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

Why is the Medicaid comparison limited to Ohio 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. Ohio (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 1376631457)

Option Care Enterprises, Inc. is a home infusion therapy pharmacy provider located in Milford, Ohio. This profile covers 0 Medicare and 44 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Option Care Enterprises, Inc.
Address	50 W Techne Center Dr
City	Milford
State	OH
ZIP	45150
Taxonomy	Home Infusion Therapy Pharmacy
NPI Enumerated	October 11, 2006

Payer Source	Total Paid
Medicaid	$18.9M
Medicare	$0

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	8,240	$1,200	$9.9M
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.	16,480	$110	$1.8M
S9500	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and…	7,350	$150	$1.1M
S9342	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	12,270	$80	$981.3K
A4223	Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)	12,780	$60	$779.5K
S9351	Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment…	1,080	$710	$769.3K
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…	1,710	$350	$592.4K
S9340	Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded…	670	$660	$440.9K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	7,010	$60	$399.5K
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…	4,150	$70	$290.8K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Option Care Enterprises, Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9340	Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded…	4	10	670	$580	$4.6M
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	1	10	1,780	$1,080	$4.1M
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…	24	30	3,220	$390	$1.5M
S9590	Home therapy, irrigation therapy (e.g., sterile irrigation of an organ or anatomical cavity); including administrative services, professional pharmacy services, care coordination, and all necessary…	2	10	970	$1,490	$1.4M
S9342	Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits…	4	10	16,370	$70	$1.2M
S9500	Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and…	4	10	2,450	$140	$851.9K
S9351	Home infusion therapy, continuous or intermittent anti-emetic infusion therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment…	1	10	1,080	$710	$768.9K
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,…	30	40	2,610	$120	$677.4K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	14	50	4,010	$80	$640.4K
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	341	560	3,370	$40	$543.8K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Doctors Urgent Care Offices Medical Group Inc	OH	Urgent Care Clinic/Center	$0	$11.2M
Prestige Patient Transport LLC	OH	Ambulance	$1.3M	$1.2M
Miami Twp Clermont Co	OH	Ambulance	$391.5K	$666.6K
Dipika Patel	OH	Foot & Ankle Surgery Podiatrist	$113.8K	$0
Kelly Bolen	OH	Occupational Therapist	$75.9K	$0
Dolores Holtmann	OH	Family Nurse Practitioner	$40.7K	$0
Richard Ruhl	OH	Anesthesiology Physician	$31.2K	$0
Jennifer Mclellan	OH	Family Medicine Physician	$29.2K	$0

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

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.	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
Option Care Enterprises, Inc.	MO	Home Infusion Therapy Pharmacy	$0	$11.2M