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.

Procare Pharmacy, L.L.C. (NPI 1518039858)

Field	Value
Entity Type	Organization
Organization	Procare Pharmacy, L.L.C.
Address	3375 Koapaka St Ste D105
City	Honolulu
State	HI
ZIP	96819
Taxonomy	Specialty Pharmacy
NPI Enumerated	November 14, 2006

Payer Source	Total Paid
Medicaid	$41.8M
Medicare	$0

Key Findings

PROCARE PHARMACY, L.L.C. is effectively a Medicaid-focused specialty pharmacy in Honolulu: it reports $41.8M in total Medicaid revenue and has no Medicare billing on file, making Medicaid the sole payer of record in the dataset. The provider’s NPI was enumerated on 2006-11-14 (~20 years ago), indicating a long tenure in the market that aligns with an established specialty operation.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 92.9% of this provider's total Medicaid revenue. The single largest driver is J3590 (Unclassified biologics) at $27.4M (65.5% of Medicaid revenue), followed by J3490 (Unclassified drugs) at $8.6M (20.6%) and J7307 (Etonogestrel implant system, including implant and supplies) at $2.9M (6.8%).

The code mix and per-claim payments point to high-cost medication dispensing and device services consistent with a specialty pharmacy model. J3590 carries a $4402 avg paid/claim and J3490 a $2112 avg paid/claim, showing that large-dollar biologics and unclassified drugs drive most revenue, while J7307 ($931 avg paid/claim) indicates bundled device-and-supply billing for contraceptive implants.

Competitive standing within the state is mixed by code. PROCARE ranks #1 of 4 providers for J3590 (100th percentile) and #1 of 2 providers for J7307 (100th percentile), signaling in-state dominance for those specific lines; by contrast J3490 ranks #13 of 49 providers (75th percentile), which indicates a solid but not market-leading position among peers for broadly categorized unclassified drugs.

Several other Medicaid codes contribute materially but at much smaller scale, providing secondary revenue diversity. J7298 (Levonorgestrel-releasing IUD, 52 mg) adds $2.2M (5.3% of Medicaid revenue) and is listed as #1 of 1 providers with no state peer volume comparison available; J0585 (onabotulinumtoxina injection) contributes $590.4K (1.4%) and ranks #2 of 8 providers (86th percentile), indicating modest participation in botulinum toxin services.

The dataset’s qualitative labels convey that volume for the two largest codes is described as typical rather than anomalous: J3590 is characterized as "typical, unremarkable volume for this code" despite its dominant share and top rank, and J3490 is similarly labeled "typical, unremarkable volume for this code" at the 75th percentile. Where peer comparisons are unavailable, such as J7298 (0th percentile; no state peer volume comparison available), the ranking should be interpreted as absence of comparable state data rather than a measured outlier.

Given that the top three codes (J3590, J3490, J7307) together represent 92.9% of Medicaid revenue, this provider’s financial performance is highly sensitive to utilization and reimbursement changes for a very small set of high-cost products. Analysts should view revenue volatility risk as concentrated in unclassified biologics/drugs and contraceptive device lines rather than a broad portfolio of services.

From a payer or network-management perspective, PROCARE’s profile signals a specialized supplier role: it handles high-cost biologics and contraceptive implants with long-tenured billing history and strong in-state positioning on specific codes, but limited payer diversification because there is no Medicare activity on file. Contracting, utilization management, or formulary actions affecting J3590 or J3490 would likely have outsized impact on the provider’s Medicaid revenue stream.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3590	Unclassified biologics	6,220	$4,400	$27.4M
J3490	Unclassified drugs	4,080	$2,110	$8.6M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	3,060	$930	$2.9M
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	2,320	$960	$2.2M
J0585	Injection, onabotulinumtoxina, 1 unit	590	$1,000	$590.4K
90782	N/A	40	$2,700	$102.7K
J7296	Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg	50	$880	$39.7K
J3031	Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)	40	$600	$24.7K

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

Procare Pharmacy, L.L.C. — 2 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3590	Unclassified biologics	1	10	690	$4,180	$8M
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	1	10	2,320	$960	$2.2M
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	1	10	1,570	$930	$1.5M
J3490	Unclassified drugs	13	50	160	$200	$740.3K
J3031	Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)	2	10	750	$700	$525.5K
J0585	Injection, onabotulinumtoxina, 1 unit	2	10	50	$1,110	$350.9K
90782	N/A	3	10	70	$1,190	$76.1K
J7296	Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg	1	10	50	$880	$39.7K

Nearby Providers

Other providers in the same ZIP code as Procare Pharmacy, L.L.C., 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
Value Drug Ltd	HI	Pharmacy	$0	$21.7M
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

Procare Pharmacy, L.L.C. — Billing Profile & Reimbursement Data

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Procare Pharmacy, L.L.C. — 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

Nearby Providers

Frequently Asked Questions

References