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

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

Costco Wholesale Corporation (NPI 1437269065)

Field	Value
Entity Type	Organization
Organization	Costco Wholesale Corporation
Address	218 Lower Mountain View Dr
City	Colchester
State	VT
ZIP	05446
Taxonomy	Community/Retail Pharmacy
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicare	$534.4K
Medicaid	$0

Key Findings

This entity reported $534.4K in total Medicare revenue and has no Medicaid billing on file (none), making its Medicare business the sole public-payer footprint visible in the dataset. The provider is effectively single-payer in these records, which concentrates reimbursement exposure to Medicare dynamics and seasonal preventive-service demand.

Revenue is heavily concentrated in a small set of vaccination and administration codes: the precomputed top three Medicare codes (91320, 90694, 90480) account for 71.9% of total Medicare revenue. Individually those codes produced $197.2K (36.9%), $107.3K (20.1%), and $79.8K (14.9%) respectively, signaling a narrow set of service lines driving the bulk of billed Medicare dollars.

The code mix confirms a retail pharmacy immunization and testing operating model: high-volume vaccine-product codes such as 91320, 90694 and 90480 are the primary revenue drivers, and the presence of K1034 (3.1K claims, $5 avg paid/claim, $15.4K revenue) indicates material activity in nonprescription self-test distribution. Administration codes like G0008 (1.4K claims, $29 avg paid/claim, $41.6K revenue) further support the interpretation that this location functions primarily as a community/retail pharmacy delivering preventive services.

Competitive standing against national Medicare peers is strong for several vaccine codes. 91320 ranks #25 of 27083 providers nationally (100th percentile; typical, unremarkable volume), 90694 ranks #32 of 51679 providers nationally (100th percentile; notably above typical national volume), and 90480 ranks #41 of 46950 providers nationally (100th percentile; typical, unremarkable volume), which together indicate above-average to very high relative volume for core immunization services.

There is at least one statistical outlier worth noting: 91304 generated $17.1K (3.2% of Medicare revenue) with 118 claims and ranks #7 of 495 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). Although it represents a smaller share of total revenue, its extremely high rank suggests this location dispensed a specific vaccine product at volumes that are rare compared with most peers.

Operational throughput is visible in the claims and average-paid metrics: 90480 shows 2K claims at $40 avg paid/claim, 91320 shows 1.5K claims at $128 avg paid/claim, and 90694 shows 1.4K claims at $76 avg paid/claim. These figures point to a high-volume, low-margin per-claim vaccination workflow consistent with retail pharmacy immunization services rather than episodic physician-level procedures.

Tenure on the NPI file is long-standing: the NPI was enumerated on 2006-08-30 (~20 years ago), indicating the provider has been registered and operating under this identifier for roughly two decades. That longevity supports interpretation of the observed billing patterns as established service lines rather than a short-term anomaly.

The absence of any Medicaid billing on file (none) creates a clear payer-mix note: public revenue in these claims is concentrated in Medicare only ($534.4K), which may reflect enrollment patterns of the local beneficiary population or contracting choices; analysts should treat Medicaid as a non-contributor to reported public-payer volume for this entity.

Medicare: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	1,540	$130	$197.2K
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…	1,410	$80	$107.3K
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.	1,990	$40	$79.8K
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.	340	$140	$47.9K
G0008	Administration of influenza virus vaccine	1,430	$30	$41.6K
91304	This code represents a SARS–CoV–2 vaccine product administered by intramuscular injection to prevent the patient from contracting COVID–19. The dosage is 5 mcg/0.5 mL.	120	$150	$17.1K
K1034	Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count	3,080	$10	$15.4K
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…	40	$280	$10.5K
0124A	N/A	210	$40	$8.2K
0134A	N/A	100	$40	$4K

Showing 1–10 of 14

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Costco Wholesale Corporation — 8 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

14 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
91322	11	60	180	$140	$34.2K
91320	1	60	40	$130	$18.1K
90694	1	60	90	$80	$10.7K
K1034	3	60	750	$10	$9.4K
90480	1	110	130	$40	$7.8K
90677	14	80	20	$270	$6.8K
91304	1	10	30	$140	$5.8K
G0008	1	170	70	$20	$3.5K
90671	1	10	10	$230	$2.8K
0124A	1	80	30	$40	$1.6K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Costco Wholesale Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planned Parenthood Of Northern New England, Inc	VT	Obstetrics & Gynecology Physician	$0	$3.9M
Vt Center For Dental Implants And Maxillofacial Surgery LLC	VT	Oral and Maxillofacial Surgery Clinic/Center	$0	$2.6M
Kids Rehabgym Inc.	VT	Physical Therapy Clinic/Center	$0	$2.5M
Saint Michaels College Fire And Rescue Inc	VT	Land Ambulance	$281.9K	$1.5M
Dennis Sanders	VT	Medical Oncology Physician	$1.3M	$0
Robert Duwors	VT	Clinical Psychologist	$45K	$1.1M
Town Of Colchester	VT	Land Ambulance	$163.6K	$638.6K
Vermont Center For Responder Wellness LLC	VT	Clinical Social Worker	$0	$719.1K
Actd,llc	VT	Ambulatory Surgical Clinic/Center	$634.9K	$0
Counseling Connection Training Institute, Plc	VT	Mental Health Counselor	$0	$619.8K

Costco Wholesale Corporation — 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