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NPI 1669791737 · Wilsonville, AL · Community/Retail Pharmacy
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J's Pharmacy LLC is a community/retail pharmacy provider located in Wilsonville, Alabama. This profile covers 1 Medicare and 1 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 | J's Pharmacy LLC |
| Address | 207 Weldon Street |
| City | Wilsonville |
| State | AL |
| ZIP | 35186 |
| Taxonomy | Community/Retail Pharmacy |
| NPI Enumerated | May 27, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $28.8M |
| Medicaid | $1K |
J'S PHARMACY LLC’s Medicare revenue is overwhelmingly driven by a single HCPCS code: K1034 (Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count). The K1034 line shows 2.4M claims at a $12 avg paid/claim producing $29.4M in revenue, and the provider-level summary flags the top 3 Medicare codes as accounting for 100.0% of this provider's total Medicare revenue, indicating a business model focused almost entirely on distributing these tests under Medicare payment rules.
The provider’s payer mix is effectively single-payer Medicare: lifetime Medicare revenue is listed as $28.8M versus Medicaid revenue of $1K. Medicaid activity is negligible in scale compared with Medicare, so analyses of commercial or Medicaid-side competitiveness will have limited signal for this entity.
Revenue concentration is extreme: the precomputed metric shows the top 3 Medicare codes account for 100.0% of Medicare revenue, and the K1034 code alone is reported as producing $29.4M. This indicates almost all billed Medicare dollars flow through a very narrow set of services, leaving the provider exposed to volume or policy changes that affect those specific codes.
On national competitive standing for the dominant code, J'S PHARMACY ranks #7 of 30143 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). That ranking identifies the pharmacy as a major national distributor for K1034 volumes rather than a typical local retail pharmacy in Medicare test provision.
The NPI has been enumerated since 2010-05-27 (~16 years ago), indicating a long-tenured enrollment in Medicare. Despite long tenure, the current billing mix is heavily concentrated on pandemic-related testing services rather than a diversified set of pharmacy billing lines.
There is a data discrepancy worth reconciling: the provider summary lists total Medicare revenue as $28.8M while the K1034 line reports $29.4M and is noted as representing 100.0% of Medicare revenue. Analysts should flag this inconsistency in financial reporting or aggregation logic when using these tables for contracting or audit planning.
Operational and strategic implications are straightforward — the code mix (K1034) reflects large-scale provisioning of nonprescription, self-administered COVID-19 tests, a service consistent with community/retail pharmacy distribution. Given the provider’s outsized ranking on K1034, any change in Medicare policy, reimbursement, or patient demand for that specific test could materially impact reported Medicare revenue.
For payer negotiation and market mapping, treat J'S PHARMACY as a specialized high-volume supplier for K1034 at the national level rather than a typical neighborhood pharmacy. Competitors or payers seeking to understand market capacity for OTC COVID test distribution should include this entity as a primary supply source based on the observed claims and revenue profile.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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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 | 2,449,490 | $10 | $29.4M |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 1 | 460 | 290 | $10 | $109.1K |
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.
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 | 4,930 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Alabama providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Alabama median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 1 | 10 | 1,850 | $1 | $1.2K |
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