Procare Pharmacy Direct, Llc.
Pharmacy, Community/Retail Pharmacy
Monroeville, Pennsylvania
NPI: 1043382302
Risk Tier
Elevated
Total Paid
$227.3M
$227,313,342
Total Claims
83K
Beneficiaries
67K
Avg Cost/Claim
$2,742.32
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (1)
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 32 procedure codes: J0584 at 1.3× median, J1726 at 3.6× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024