Statistical flag only — not an accusation of fraud
This provider's $5.8M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
Medicare payments to this provider grew 2469% from 2021 to 2023.
90% 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 68/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 682% 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 |
|---|---|---|---|---|---|---|---|
| 2021 | $66.93 | $36.68 | 1.82x | $30.25 | $168.7K | 4.6K | 14 |
| 2022 | $18.01 | $15.24 | 1.18x | $2.77 | $1.3M | 86.5K | 22 |
| 2023 | $12.79 | $11.78 | 1.09x | $1.01 | $4.3M | 368.0K | 3 |
| 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 | 444.3K | $5.2M | $11.76 | 1.09x |
| M0201 | Covid-19 vaccine administration inside a patient's home; reported only once per individual home per date of service when only covid-19 vaccine administration is performed at the patient's home | 5.2K | $177.8K | $34.11 | 1.13x |
| 0003A | Adm sarscov2 30mcg/0.3ml 3rd | 2.2K | $86.4K | $38.87 | 2.18x |
| 0124A | Adm sarscv2 bvl 30mcg/.3ml a | 1.6K | $58.9K | $37.82 | 1.03x |
| 0051A | Adm sarscv2 30mcg trs-sucr 1 | 1.0K | $38.6K | $38.17 | 1.03x |
| M0222 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring | 93 | $30.7K | $329.89 | 2.39x |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 554 | $28.4K | $51.21 | 2.59x |
| 90756 | Influenza vaccine, quadrivalent derived from cell cultures | 912 | $27.3K | $29.97 | 1.02x |
| G0008 | Administration of influenza virus vaccine | 1.2K | $23.3K | $19.59 | 1.02x |
| M0223 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency | 37 | $19.0K | $514.50 | 1.54x |
| 0054A | Adm sarscv2 30mcg trs-sucr b | 441 | $16.8K | $38.16 | 1.04x |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | 225 | $15.8K | $70.22 | 1.02x |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 256 | $13.1K | $51.31 | 1.95x |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | 21 | $9.0K | $429.23 | 2.26x |
| M0248 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency | 12 | $8.6K | $715.58 | 1.68x |
| 0064A | Adm sarscov2 50mcg/0.25mlbst | 209 | $8.0K | $38.11 | 1.04x |
| 0134A | Fee covid-19 vac 14 res | 165 | $6.2K | $37.79 | 1.04x |
| 0002A | Adm sarscov2 30mcg/0.3ml 2nd | 118 | $4.6K | $38.88 | 2.15x |
| 0004A | Adm sarscov2 30mcg/0.3ml bst | 105 | $4.1K | $38.62 | 1.05x |
| 0013A | Adm sarscov2 100mcg/0.5ml3rd | 97 | $3.8K | $38.68 | 1.96x |
This provider submits charges 1.13 times higher than what Medicare actually pays.
A markup ratio of 1.13x means for every $100 Medicare pays, this provider initially charges $113. 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 FL for peer comparison.
| Provider | Location | Total Payments | Status |
|---|---|---|---|
| Vra Enterprises, Llc | Tampa, FL | $75.8M | ⚠️ Flagged |
| Ez Rx Boynton Beach Llc | Boca Raton, FL | $58.7M | ⚠️ Flagged |
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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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