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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 1548347156)

Field	Value
Entity Type	Organization
Organization	Option 1 Nutrition Solutions LLC
Address	4990 Nome St
City	Denver
State	CO
ZIP	80239
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$168.4M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: Medicare billing is listed as none (no Medicare billing on file), while total Medicaid revenue is $168.4M, indicating that Medicaid entirely dominates the observable public-payer business for this NPI. Analysts should treat Medicaid trends as the primary driver of overall revenue and operational scale.

Revenue is highly concentrated in a small set of enteral nutrition codes: the precomputed top 3 Medicaid codes account for 56.2% of this provider's total Medicaid revenue, with B4160 ($36M, 21.9%), B4161 ($31.8M, 19.3%), and B4035 ($24.6M, 14.9%) standing out as the dominant revenue drivers. This concentration implies that changes to coverage or pricing for those codes would materially affect the provider's topline.

The code mix reflects a specialized DME operation focused on enteral nutrition and pediatric formulas: high-volume pediatric formula codes such as B4160 (116.9K claims) and B4161 (43.6K claims) appear alongside large volumes for feeding supply kits (B4035, 98.2K claims) and gastrostomy/jejunostomy tubes (B4088, 74.3K claims). Together these patterns point to a business model centered on recurring supplies and device provisioning for tube-fed patients, including substantial pediatric demand.

Competitive standing within Colorado is dominant for core product lines: multiple top codes rank #1 in-state and are described as extreme outliers, for example B4160 ranks #1 of 22 providers (100th percentile), B4161 ranks #1 of 14 providers (100th percentile), and B4035 ranks #1 of 22 providers (100th percentile). These rankings indicate the provider is the leading in-state supplier for several enteral nutrition and supply codes, far exceeding typical peer volumes.

Claim volumes are large and operationally significant, consistent with a high-throughput supply business: examples include 116.9K claims for B4160, 108.2K claims for B9998, and 98.2K claims for B4035. The mix of very high claim counts and recurring‑use codes suggests long-term dispensing relationships with Medicaid beneficiaries rather than one-off device sales.

The provider supplies both consumable nutrition products and supporting equipment, indicating diversified DME lines of business: beyond formulas (e.g., B4153 $4.6M; B4150 $3.5M), it bills for supplies and devices such as B4088 gastrostomy/jejunostomy tubes ($10M, 6.1%) and B9002 enteral nutrition infusion pumps ($1.8M, 1.1%). This balance between high-revenue consumables and device/supply lines suggests vertical breadth in enteral nutrition provisioning.

Many of the provider's leading codes are flagged as statistical extremes or notably above typical state volume, reinforcing its outlier status: several top codes are labeled "extreme outlier" or "notably above typical," including B4160, B4161, B4035 and others, while a few codes (e.g., A4554, A6212) appear at more typical volumes. For network or competitive analyses, treat the provider as an outsized, specialized player for enteral-related Medicaid billing rather than a representative average supplier.

The NPI tenure is long-standing: enumerated on 2006-11-01 (~20 years ago), which combined with the current Medicaid scale ($168.4M) implies an established operation with sustained relationships in the state Medicaid market. Longevity plus concentrated, high-volume code performance increases the likelihood that the provider is a persistent market leader in its niche.

Medicaid: Complete Services Breakdown

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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,…	116,890	$310	$36M
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…	43,580	$730	$31.8M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	98,250	$250	$24.6M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	35,330	$350	$12.3M
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	74,280	$130	$10M
B9998	Noc for enteral supplies	108,180	$80	$8.2M
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…	8,260	$550	$4.6M
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	24,120	$180	$4.3M
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…	23,920	$180	$4.2M
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…	28,120	$140	$3.9M

Showing 1–10 of 65

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Option 1 Nutrition Solutions LLC — 20 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

65 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	1,430	$720	$3.4M
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	20	2,100	$310	$2.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	20	2,840	$230	$1.8M
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	1,400	$340	$1.4M
B4088	Gastrostomy/jejunostomy tube, low-profile, any material, any type, each	1	10	2,420	$140	$1.3M
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…	2	10	670	$450	$1.1M
B9998	Noc for enteral supplies	1	10	4,710	$80	$1M
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…	1	20	840	$310	$871K
T4527	Adult sized disposable incontinence product, protective underwear/pull-on, large size, each	26	40	2,280	$150	$795.4K
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	1	20	2,210	$170	$748.4K

Showing 1–10 of 65

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
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

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
Kaiser Foundation Health Plan Of Colorado	CO	Clinical Medical Laboratory	$118.8K	$19.8M
Queen's Care In Home Inc.	CO	Respite Care	$0	$18.4M
Peoples Day Services	CO	Developmentally Disabled Services Day Training Agency	$0	$15.4M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$15.2M
Peoplecare Of Eastern Colorado, LLC	CO	In Home Supportive Care Agency	$0	$8M
Magnolia Medical Company	CO	Clinical Medical Laboratory	$0	$5.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$5M
New Schryver LLC	CO	Clinical Medical Laboratory	$1.3M	$3.1M
Kan-di-ki LLC	CO	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1M	$289.2K
Kan-di-ki LLC	CO	Diagnostic Ultrasound Physician	$80.1K	$0

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