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NPI 1972617736 · Humble, TX · Pharmacotherapy Pharmacist
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Groveway Pharmacy, Inc. is a pharmacotherapy pharmacist provider located in Humble, Texas. 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 | Groveway Pharmacy, Inc. |
| Address | 1485 Fm 1960 Bypass Rd. East |
| City | Humble |
| State | TX |
| ZIP | 77338 |
| Taxonomy | Pharmacotherapy Pharmacist |
| NPI Enumerated | August 18, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $6.8M |
| Medicaid | $0 |
This provider’s Medicare activity dominates its payer mix: Total Medicare revenue is $6.8M while Total Medicaid revenue is $0, making the entity effectively single-payer (Medicare) in the available claims data. The practice is located in HUMBLE, TX and is filed under the Pharmacotherapy Pharmacist taxonomy, which aligns with pharmacy-centered services.
Revenue for this provider is highly concentrated: the precomputed top-3 Medicare codes account for 100.0% of its total Medicare revenue, and all reported Medicare revenue is tied to K1034. The provider’s Medicare billing profile is therefore driven entirely by a very narrow set of services rather than a diversified procedure mix.
The code mix and taxonomy indicate a pharmacy-oriented business model focused on distribution/provision of over-the-counter self-testing: K1034 is described as provision of nonprescription self-administered COVID-19 tests, and the provider reported 568.2K claims for that code with a $12 avg paid/claim for $6.8M in revenue. This combination of high claim volume and low per-claim payment is consistent with high-throughput retail dispensing or mass distribution of test kits to Medicare beneficiaries.
On national competitiveness for its top code, this provider ranks #73 of 30143 providers and is listed in the 100th percentile as an extreme outlier, indicating it is a major national-volume participant for K1034. That ranking signals market dominance for this particular service relative to typical national peers, not necessarily across other pharmacy services.
Operationally, the scale implied by 568.2K claims at $12 avg paid/claim suggests significant logistical capacity and sustained throughput to process hundreds of thousands of small-dollar transactions. Analysts should view the volume as evidence of broad reach in dispensing or distribution channels rather than high-margin clinical services.
The provider’s financial profile carries concentration risk: dependence on a single HCPCS code (K1034) and a single payer (Medicare) for all reported revenue creates exposure to reimbursement changes, coding policy shifts, or demand fluctuations for COVID-19 self-tests. Any changes to coverage or unit reimbursement for K1034 would likely have an outsized impact on this entity’s reported revenue.
This NPI has been enumerated since 2006-08-18 (~20 years ago), indicating long-standing enrollment even though the current billed revenue is narrowly concentrated in pandemic-era test provisioning. The long tenure suggests established operations and credentialing history, but the present billing footprint is highly specialized toward a single, high-volume service.
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 | 568,250 | $10 | $6.8M |
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
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| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| K1034 | 14 | 2,490 | 450 | $10 | $117.8K |
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 | 1,420 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Texas 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 | 15 | 80 | 340 | $1 | $1.5K |
Other providers in the same ZIP code as Groveway Pharmacy, Inc., ranked by combined Medicare and Medicaid revenue.
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