Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Colorado (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Option Care Enterprises, Inc. (NPI 1083775621)

Field	Value
Entity Type	Organization
Organization	Option Care Enterprises, Inc.
Address	345 Inverness Dr S
City	Englewood
State	CO
ZIP	80112
Taxonomy	Home Infusion Therapy Pharmacy
NPI Enumerated	December 13, 2006

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	6,810	$160	$1.1M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	1,740	$550	$958.7K
B4224	Parenteral nutrition administration kit, per day	8,680	$100	$877.1K
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	1,500	$310	$462.6K
B4220	Parenteral nutrition supply kit; premix, per day	8,400	$30	$268.9K
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	2,270	$90	$206.1K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	7,030	$20	$154.7K
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	1,710	$90	$147.2K
B4152	Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include…	1,880	$70	$131.5K
A4211	Supplies for self-administered injections	11,210	$10	$112.1K

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.

Claims Volume vs. Colorado Distribution

Option Care Enterprises, Inc. — 1 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	6	10	1,430	$720	$3.4M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	13	20	2,100	$310	$2.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	7	20	2,840	$230	$1.8M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	11	10	1,400	$340	$1.4M
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	8	10	2,420	$140	$1.3M
B9998	Noc for enteral supplies	12	10	4,710	$80	$1M
B4155	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium…	17	20	840	$310	$871K
B4158	Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an…	7	10	1,110	$230	$693.6K
B4224	Parenteral nutrition administration kit, per day	2	10	6,370	$80	$486.7K
B4150	Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100…	26	40	1,190	$90	$424.3K

Showing 1–10 of 19

Related Providers

Other providers that share a Tax Identification Number (TIN) with Option Care Enterprises, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trinity Homecare LLC	NY	Home Infusion Therapy Pharmacy	$0	$46.8M
Option Care Enterprises, Inc.	IL	Home Infusion Therapy Pharmacy	$0	$45.6M
Option Care Enterprises Inc	KY	Pharmacy	$0	$39.1M
Option Care Enterprises Inc	MA	Home Infusion Therapy Pharmacy	$0	$37M
Option Care Enterprises, Inc.	FL	Home Infusion Therapy Pharmacy	$0	$29.3M
Option Care Enterprises, Inc.	OH	Home Infusion Therapy Pharmacy	$0	$18.9M
Option Care Enterprises, Inc.	WA	Home Infusion Therapy Pharmacy	$0	$18.9M
Option Care Enterprises, Inc.	TX	Home Infusion Therapy Pharmacy	$0	$13.8M
Option Care Enterprises, Inc	CT	Home Infusion Therapy Pharmacy	$0	$13.3M
Option Care Home Care Inc	WI	Pharmacy	$0	$12.5M

Nearby Providers

Other providers in the same ZIP code as Option Care Enterprises, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America	CO	Clinical Medical Laboratory	$14.9M	$77.8M
R&a Home Care	CO	Home Health Agency	$0	$83.4M
Antonina Health Care LLC	CO	Home Health Agency	$0	$36.6M
Highpointe Services	CO	Developmentally Disabled Services Day Training Agency	$0	$24M
Radiology Imaging Associates, PC	CO	Diagnostic Radiology Physician	$0	$18.8M
Mairik Adult Day Care	CO	Adult Day Care Clinic/Center	$0	$16.3M
Dawson Thomas, Inc.	CO	Home Health Agency	$0	$8.8M
South Metro Fire Rescue Fire Protection District	CO	Land Ambulance	$2.2M	$6.1M
Apria Healthcare LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$7.7M
Amerita, Inc.	CO	Home Infusion Therapy Pharmacy	$0	$7.4M

Option Care Enterprises, Inc. — Billing Profile & Reimbursement Data

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Option Care Enterprises, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References