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

Why is the Medicaid comparison limited to Washington 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. Washington (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 1366554701)

Field	Value
Entity Type	Organization
Organization	Option Care Enterprises, Inc.
Address	728 134th St Sw
City	Everett
State	WA
ZIP	98204
Taxonomy	Home Infusion Therapy Pharmacy
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$5.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	2,790	$780	$2.2M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	6,710	$160	$1.1M
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…	3,440	$130	$447.7K
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…	910	$470	$425K
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	2,790	$110	$293.1K
99601	The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for up to the first two hours of a visit.	2,000	$120	$237.4K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	2,740	$90	$235.8K
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…	1,980	$110	$223.5K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	60	$2,640	$169.2K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	5,540	$20	$116.3K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Washington Distribution

Option Care Enterprises, Inc. — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	5	10	3,990	$610	$2.8M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	8	20	6,040	$210	$2.1M
A4222	Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)	6	10	3,880	$310	$2.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	16	20	190	$1,670	$956.2K
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	10	2,060	$120	$716.9K
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…	7	10	1,140	$450	$561.4K
99601	The provider visits the patient at home to provide an infusion or administer a specialty drug. Use this code for up to the first two hours of a visit.	6	10	2,660	$110	$397.1K
B4185	Parenteral nutrition solution, not otherwise specified, 10 grams lipids	6	10	290	$220	$333.6K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	6	10	1,450	$100	$296.4K
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…	7	20	1,760	$100	$281.3K

Showing 1–10 of 16

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
United Seating And Mobility LLC	WA	Durable Medical Equipment & Medical Supplies	$0	$19M
Therapeutic Health Services	WA	Methadone Clinic	$0	$13.3M
Advanced Lifeline Services Inc	WA	Certified Respiratory Therapist	$0	$8.8M
Vanessa Moeller	WA	Physical Therapist	$190.3K	$0
Walter Akwo	WA	Psychiatric/Mental Health Nurse Practitioner	$132.9K	$0

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