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

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

Pantherx Specialty LLC (NPI 1316213531)

Field	Value
Entity Type	Organization
Organization	Pantherx Specialty LLC
Address	24 Summit Park Dr Ste 101
City	Pittsburgh
State	PA
ZIP	15275
Taxonomy	Specialty Pharmacy
NPI Enumerated	April 2, 2012

Payer Source	Total Paid
Medicaid	$64.9M
Medicare	$0

Key Findings

PANTHERX SPECIALTY LLC has no Medicare billing on file (listed as "none below") and is effectively a single-payer Medicaid operator: its only reported lifetime revenue is Medicaid at $64.9M. This makes Medicaid the sole source of reported public-payer revenue for this NPI, rather than it being a dual-payer profile with meaningful Medicare activity.

Revenue is highly concentrated in a very small set of high-cost biologic codes: the top 3 Medicaid codes — J0584, J3316, and J3590 — account for 99.1% of the provider's total Medicaid revenue. Individually, J0584 accounts for 88.3% of Medicaid revenue, J3316 for 10.0%, and J3590 for 0.8%, indicating near-total reliance on these few lines.

J0584 (Injection, burosumab-twza 1 mg) is by far the dominant revenue driver with 4.5K claims and an average paid/claim of $12871, producing $57.4M in revenue (88.3% of the provider's Medicaid revenue). The provider ranks #1 of 4 in-state for J0584 at the 100th percentile, and peer-volume characterization for this code is recorded as "typical, unremarkable volume for this code," suggesting the provider's high absolute revenue for J0584 comes from handling many high-dollar claims rather than from an unusually high per-provider claim count by in-state standards.

J3316 (Injection, triptorelin, extended-release, 3.75 mg) is the secondary revenue source with 437 claims, an average paid/claim of $14808, and $6.5M in revenue (10.0% of Medicaid revenue). The provider ranks #1 of 2 in-state for J3316 at the 100th percentile and is likewise described as having "typical, unremarkable volume for this code," indicating state-leading placement for this specific specialty therapy as well.

J3590 (J3590 – Unclassified biologics) contributes a small share (44 claims, $11622 avg paid/claim, $511.4K revenue; 0.8% of Medicaid revenue) and ranks #2 of 4 in-state at the 67th percentile with a "typical, unremarkable volume for this code" label. This suggests the provider also bills for miscellaneous high-cost biologic items, but these account for a materially smaller slice of revenue compared with the two primary codes.

Operationally, the billing profile and code mix (high per-claim payments for J0584 and J3316 plus pharmacy supply fees Q0512 and Q0511 with 4.8K and 2.8K claims respectively) are consistent with specialty pharmacy dispensing and administration of chronic, high-cost injectables. The presence of recurring pharmacy supply fee claims (Q0512, Q0511) supports a business model focused on ongoing medication supply and follow-on fills rather than one-off infusions.

Competitive standing in-state is concentrated: PANTHERX ranks #1 statewide for both J0584 and J3316 (100th percentile), indicating it is a dominant provider for those specific high-cost specialty therapies within Pennsylvania. For other codes the provider is mid-ranked or has limited peer comparison (for example, some codes show 0th percentile or "no state peer volume comparison available"), so its dominance appears tightly focused on a small set of products.

The provider has a multi-year presence: its NPI was enumerated on 2012-04-02 (~14 years ago), indicating established operations over a long tenure. Given the extreme revenue concentration in a few biologic products, the provider's Medicaid revenue profile is sensitive to utilization or formulary changes affecting those specific codes and to payer contracting around high-cost specialty drugs.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0584	Injection, burosumab-twza 1 mg	4,460	$12,870	$57.4M
J3316	Injection, triptorelin, extended-release, 3.75 mg	440	$14,810	$6.5M
J3590	Unclassified biologics	40	$11,620	$511.4K
Q0512	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	4,770	$40	$176.4K
J7503	Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg	850	$150	$126.9K
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	2,850	$40	$111K
J7518	Mycophenolic acid, oral, 180 mg	1,280	$70	$86K
J7507	Tacrolimus, immediate release, oral, 1 mg	1,780	$30	$58.7K
J7517	Mycophenolate mofetil, oral, 250 mg	1,500	$10	$9K
J7508	Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg	120	$70	$8.5K

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Pantherx Specialty LLC — 4 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0584	Injection, burosumab-twza 1 mg	1	10	2,490	$15,640	$38.8M
J3316	Injection, triptorelin, extended-release, 3.75 mg	1	10	390	$14,870	$5.8M
J3590	Unclassified biologics	2	10	40	$6,230	$305.2K
J7518	Mycophenolic acid, oral, 180 mg	2	10	1,310	$50	$64.8K
J7503	Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg	1	10	580	$110	$63.8K
Q0512	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period	2	10	3,370	$10	$53.6K
Q0511	Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period	1	10	1,420	$20	$31.2K
J7507	Tacrolimus, immediate release, oral, 1 mg	2	10	360	$10	$20K
J7517	Mycophenolate mofetil, oral, 250 mg	2	10	940	$10	$10.2K
J7508	Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg	1	10	120	$70	$8.5K

Showing 1–10 of 12

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pantherx Specialty LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pantherx Specialty LLC	PA	Specialty Pharmacy	$0	$22.6M
Pantherx Specialty LLC	PA	Specialty Pharmacy	$0	$7.7M

Nearby Providers

Other providers in the same ZIP code as Pantherx Specialty LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Qualitox Laboratories, LLC	PA	Clinical Medical Laboratory	$1M	$16.9M
Annemarie Hartbauer	PA	Nurse Practitioner	$104.4K	$3.6K
Christine Henney	PA	Family Nurse Practitioner	$99.2K	$1.8K
Maureen Higgins	PA	Family Nurse Practitioner	$9.9K	$0

Pantherx Specialty LLC — Billing Profile & Reimbursement Data

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Pantherx Specialty LLC — 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