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

Why is the Medicaid comparison limited to Texas 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. Texas (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.

Star Formula Inc (NPI 1538511910)

Star Formula Inc is a durable medical equipment & medical supplies provider located in Addison, Texas. This profile covers 0 Medicare and 45 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	Star Formula Inc
Address	4386 Sunbelt Dr
City	Addison
State	TX
ZIP	75001
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	July 8, 2016

Payer Source	Total Paid
Medicaid	$13.4M
Medicare	$0

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

45 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…	8,910	$500	$4.5M
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,…	14,780	$170	$2.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	6,550	$250	$1.6M
B9998	Noc for enteral supplies	11,130	$60	$712.2K
B4155	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium…	2,850	$250	$699.9K
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…	2,320	$200	$466.7K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1,750	$250	$430.3K
E0603	Breast pump, electric (ac and/or dc), any type	3,030	$130	$396.5K
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…	1,150	$280	$323.1K
B4158	Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an…	1,450	$200	$295K

Showing 1–10 of 45

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Star Formula Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

45 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…	11	40	2,180	$270	$7.2M
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,…	10	50	2,810	$150	$3.2M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	18	60	2,520	$210	$1.8M
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…	18	20	630	$1,010	$1.2M
E0603	Breast pump, electric (ac and/or dc), any type	8	20	1,510	$140	$1.1M
B9998	Noc for enteral supplies	15	60	4,690	$90	$1.1M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	14	30	1,100	$360	$977.3K
B4155	Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium…	12	30	1,340	$250	$771.4K
B4158	Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an…	10	20	1,580	$160	$478.4K
B4154	Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or…	26	30	640	$280	$397.3K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mga Healthcare Texas, LLC	TX	Home Health Agency	$0	$49.6M
Elitemed Laboratories, LLC	TX	Clinical Medical Laboratory	$2M	$2.7M
Lost Pines Mobile Imaging LLC	TX	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$2.5M	$933.8K
Pruven Health	TX	Clinical Medical Laboratory	$2.1M	$503.4K
Linear Care Diagnostics	TX	Clinical Medical Laboratory	$1.1M	$1.4M
Tameka Simmons	TX	Family Nurse Practitioner	$897.8K	$0
Reliance Imaging LLC	TX	Vascular Sonography Radiologic Technologist	$428.8K	$115.7K
Texas Center For Interventional Surgery, LLC	TX	Ambulatory Surgical Clinic/Center	$488.4K	$0
Marvin Fojtasek	TX	Infectious Disease Physician	$440.6K	$0
William Tucker	TX	Orthopaedic Surgery Physician	$351.5K	$0

Star Formula Inc — Billing Profile & Reimbursement Data

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Star Formula 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

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Frequently Asked Questions

References