This provider's $45.2M in total Medicare payments ranks in the 99th percentile of Pharmacy providers nationally.
63% 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 94% 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 | $47.0K | $36.7K | 1.28x | $10.3K | $3.7M | 100 | 1 |
| 2015 | $45.3K | $35.5K | 1.28x | $9.8K | $3.4M | 95 | 1 |
| 2016 | $42.7K | $32.8K | 1.30x | $9.9K | $4.0M | 122 | 1 |
| 2017 | $46.1K | $35.9K | 1.29x | $10.2K | $3.2M | 90 | 1 |
| 2019 | $5.9K | $4.6K | 1.28x | $1.3K | $6.3M | 1.4K | 2 |
| 2020 | $51.1K | $40.6K | 1.26x | $10.4K | $6.9M | 170 | 1 |
| 2021 | $50.1K | $40.0K | 1.25x | $10.0K | $7.1M | 178 | 1 |
| 2022 | $154.17 | $121.72 | 1.27x | $32.45 | $5.5M | 44.9K | 1 |
| 2023 | $50.52 | $39.60 | 1.28x | $10.92 | $5.1M | 129.6K | 1 |
This provider submits charges 1.27 times higher than what Medicare actually pays.
A markup ratio of 1.27x means for every $100 Medicare pays, this provider initially charges $127. 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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