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

Why is the Medicaid comparison limited to Nevada 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. Nevada (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 1 Nutrition Solutions, LLC (NPI 1396823654)

Field	Value
Entity Type	Organization
Organization	Option 1 Nutrition Solutions, LLC
Address	5670 Wynn Rd Ste F
City	Las Vegas
State	NV
ZIP	89118
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	November 2, 2006

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid supplier: there is no Medicare billing on file and lifetime Medicaid revenue is $15.1M. The absence of Medicare activity indicates the practice’s commercial scale and reimbursement exposure are concentrated in Medicaid programs rather than split across federal Medicare accounts.

Revenue is highly concentrated in a small set of enteral nutrition lines: the precomputed top‑3 Medicaid codes (B4161, B4160, B4035) account for 74.0% of the provider’s total Medicaid revenue. The three top codes are B4161 ($5.1M, 34.0%), B4160 ($3.1M, 20.9%), and B4035 ($2.9M, 19.0%), which together dominate this provider’s billing footprint.

The code mix signals a specialized parenteral/enteral nutrition DME operation with a pediatric emphasis: B4161 and B4160 are pediatric enteral formulas and together represent a majority of revenue, while B4035 (pump‑fed daily supply kits) is the third largest revenue driver. Unit payment patterns reinforce this focus — B4161 shows a high average paid/claim ($1017) compared with B4160 ($382) and B4035 ($213), consistent with specialized pediatric formula reimbursement.

Competitive standing in Nevada appears dominant for core enteral lines: the provider ranks #1 in‑state and at the 100th percentile for primary codes including B4161, B4160, and B4035, which indicates it is the leading supplier statewide for these items. This statewide dominance on the highest‑revenue codes suggests it is the market leader among Nevada DME suppliers for pediatric enteral nutrition.

The vendor’s portfolio extends beyond formula to connected supplies and equipment, providing some diversification of revenue: notable supporting codes include B4149 ($1.8M, 11.8%), B4034 ($549.1K, 3.6%), B4088 ($402.7K, 2.7%), and B9002 ($113.5K, 0.8%). Several of these auxiliary codes also rank at the 100th percentile or are described as “typical,” indicating the provider bundles formulas with feeding supplies, tubes, and infusion pumps rather than selling formulas alone.

Several high‑volume codes are flagged as notably above typical state volume or otherwise extreme relative to peers — the dataset explicitly notes B4161, B4160, B4035, B4088, B9002, and E0776 as notably above typical state volume and many of these rank #1 in‑state. This pattern of multiple “notably above typical” code flags corroborates the provider’s unusually large market share in Nevada for enteral nutrition and related DME.

Despite clear leadership on primary enteral codes, the provider is not universally dominant across all supply categories: codes for incontinence and some adult products show more modest positioning (for example, T4522 ranks #6 of 21, 75th percentile; T4541 ranks #9 of 31, 73rd percentile). These middling ranks on noncore products imply the business’s competitive advantage is concentrated in pediatric enteral nutrition rather than across every DME supply line.

The provider has an established operating history, with its NPI enumerated on 2006-11-02 (~20 years ago), which supports the picture of a long‑standing DME supplier that has built scale in Medicaid pediatric enteral nutrition over time. Longevity combined with concentrated, high‑percentile billing suggests entrenched relationships with state Medicaid formularies and referral sources.

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	5,050	$1,020	$5.1M
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,…	8,240	$380	$3.1M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	13,490	$210	$2.9M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	5,330	$330	$1.8M
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	4,500	$120	$549.1K
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	4,790	$80	$402.7K
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	3,130	$60	$178.4K
T4530	Pediatric sized disposable incontinence product, brief/diaper, large size, each	3,210	$60	$176.6K
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	2,420	$70	$161.8K
T4541	Incontinence product, disposable underpad, large, each	4,940	$30	$128.4K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Option 1 Nutrition Solutions, LLC — 11 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

25 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…	1	10	250	$930	$905.7K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	10	3,440	$180	$673K
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	10	820	$360	$604.5K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1	10	850	$310	$571.8K
T4541	Incontinence product, disposable underpad, large, each	9	30	1,460	$30	$266K
T4526	Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each	24	30	990	$70	$238.1K
T4523	Adult sized disposable incontinence product, brief/diaper, large, each	8	20	370	$80	$199.7K
B4034	Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	10	1,630	$100	$183.7K
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	1,000	$110	$134.5K
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	6	20	670	$60	$133.1K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Option 1 Nutrition Solutions, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Option 1 Nutrition Solutions LLC	CO	Parenteral & Enteral Nutrition Supplies (DME)	$0	$168.4M
Option 1 Nutrition Solutions, LLC	AZ	Parenteral & Enteral Nutrition Supplies (DME)	$0	$79M

Nearby Providers

Other providers in the same ZIP code as Option 1 Nutrition Solutions, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spring Valley Medical Center	NV	General Acute Care Hospital	$0	$33.5M
Optum Frontier Therapies Ii, LLC	NV	Community/Retail Pharmacy	$0	$9.3M
J Paul Wiesner & Associates Chartered	NV	Diagnostic Radiology Physician	$0	$5.6M
Spring Valley Dialysis Center LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.4M
Little Smiles LLC	NV	Pediatric Dentistry	$0	$4.2M
Procare Medical Group LLC	NV	Urgent Care Clinic/Center	$0	$2.9M
1 Love Wellness Society LLC	NV	Community/Behavioral Health Agency	$0	$2.1M
Mobile Mental Health Support Services, Inc.	NV	Physical Disabilities Residential Treatment Facility	$0	$2.1M
Rosa Bellota	NV	Child & Adolescent Psychiatry Physician	$51.1K	$2M
My Genius Lab LLC	NV	Clinical Medical Laboratory	$544.7K	$1.5M

Option 1 Nutrition Solutions, LLC — Billing Profile & Reimbursement Data

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Option 1 Nutrition Solutions, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References