NPI 1457091324 — Billing Profile & Reimbursement Data

This provider’s billed Medicare volume is concentrated in a single payer channel: Total Medicare revenue is $5.6M while Total Medicaid revenue is none (no Medicaid billing on file), indicating the entity is effectively a Medicare-only biller in the available data rather than a dual-payer operator. The absence of Medicaid claims limits any Medicaid-level competitive or state-market analysis.

Revenue is extremely concentrated in a very small set of Medicare codes: the precomputed top 3 Medicare codes by revenue account for 97.5% of this provider's total Medicare revenue, with a single code, K1034, contributing $5.4M (95.4% of Medicare revenue). Such concentration creates material revenue dependence on the policies and reimbursement dynamics affecting those few codes.

K1034 (450.2K claims, $12 avg paid/claim, $5.4M revenue) dominates the provider’s Medicare picture and is a national outlier: it ranks #84 of 30143 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). This pattern — very high claim volume at low average paid/claim — is consistent with large-scale distribution or provisioning of low-unit-cost items (nonprescription self-administered COVID-19 tests) rather than traditional episodic clinical services.