not stand out and appears to be a routine participant in this single Medicaid-covered service.
There is a notable reimbursement differential between payers for the same code: the average paid per claim is $12 under Medicare versus $2 under Medicaid for K1034. This gap, together with the vastly different claim volumes (446.9K Medicare claims vs. 191 Medicaid claims), underscores that Medicare is the primary revenue source and that payer-specific pricing materially affects the provider’s revenue profile.
The provider’s NPI has been enumerated since 2014-05-07 (~12 years ago), indicating a long-standing registration that would support an established retail footprint. Coupled with the extremely high Medicare claim volume for K1034, the tenure suggests the entity has had time to scale distribution or billing workflows for high-volume test provisioning.
Because a single HCPCS code (K1034) drives 100.0% of revenue for both payers, the business is highly specialized and therefore sensitive to any changes in coverage, reimbursement, or program rules for that code. A policy or payment change affecting K1034 could materially alter BAYSHORE’s revenue, so analysts should flag concentration risk when assessing financial or operational resilience.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 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 | 446,950 | $10 | $5.4M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 16 | 2,490 | 450 | $10 | $117.8K |
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.
1 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 | 190 | $1 | $380 |
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 46 | 80 | 340 | $1 | $1.5K |
Other providers in the same ZIP code as Bayshore Health Mart, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Chca Bayshore LP | TX | General Acute Care Hospital | $0 | $46.9M |
| Chartwell Community Services Inc. | TX | Home Health Agency | $0 | $38.4M |
| Fairmont Pediatrics And Associates | TX | Pediatrics Physician | $0 | $11.5M |
| New Dimensions Caregivers LLC | TX | Home Health Agency | $0 | $11M |
| Burke Family Pharmacy Inc | TX | Community/Retail Pharmacy | $3.8M | $0 |
| Naveed Saqib | TX | Vascular Surgery Physician | $611.7K | $0 |
| Ashkan Ghorbani | TX | Dermatology Physician | $566.7K | $0 |
| Dixie Melillo | TX | Diagnostic Radiology Physician | $429.3K | $0 |
| Lawrence Clarke | TX | Otolaryngic Allergy Physician | $333.2K | $0 |
| Jojy George | TX | Surgery Physician | $319.6K | $0 |
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