This provider's $17.9M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
Medicare payments to this provider grew 365% from 2017 to 2023.
71% of their billing comes from a single procedure code (J7170 — Injection, emicizumab-kxwh, 0.5 mg).
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 430% in 2022
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 |
|---|---|---|---|---|---|---|---|
| 2017 | $4.91 | $1.81 | 2.71x | $3.10 | $1.5M | 837.3K | 1 |
| 2020 | $2.96 | $1.06 | 2.79x | $1.90 | $1.4M | 1.3M | 1 |
| 2021 | $3.05 | $1.10 | 2.77x | $1.95 | $1.3M | 1.2M | 1 |
| 2022 | $10.98 | $6.45 | 1.70x | $4.53 | $6.7M | 1.0M | 2 |
| 2023 | $63.16 | $39.62 | 1.59x | $23.54 | $7.0M | 177.5K | 1 |
This provider submits charges 1.91 times higher than what Medicare actually pays.
A markup ratio of 1.91x means for every $100 Medicare pays, this provider initially charges $191. This is lower than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Other Pharmacy providers in CA for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Caremark, L.L.C. | Redlands, CA | $188.6M | ✓ Clear |
| Advanced Bionics, Llc. | Valencia, CA | $54.5M | ⚠️ Flagged |
Share this provider's Medicare payment information
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.
Believe this data is inaccurate? Dispute this data