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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 1700827631)

Option Care Enterprises, Inc. is a home infusion therapy pharmacy provider located in Grand Rapids, Michigan. This profile covers 0 Medicare and 27 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	1255 Michigan St Ne
City	Grand Rapids
State	MI
ZIP	49503
Taxonomy	Home Infusion Therapy Pharmacy
NPI Enumerated	June 10, 2006

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	10,500	$140	$1.4M
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…	3,580	$380	$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…	29,250	$20	$526.6K
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,…	2,970	$140	$400.8K
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…	2,720	$130	$348.2K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	1,260	$270	$344.1K
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…	4,440	$70	$292.8K
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…	630	$460	$291.1K
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…	2,260	$120	$278.5K
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.	4,160	$60	$261.9K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Option Care Enterprises, Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

27 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…	3	10	1,060	$450	$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…	2	10	32,970	$20	$666.5K
B4154	Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or…	4	10	910	$130	$532K
B4185	Parenteral nutrition solution, not otherwise specified, 10 grams lipids	3	10	1,770	$170	$486.1K
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…	3	10	610	$400	$443.6K
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	3	50	450	$140	$348.3K
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,…	7	30	1,010	$150	$347.2K
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	2	10	1,160	$270	$338.9K
B4224	Parenteral nutrition administration kit, per day	4	10	840	$150	$328K
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…	20	50	1,510	$70	$292K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectrum Health Hospitals	MI	General Acute Care Hospital	$0	$243.2M
Kent County Cmh Authority	MI	Community/Behavioral Health Agency	$0	$97.6M
Saint Mary's Health Services	MI	General Acute Care Hospital	$0	$92M
Cancer & Hematology Centers Of Western Mi, P.C.	MI	Specialist	$0	$59.5M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$50.9M
Ecs Western Michigan PC	MI	Emergency Medicine Physician	$0	$50.6M
Neo Natal Associates Plc	MI	Neonatal-Perinatal Medicine Physician	$0	$27.7M
Spectrum Health Hospitals	MI	Hospitalist Physician	$0	$25.2M
Life Ems Inc	MI	Land Ambulance	$3.1M	$22M
Cherry Street Services, Inc.	MI	Federally Qualified Health Center (FQHC)	$0	$24.6M

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

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