Statistical flag only — not an accusation of fraud
This provider's $8.4M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
Medicare payments to this provider grew 1681% from 2022 to 2023.
100% of their billing comes from a single procedure code (K1034 — Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count).
This provider has been statistically flagged with a risk score of 71/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 1681% in 2023
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2022 | $12.00 | $11.76 | 1.02x | $0.24 | $445.1K | 37.9K | 1 |
| 2023 | $12.00 | $11.76 | 1.02x | $0.24 | $7.9M | 674.1K | 1 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | 712.0K | $8.4M | $11.76 | 1.02x |
This provider submits charges 1.02 times higher than what Medicare actually pays.
A markup ratio of 1.02x means for every $100 Medicare pays, this provider initially charges $102. This is lower than the national average.
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Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
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