Medicare spending analysis for Pharmacy providers
Pharmacy accounts for $1.2B in Medicare payments across 12.8K providers.
The specialty's average markup of 1.7x is below the overall Medicare average of 3.77x.
AI-generated analysis based on Medicare payment data.
| Year | Payments | Services | Providers | YoY Change |
|---|---|---|---|---|
| 2014 | $25.0K | 1.3K | 3 | — |
| 2015 | $36.5K | 1.2K | 2 | +45.9% |
| 2017 | $7.5M | 7.5K | 29 | +20463.9% |
| 2018 | $79.4M | 26.4M | 845 | +957.8% |
| 2019 | $111.4M | 48.8M | 1.2K | +40.3% |
| 2020 | $111.9M | 38.3M | 1.6K | +0.5% |
| 2021 | $186.9M | 35.5M | 3.1K | +67.0% |
| 2022 | $294.8M | 37.2M | 3.1K | +57.7% |
| 2023 | $432.0M | 48.1M | 3.0K | +46.6% |
| Code | Description | Payments | Services | Avg/Service |
|---|---|---|---|---|
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | $252.7M | 21.5M | $11.75 |
| J7170 | Injection, emicizumab-kxwh, 0.5 mg | $50.2M | 1.3M | $38.81 |
| 91322 | Sarscov2 vac 50 mcg/0.5ml im | $18.4M | 128.9K | $142.36 |
| J7192 | Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified | $15.8M | 14.0M | $1.13 |
| 90694 | Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage | $13.2M | 175.5K | $75.37 |
| 91320 | Sarscv2 vac 30mcg trs-suc im | $12.6M | 98.3K | $128.11 |
| 90480 | Admn sarscov2 vacc 1 dose | $8.7M | 242.6K | $35.79 |
| G0008 | Administration of influenza virus vaccine | $8.7M | 309.9K | $28.00 |
| 90662 | Influenza vaccine split virus, preservative free | $7.0M | 98.6K | $71.10 |
| L8619 | Cochlear implant, external speech processor and controller, integrated system, replacement | $5.9M | 816 | $7.2K |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | $5.8M | 20.5K | $281.41 |
| J7195 | Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified | $5.2M | 3.9M | $1.34 |
| J7205 | Injection, factor viii fc fusion protein (recombinant), per iu | $4.5M | 2.7M | $1.70 |
| Q0508 | Miscellaneous supply or accessory for use with an implanted ventricular assist device | $3.7M | 5.4K | $680.72 |
| J7187 | Injection, von willebrand factor complex (humate-p), per iu vwf:rco | $3.1M | 2.9M | $1.05 |
| J7999 | Compounded drug, not otherwise classified | $2.9M | 12.5K | $235.34 |
| J0475 | Injection, baclofen, 10 mg | $1.8M | 13.1K | $141.05 |
| 0124A | Adm sarscv2 bvl 30mcg/.3ml a | $1.6M | 38.5K | $40.54 |
| J1569 | Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg | $1.5M | 42.2K | $35.76 |
| Q0509 | Miscellaneous supply or accessory for use with any implanted ventricular assist device for which payment was not made under medicare part a | $1.4M | 1.4K | $990.63 |
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.