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NPI 1164612040 · West Allis, WI · Home Infusion Therapy Pharmacy
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Visiting Nurse Association Of Wisconsin, Inc. is a home infusion therapy pharmacy provider located in West Allis, Wisconsin. This profile covers 0 Medicare and 94 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Visiting Nurse Association Of Wisconsin, Inc. |
| Address | 11333 W National Ave |
| City | West Allis |
| State | WI |
| ZIP | 53227 |
| Taxonomy | Home Infusion Therapy Pharmacy |
| NPI Enumerated | July 27, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $21.3M |
| Medicare | $0 |
This provider is effectively a single-payer Medicaid supplier: there is no Medicare billing on file and lifetime Medicaid revenue is $21.3M. That concentration means payer exposure is heavily skewed to state Medicaid policy and fee schedules rather than a blended Medicare/Medicaid risk profile.
Medicaid revenue is materially concentrated in a small set of codes: the precomputed top three Medicaid codes account for 35.3% of total Medicaid revenue. The top three drivers are E1390 ($2.6M revenue, 13.2%), B4035 ($2.3K claims, $2.3M revenue, 12.1%), and E0601 ($2M revenue, 10.1%), indicating a tight revenue share among a few high-volume items.
The service mix indicated by dominant codes points to a hybrid operation focused on respiratory durable medical equipment and enteral/home infusion supplies. High-revenue respiratory items (E0601, E1390, E0562) alongside enteral items (B4035, B4160, B4149, B4088) align with the Home Infusion Therapy Pharmacy taxonomy while showing the provider also functions as a major DME/respiratory supplier.
Competitive standing in the state is strong on multiple respiratory lines: E0601 ranks #1 of 88 providers in-state (100th percentile; extreme outlier), and E0562 ranks #1 of 88 providers in-state (100th percentile; extreme outlier). E1390 and several mask/tubing/accessory codes (A7030, A7035, A7037) are ranked at or near the top (99th percentile and above), signaling the provider is a dominant statewide supplier for CPAP/oxygen-related products.
The provider is also a significant player in enteral nutrition and supplies regionally: B4035 ranks #2 of 20 providers in-state (95th percentile) and B4160 ranks #2 of 10 providers in-state (89th percentile). Multiple enteral formulas and tube supplies (B4149, B4161, B4152, B4150) appear in the top codes list, demonstrating a broad enteral product mix that supports recurring, per-day billing patterns.
Several high-volume accessory and consumable codes support large recurring revenue streams — for example, A7035 (headgear) and A7037 (tubing) appear with very high claim counts and rank in the 99th percentile statewide. These consumable lines (also including A7046 water chambers and A7038 filters) typically drive steady, repeated utilization and suggest operational focus on supply logistics and replenishment.
Rental and complex device codes such as E0431 (portable gaseous oxygen system, rental; $682.7K revenue, ranks #2 of 59 providers) and E0465 (home ventilator; $628.7K revenue) indicate the provider manages both high-volume consumables and capital-equipment rentals. The mix of rental devices, high-cost ventilators, and per-day enteral supplies implies a diversified revenue structure within Medicaid but still concentrated by payer.
The NPI tenure signals an established presence in the market: the NPI was enumerated 2007-07-27 (~19 years ago). Long standing enrollment combined with top-state rankings on multiple codes suggests an experienced operator with entrenched distribution and billing processes in Wisconsin Medicaid markets.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
94 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 29,420 | $90 | $2.6M |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 13,240 | $180 | $2.3M |
| E0601 | Continuous positive airway pressure (CPAP) device | 35,700 | $60 | $2M |
| A7030 | Full face mask used with positive airway pressure device, each | 11,900 | $130 | $1.6M |
| 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,… | 7,350 | $190 | $1.4M |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 2,890 | $410 | $1.2M |
| 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… | 2,300 | $420 | $972.5K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 10,950 | $80 | $908.7K |
| E0562 | Humidifier, heated, used with positive airway pressure device | 32,980 | $30 | $890.5K |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | 8,480 | $80 | $704K |
Showing 1–10 of 94
How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wisconsin median
94 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 3 | 10 | 1,140 | $440 | $999.5K |
| B4149 | Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 3 | 10 | 2,610 | $310 | $912.3K |
| 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… | 3 | 10 | 2,300 | $370 | $781.6K |
| B4035 | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape | 2 | 20 | 530 | $140 | $543.1K |
| 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,… | 2 | 10 | 1,870 | $150 | $413.2K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 2 | 70 | 4,670 | $40 | $311K |
| B4088 | Gastrostomy/jejunostomy tube, low-profile, any material, any type, each | 3 | 10 | 2,720 | $60 | $291.8K |
| A7520 | Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each | 4 | 10 | 570 | $30 | $201.2K |
| B4153 | Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral… | 3 | 10 | 270 | $400 | $182.8K |
| 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… | 3 | 10 | 350 | $110 | $177.7K |
Showing 1–10 of 94
Other providers in the same ZIP code as Visiting Nurse Association Of Wisconsin, Inc., ranked by combined Medicare and Medicaid revenue.
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