NPI 1538814678 — Billing Profile & Reimbursement Data
NPI 1538814678 · XX · healthcare
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NPI 1538814678 is a healthcare provider located in Unspecified Location. This profile covers 1 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | NPI 1538814678 |
| Address | |
| City | |
| State | XX (Unspecified Location) |
| ZIP | |
| Taxonomy | N/A |
| NPI Enumerated | |
| NPI Deactivated | June 23, 2023 |
(source: CMS Medicare & Medicaid claims data)
Key Findings
This provider’s recorded lifetime Medicare revenue is $10.6M while there is no Medicaid billing on file, indicating an effectively single‑payer footprint concentrated in Medicare rather than a dual Medicaid/Medicare practice. The lack of Medicaid activity means payer-mix analysis is limited to Medicare data only and the provider likely does not participate meaningfully in state Medicaid markets based on available records.
Revenue is extremely concentrated in a single service area: the dataset’s precomputed top-3 codes account for 100.0% of this provider’s Medicare revenue, and K1034 alone is reported as $10.8M of revenue and as 100.0% of the provider’s Medicare revenue. That concentration implies the provider’s financial profile is heavily dependent on one type of billed service rather than a diversified CPT mix.
The code driving all reported Medicare revenue is K1034, which describes provision of nonprescription self‑administered, self‑collected COVID‑19 tests (one test count). This code mix indicates the operation’s core business is supplying or distributing at‑home/OTC COVID‑19 test kits billed to Medicare rather than delivering traditional in‑office clinical services or procedures.
Medicare: Total Revenue Breakdown by CPT/HCPCS Code
Medicare revenue breakdown by CPT/HCPCS procedure code.
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Medicare: Complete Services Breakdown
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 | 901,210 | $10 | $10.8M |
Medicare: Competitive Analysis & Benchmarks
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
View: State1 / 2
Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 7 | 0 | N/A | $N/A | $N/A |
Frequently Asked Questions
References
- 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
- 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.
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