This provider's $58.2M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
Medicare payments to this provider grew 212% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 123% in 2017
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 |
|---|---|---|---|---|---|---|---|
| 2014 | $27.0K | $19.2K | 1.41x | $7.8K | $1.9M | 101 | 1 |
| 2015 | $26.4K | $20.5K | 1.29x | $5.9K | $2.6M | 127 | 1 |
| 2016 | $31.8K | $23.3K | 1.36x | $8.5K | $3.3M | 140 | 1 |
| 2017 | $22.9K | $17.3K | 1.32x | $5.6K | $7.3M | 420 | 2 |
| 2018 | $15.02 | $11.53 | 1.30x | $3.49 | $7.3M | 630.3K | 2 |
| 2019 | $66.23 | $50.43 | 1.31x | $15.80 | $8.5M | 169.4K | 3 |
| 2020 | $51.26 | $39.23 | 1.31x | $12.03 | $6.9M | 176.2K | 2 |
| 2021 | $44.81 | $35.18 | 1.27x | $9.63 | $7.0M | 199.5K | 2 |
| 2022 | $55.50 | $42.36 | 1.31x | $13.14 | $7.3M | 172.8K | 2 |
| 2023 | $51.19 | $39.61 | 1.29x | $11.58 | $6.1M | 152.9K | 1 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| J7170 | Injection, emicizumab-kxwh, 0.5 mg | 728.0K | $27.9M | $38.38 | 1.31x |
| J7192 | Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified | 413.6K | $15.5M | $37.56 | 1.34x |
| J7205 | Injection, factor viii fc fusion protein (recombinant), per iu | 360.3K | $14.7M | $40.84 | 1.29x |
This provider submits charges 1.31 times higher than what Medicare actually pays.
A markup ratio of 1.31x means for every $100 Medicare pays, this provider initially charges $131. 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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