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 Puerto Rico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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.

Best Option Healthcare Puerto Rico LLC (NPI 1164421822)

Field	Value
Entity Type	Organization
Organization	Best Option Healthcare Puerto Rico LLC
Address	355 Avenida De Diego
City	San Juan
State	PR
ZIP	00909
Taxonomy	Home Infusion Therapy Pharmacy
NPI Enumerated	July 15, 2005

Payer Source	Total Paid
Medicaid	$41.5M
Medicare	$0

Key Findings

BEST OPTION HEALTHCARE PUERTO RICO LLC is effectively a single-payer Medicaid operation: it has no Medicare billing on file and reports $41.5M in lifetime Medicaid revenue, so all observable fee-for-service scale in the dataset is concentrated in state Medicaid. This payer mix means analyses of its financial exposure and contracting should focus on Medicaid reimbursement dynamics and state-level competitive positioning rather than Medicare trends.

Revenue is highly concentrated in a small number of codes: the precomputed top three Medicaid codes (S9097, 97602, J9035) together account for 49.7% of the provider’s Medicaid revenue. Those top three codes individually include S9097 ($8.7M, 21.1%), 97602 ($6.3M, 15.3%), and J9035 ($5.4M, 13.3%), indicating that a few services drive nearly half of reported Medicaid receipts.

The provider’s code mix and high-volume codes indicate a home-based infusion and wound-care business model. High-volume home-visit wound care S9097 (111.1K claims) and debridement 97602 (72.2K claims) together with nursing per-diem T1030 (23.1K claims) and infusion administration 96365 (20K claims) point to combined wound-care nursing and infusion therapy operations delivered in patients’ homes.

BEST OPTION is an outlier in several home-care categories within Puerto Rico: S9097 ranks #1 of 23 providers in-state at the 100th percentile and is labeled an "extreme outlier" far above typical state volume for this code. T1030 (nursing care in the home) and 96365 (initial IV infusion up to one hour) also rank #1 in-state and are flagged as extreme outliers, reinforcing that the provider dominates Medicaid home nursing and basic infusion visit volume locally.

The provider also supplies high-cost specialty oncology/biologic drugs alongside home-care services. J9035 (bevacizumab) generated $5.4M across 1.3K claims with a high avg paid/claim of $4133 and ranks #4 of 23 providers (86th percentile), while J9355 (trastuzumab) generated $3.7M and ranks #3 of 6 providers (60th percentile), showing meaningful revenue from specialty injectables typical of infusion pharmacies.

Per-claim payment patterns and equipment codes suggest an integrated clinical-supply offering: several high avg-paid injectable codes (for example J9035 at $4133/claim and J9355 at $4361/claim) plus durable-device billing such as E2402 (negative pressure wound therapy pump, $1.1M) and S9494 (home infusion per diem services, $1M) are consistent with a provider that combines drug dispensing, nursing visits, and durable equipment in home-based care packages.

Competitively, the provider is a dominant state player for home wound care and basic infusion visits but a more typical participant for expensive biologic drugs. Its #1 statewide ranks and 100th-percentile positions on S9097, T1030, and 96365 indicate market leadership in those service lines, while its rankings for high-cost drugs (e.g., J9035 at the 86th percentile, J9355 at the 60th percentile) show it participates meaningfully in specialty drug dispensing without being the clear statewide leader for those products.

The entity appears established and operationally mature: its NPI was enumerated on 2005-07-15 (~21 years ago), which combined with very large claim volumes (e.g., 111.1K S9097 claims and 72.2K 97602 claims) suggests substantial local capacity and an entrenched home-infusion/wound-care footprint. That maturity and volume concentration imply both operational scale advantages and potential revenue concentration risk if Medicaid coverage or coding patterns change for the few codes that produce most revenue.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9097	Home visit for wound care	111,090	$80	$8.7M
97602	The provider removes dead tissue from a wound without differentiating between viable and nonviable tissues. This service helps in assessing the depth of the wound, reduces the risk of infection and…	72,200	$90	$6.3M
J9035	Injection, bevacizumab, 10 mg	1,320	$4,130	$5.4M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	840	$4,360	$3.7M
T1030	Nursing care, in the home, by registered nurse, per diem	23,090	$110	$2.5M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	20,020	$110	$2.2M
J9299	Injection, nivolumab, 1 mg	630	$3,560	$2.2M
J9306	Injection, pertuzumab, 1 mg	420	$4,280	$1.8M
J9271	Injection, pembrolizumab, 1 mg	270	$4,240	$1.1M
J9312	Injection, rituximab, 10 mg	280	$3,990	$1.1M

Showing 1–10 of 52

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Puerto Rico Distribution

Best Option Healthcare Puerto Rico LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. Puerto Rico median

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	3	10	220	$9,780	$16.9M
J9299	Injection, nivolumab, 1 mg	3	10	1,120	$7,470	$8M
J9306	Injection, pertuzumab, 1 mg	3	10	420	$5,490	$5M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	3	10	490	$4,520	$4.4M
J9312	Injection, rituximab, 10 mg	3	10	720	$4,970	$3.3M
J0897	Injection, denosumab, 1 mg	4	10	940	$2,500	$3.2M
J9035	Injection, bevacizumab, 10 mg	4	20	370	$2,820	$2.3M
97602	The provider removes dead tissue from a wound without differentiating between viable and nonviable tissues. This service helps in assessing the depth of the wound, reduces the risk of infection and…	1	10	2,250	$80	$1.2M
J9395	Injection, fulvestrant, 25 mg	4	10	750	$1,210	$903K
S9097	Home visit for wound care	1	20	4,150	$70	$761.3K

Showing 1–10 of 52

Nearby Providers

Other providers in the same ZIP code as Best Option Healthcare Puerto Rico LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vita Healthcare Inc	PR	Home Health Agency	$0	$9.4M
Eladio Perez Cruz	PR	Gastroenterology Physician	$2.1K	$2.5M
Felix Lugo-adams	PR	Interventional Cardiology Physician	$3.7K	$1.9M
Farmacia San Rafael Santurce, Inc	PR	Community/Retail Pharmacy	$0	$1.5M
Lauren Lynch	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
St Gianna Pediatrics	PR	Pediatrics Physician	$0	$1.3M
Jaime Ruiz-rodriguez	PR	Cardiovascular Disease Physician	$17.7K	$1.2M
Empresas Alvaro Torres	PR	Speech-Language Pathologist	$0	$1.1M
Best Option Healthcare Puerto Rico LLC	PR	Home Health Agency	$0	$1.1M
Ag Thyroid & Endocrine Clinic LLC	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$983.2K

Best Option Healthcare Puerto Rico LLC — Billing Profile & Reimbursement Data

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Best Option Healthcare Puerto Rico LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References