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

Why is the Medicaid comparison limited to Arizona 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. Arizona (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 1871509489)

Key Findings

Field	Value
Entity Type	Organization
Organization	Option 1 Nutrition Solutions, LLC
Address	2460 E Germann Rd.
City	Chandler
State	AZ
ZIP	85286
Taxonomy	Parenteral & Enteral Nutrition Supplies (DME)
NPI Enumerated	August 1, 2006

Payer Source	Total Paid
Medicaid	$79M
Medicare	$0

OPTION 1 NUTRITION SOLUTIONS, LLC is a specialized Parenteral & Enteral Nutrition Supplies (DME) provider based in CHANDLER, AZ with $79M in lifetime Medicaid revenue and no Medicare billing on file; its NPI was enumerated 2006-08-01 (~20 years ago), indicating longstanding presence in the market. The absence of Medicare activity means the organization operates effectively as a single-payer (Medicaid) DME supplier at scale.

The provider's revenue and claim mix are dominated by pediatric enteral nutrition and associated supply kits: B4161 (74.9K claims, $270 avg paid/claim, $20.2M), B4160 (173.8K claims, $94 avg paid/claim, $16.3M), and B4035 (141.2K claims, $104 avg paid/claim, $14.7M). These codes point to an operation supplying calorically quantified enteral formulas and pump-fed daily kits rather than primarily supplying adult or orthotic DME lines.

Revenue is highly concentrated: the top three Medicaid codes (B4161, B4160, B4035) account for 65.4% of this provider's total Medicaid revenue. That concentration signals that shifts in coverage, reimbursement, or utilization for pediatric enteral formulas and pump kits would disproportionately affect overall revenue.

Competitive standing in-state is dominant for the core product set: this provider ranks #1 and at the 100th percentile for a wide array of enteral codes (including B4161, B4160, B4035, B9998, B4149, B4158, B4152, B9002 and others), indicating it is a market leader across Arizona for pediatric enteral formulas, feeding kits, and related supplies. B4035 is described as an "extreme outlier, far above typical state volume," reinforcing that the provider runs substantially higher volumes than peers for pump-fed daily supply kits.

Operational scale is evident from claims volumes on primary codes—173.8K claims for B4160, 74.9K claims for B4161, and 141.2K claims for B4035—showing high throughput and suggesting broad, ongoing dispensing to a pediatric enteral population or large managed-care contracts. High claim counts combined with mid-range average paid/claim values point to a business model based on volume delivery of recurring nutritional products and daily supplies.

The provider’s product breadth extends beyond formulas to equipment and consumables: B9002 (enteral nutrition infusion pump, 62.5K claims, $35 avg paid/claim, $2.2M) and B4088 (gastrostomy/jejunostomy tube, 37.7K claims, $36 avg paid/claim, $1.4M) indicate the company supplies both infusion devices and procedural consumables, supporting an end-to-end enteral nutrition service line. This mix aligns with a DME supplier that bundles pumps, tubing, kits, and formula for pediatric patients.

Dependence on Medicaid ($79M) with no Medicare revenue creates payer concentration risk: operational performance and margins are likely sensitive to state Medicaid policy changes, provider enrollment rules, and fee schedule adjustments in Arizona. The provider’s exposure is concentrated by product line as well, given that B4161/B4160/B4035 together make up the bulk of revenue.

Not all codes are extreme: several items are labeled as "typical, unremarkable volume" despite ranking #1 (for example, B9998 with 63.1K claims, $51 avg paid/claim, $3.2M and B4162 with 2.2K claims, $378 avg paid/claim, $816.5K). Meanwhile, many other codes are described as "notably above typical state volume," which together paints a picture of a dominant specialist with a few routine-volume lines and several high-volume outlier codes concentrated in pediatric enteral nutrition.

Medicaid: Complete Services Breakdown

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

53 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…	74,940	$270	$20.2M
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,…	173,840	$90	$16.3M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	141,230	$100	$14.7M
B9998	Noc for enteral supplies	63,140	$50	$3.2M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	23,070	$130	$3M
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…	17,600	$140	$2.5M
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…	28,520	$90	$2.5M
B9002	Enteral nutrition infusion pump, any type	62,530	$40	$2.2M
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…	34,290	$60	$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…	7,860	$230	$1.8M

Showing 1–10 of 53

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona 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 — Arizona

Full comparison — all codes billed, vs. Arizona median

53 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	4,650	$200	$3.1M
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,…	1	10	2,270	$70	$1.6M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	1	10	910	$80	$1.2M
B9998	Noc for enteral supplies	1	10	290	$50	$811.5K
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	4,300	$80	$596.9K
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	10	800	$120	$427.6K
B4162	Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an…	1	10	1,180	$350	$408.8K
E1399	Durable medical equipment, miscellaneous	18	20	360	$330	$403K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	13	10	890	$110	$398K
T4534	Youth sized disposable incontinence product, protective underwear/pull-on, each	3	10	1,620	$50	$377.7K

Showing 1–10 of 53

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keith Goss	AZ	Foot & Ankle Surgery Podiatrist	$91.3M	$0
Tylers Place Az Inc	AZ	Home Health Agency	$0	$18.7M
Nava Home Crae LLC	AZ	Assisted Living Facility	$0	$18.5M
Banner Health	AZ	General Acute Care Hospital	$0	$8.3M
Mohammad Shakir	AZ	Specialist	$838.6K	$0
Bsc Chandler LLC	AZ	Ambulatory Surgical Clinic/Center	$569.3K	$180.6K
Jon Stevenson	AZ	Interventional Cardiology Physician	$748.6K	$0
Gautam Kedia	AZ	Cardiovascular Disease Physician	$716K	$0
Himal Shah	AZ	Clinical Cardiac Electrophysiology Physician	$578.8K	$0
Akshit Sharma	AZ	Interventional Cardiology Physician	$506.3K	$0

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