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NPI 1770528994 · Upper Chichester, PA · Home Infusion Therapy Pharmacy
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Pentec Health Inc is a home infusion therapy pharmacy provider located in Upper Chichester, Pennsylvania. This profile covers 7 Medicare and 26 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Pentec Health Inc |
| Address | 4 Creek Pkwy |
| City | Upper Chichester |
| State | PA |
| ZIP | 19061 |
| Taxonomy | Home Infusion Therapy Pharmacy |
| NPI Enumerated | June 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $40.2M |
| Medicare | $4.4M |
PENTEC HEALTH INC is a home infusion therapy pharmacy by taxonomy and its claims mix confirms focus on infusion and implantable pump services: Medicare top codes are dominated by compounded drug administrations (J7999) and intrathecal/spinal injections such as baclofen (J0475) and ziconotide (J2278), while Medicaid revenues are concentrated in per-diem home infusion service codes (S9363, S9328) and multiple parenteral nutrition product codes (B4197, B4193). This mix indicates the operation combines high-volume drug compounding for infusion with care coordination and pump-related services rather than being a general retail pharmacy.
Revenue concentration is high on both payers: the precomputed top three Medicare codes account for 94.3% of total Medicare revenue, indicating Medicare income is extremely concentrated in a very small set of services; similarly, the top three Medicaid codes account for 65.7% of total Medicaid revenue, showing Medicaid revenue is also focused but somewhat more distributed across infusion and nutrition products.
Scale and payer mix show Medicaid dominates this provider’s public-payer footprint in dollar terms: lifetime Medicaid revenue is $40.2M compared with $4.4M in Medicare, making Medicaid the primary revenue source by an order of magnitude and suggesting the provider’s business model and customer base are heavily oriented toward state-covered home infusion and parenteral nutrition programs.
Competitive standing on Medicare is exceptional for several high-revenue codes: J7999 ranks #1 of 1333 providers nationally and is labeled an extreme outlier, and J0475 ranks #1 of 111 providers nationally (extreme outlier), indicating PENTEC HEALTH is a dominant national volume driver for compounded infusion drugs and baclofen injections. On Medicaid, the provider also shows dominant in-state positions for key service lines — S9363 ranks #1 of 2 in-state and S9328 ranks #1 of 1 in-state — supporting a strong statewide presence in home infusion per-diem services.
Several individual codes are flagged as statistical outliers or notably above typical volume: on Medicare J7999 and J0475 are extreme outliers (100th percentile) and J2278 is also ranked #1 of 2 providers; on Medicaid S9363 and J0475 are 100th-percentile in-state rankings or notably above typical state volume. These labels indicate PENTEC HEALTH performs at volumes far above typical peers for multiple specialized infusion and compounded drug services.
Service-level detail shows both device/pump management and nutrition therapy are material business lines: Medicare includes A4220 (refill kit for implantable infusion pump) and pump-related injection codes, while Medicaid lists multiple parenteral nutrition codes (B4197, B4193, B4189, B4224) and high per-diem infusion codes, implying the provider supplies both pump maintenance/visits and complex nutrition compounding.
Operational tenure is long: the NPI was enumerated around 2006-06-19 (~20 years ago), indicating the provider has an established presence and multi-year operational history in the home infusion market.
Volume and unit-payment signals differ by payer: several high-volume Medicare codes have relatively low avg paid/claim (e.g., J2278 $7 avg, J1170 $3 avg) while some Medicaid per-diem codes carry high avg paid/claim (e.g., S9363 $748 avg, S9328 $405 avg), suggesting Medicare revenue is driven by very high claim counts for lower-priced items and Medicaid revenue is driven by fewer, higher-priced per-diem service payments.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
7 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J7999 | Compounded drug, not otherwise classified | 9,880 | $220 | $2.2M |
| J0475 | Injection, baclofen, 10 mg | 10,800 | $140 | $1.5M |
| J2278 | Injection, ziconotide, 1 microgram | 53,500 | $10 | $374.5K |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | 10,710 | $10 | $107.1K |
| A4220 | Refill kit for implantable infusion pump | 6,810 | $20 | $102.1K |
| J1170 | Injection, hydromorphone, up to 4 mg | 13,550 | $1 | $40.6K |
| J3010 | Injection, fentanyl citrate, 0.1 mg | 710 | $1 | $710 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
26 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| S9363 | Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded… | 18,930 | $750 | $14.2M |
| S9328 | Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing… | 16,160 | $410 | $6.5M |
| B4197 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix | 36,090 | $160 | $5.7M |
| B4193 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix | 26,360 | $130 | $3.5M |
| J0475 | Injection, baclofen, 10 mg | 11,930 | $210 | $2.5M |
| B4189 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix | 18,880 | $130 | $2.4M |
| B4224 | Parenteral nutrition administration kit, per day | 88,270 | $10 | $1.1M |
| S9325 | Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded… | 1,020 | $1,120 | $1.1M |
| B4199 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix | 3,990 | $190 | $754.3K |
| 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. | 9,270 | $60 | $519.2K |
Showing 1–10 of 26
How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Pennsylvania median
26 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| S9363 | Home infusion therapy, anti-spasmotic therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded… | 1 | 10 | 9,810 | $750 | $7.3M |
| S9328 | Home infusion therapy, implanted pump pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing… | 1 | 10 | 16,160 | $400 | $6.5M |
| B4197 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix | 1 | 10 | 36,090 | $160 | $5.8M |
| B4193 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix | 1 | 10 | 26,360 | $130 | $3.5M |
| B4189 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix | 1 | 10 | 18,880 | $130 | $2.4M |
| S9325 | Home infusion therapy, pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment, (drugs and nursing visits coded… | 1 | 10 | 1,020 | $1,120 | $1.1M |
| B4199 | Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix | 1 | 10 | 3,990 | $190 | $754.9K |
| 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. | 5 | 20 | 4,620 | $80 | $561.5K |
| J0475 | Injection, baclofen, 10 mg | 1 | 10 | 330 | $200 | $443K |
| S9379 | Home infusion therapy, infusion therapy, not otherwise classified; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and… | 3 | 10 | 1,830 | $190 | $359.2K |
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Other providers in the same ZIP code as Pentec Health Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Paul Frumento | PA | Podiatrist | $246.3K | $0 |
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