Statistical flag only — not an accusation of fraud
This provider's $54.5M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
83% of their billing comes from a single procedure code (L8619 — Cochlear implant, external speech processor and controller, integrated system, replacement).
This provider has been statistically flagged with a risk score of 69/100. Statistical flags are not accusations of fraud.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 98% in 2019
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 | $754.86 | $529.71 | 1.43x | $225.15 | $4.6M | 8.7K | 8 |
| 2015 | $796.55 | $557.05 | 1.43x | $239.50 | $4.0M | 7.1K | 9 |
| 2016 | $536.83 | $344.08 | 1.56x | $192.75 | $3.4M | 9.9K | 9 |
| 2017 | $681.70 | $446.51 | 1.53x | $235.19 | $4.8M | 10.9K | 8 |
| 2018 | $460.15 | $285.62 | 1.61x | $174.53 | $3.5M | 12.3K | 9 |
| 2019 | $947.93 | $645.60 | 1.47x | $302.33 | $7.0M | 10.8K | 9 |
| 2020 | $796.87 | $542.36 | 1.47x | $254.51 | $5.2M | 9.5K | 9 |
| 2021 | $1.2K | $767.66 | 1.50x | $386.58 | $7.3M | 9.5K | 9 |
| 2022 | $1.2K | $845.51 | 1.44x | $373.76 | $7.9M | 9.3K | 9 |
| 2023 | $1.2K | $817.60 | 1.43x | $350.10 | $6.9M | 8.4K | 9 |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement | 7.0K | $45.1M | $6.5K | 1.33x |
| L8624 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each | 42.7K | $5.2M | $120.74 | 2.37x |
| L8615 | Headset/headpiece for use with cochlear implant device, replacement | 7.8K | $2.7M | $341.62 | 1.35x |
| L8616 | Microphone for use with cochlear implant device, replacement | 8.6K | $683.3K | $79.23 | 3.92x |
| L7510 | Repair of prosthetic device, repair or replace minor parts | 1.3K | $664.6K | $530.38 | 1.32x |
| L8618 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement | 6.0K | $108.5K | $18.04 | 6.55x |
| L8623 | Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each | 1.6K | $73.4K | $44.98 | 4.51x |
| L8625 | External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each | 306 | $43.4K | $141.92 | 2.69x |
| L8621 | Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each | 21.0K | $9.1K | $0.43 | 2.63x |
| L9900 | Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code | 33 | $3.8K | $115.53 | 1.39x |
This provider submits charges 1.48 times higher than what Medicare actually pays.
A markup ratio of 1.48x means for every $100 Medicare pays, this provider initially charges $148. 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 |
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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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