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NPI 1598889172 · Waltham, MA · Long Term Care Pharmacy
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Pelham Community Pharmacy, Inc is a long term care pharmacy provider located in Waltham, Massachusetts. This profile covers 12 Medicare and 8 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Pelham Community Pharmacy, Inc |
| Address | 21 Green St |
| City | Waltham |
| State | MA |
| ZIP | 02451 |
| Taxonomy | Long Term Care Pharmacy |
| NPI Enumerated | March 19, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $222.1K |
| Medicaid | $101.9K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 1,020 | $50 | $51.1K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2,000 | $20 | $46.1K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 980 | $40 | $34.2K |
| 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. | 220 | $130 | $27.5K |
| 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. | 120 | $140 | $16.4K |
| 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. | 330 | $40 | $14.5K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 1,010 | $10 | $11.1K |
| G0008 | Administration of influenza virus vaccine | 280 | $30 | $9.5K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 220 | $20 | $4.8K |
| 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… | 60 | $80 | $4.5K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
12 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| P9604 | 9 | 10 | 5,270 | $10 | $44.4K |
| 91322 | 374 | 650 | 150 | $140 | $29.1K |
| 91320 | 198 | 640 | 80 | $130 | $25.1K |
| K1034 | 674 | 700 | 1,190 | $10 | $16.5K |
| G2023 | 1 | 10 | 210 | $20 | $14.3K |
| 90480 | 317 | 1,130 | 160 | $40 | $9.4K |
| 90694 | 683 | 1,530 | 50 | $70 | $8.6K |
| 0134A | 392 | 460 | 60 | $40 | $3.5K |
| G0008 | 398 | 3,490 | 40 | $30 | $3.5K |
| 87635 | 2 | 270 | 20 | $50 | $2.7K |
Showing 1–10 of 12
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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 |
|---|---|---|---|---|
| A4927 | Gloves, non-sterile, per 100 | 2,100 | $40 | $77.5K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 6,130 | $1 | $18.4K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 6,230 | $1 | $6.2K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 440 | $0 | $0 |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 130 | $0 | $0 |
| 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… | 50 | $0 | $0 |
| G0008 | Administration of influenza virus vaccine | 180 | $0 | $0 |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 6,780 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| A4927 | Gloves, non-sterile, per 100 | 21 | 40 | 2,580 | $30 | $338.5K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 31 | 720 | 200 | $40 | $60.2K |
| P9604 | Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge | 12 | 30 | 5,180 | $1 | $57.8K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 41 | 550 | 190 | $20 | $38.9K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 66 | 220 | 150 | $30 | $28.3K |
| 90686 | This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL… | 307 | 780 | 70 | $10 | $9.1K |
| G0008 | Administration of influenza virus vaccine | 186 | 1,030 | 60 | $1 | $1.1K |
| 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… | 44 | 120 | 30 | $10 | $1K |
Other providers in the same ZIP code as Pelham Community Pharmacy, Inc, ranked by combined Medicare and Medicaid revenue.
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