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OPTION CARE ENTERPRISES, INC.

Pharmacy, Home Infusion Therapy Pharmacy·ITASCA, IL·NPI: 1346270527Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$45.5M

$45,467,311

Total Claims

664K

Beneficiaries

162K

4.1 claims/patient

Avg Cost/Claim

$68

Monthly Spending Trend

Yearly Spending

2018
$4.6M
+32%
2019
$6.0M
+12%
2020
$6.8M
+10%
2021
$7.4M
-2%
2022
$7.3M
-8%
2023
$6.8M
-3%
2024
$6.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 38 distinct procedure codes. The top code (B4035 (Enteral feeding supply kit, pump fed, per day)) accounts for 23% of total spending.

B4035Normal range

Enteral feeding supply kit, pump fed, per day

$10.4M

240K claims · 23.0%

Your Cost: $43.59/claim|Median: $117.24
0.4× median
B4161Normal range

Enteral formula, semisolid, 100 calories = 1 unit

$9.1M

15K claims · 20.0%

Your Cost: $617.69/claim|Median: $465.86
1.3× median
B4160Normal range

Enteral formula, per 100 calories

$3.0M

16K claims · 6.5%

Your Cost: $182.76/claim|Median: $157.30
1.2× median
B4224Normal range

$2.8M

63K claims · 6.1%

Your Cost: $44.30/claim|Median: $78.83
0.6× median
A4223Normal range

$2.7M

29K claims · 5.9%

Your Cost: $91.70/claim|Median: $60.92
1.5× median
S9500Normal range

$2.2M

105K claims · 4.7%

Your Cost: $20.52/claim|Median: $144.40
0.1× median
B4105Normal range

$2.1M

476 claims · 4.5%

Your Cost: $4,327.34/claim|Median: $4,164.23
1.0× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$1.9M

6,711 claims · 4.2%

Your Cost: $283.09/claim|Median: $300.16
0.9× median
B4154Top 25%

$1.5M

6,772 claims · 3.3%

Your Cost: $224.25/claim|Median: $132.96
1.7× median
A4222Normal range

$1.5M

36K claims · 3.2%

Your Cost: $40.84/claim|Median: $62.70
0.7× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$1.4M

12K claims · 3.0%

Your Cost: $112.14/claim|Median: $92.20
1.2× median
B4153Normal range

$1.3M

3,026 claims · 2.8%

Your Cost: $422.80/claim|Median: $410.73
1.0× median
G0299Normal range

Skilled nursing services, home health, per visit, RN

$1.1M

16K claims · 2.5%

Your Cost: $73.35/claim|Median: $51.67
1.4× median
B4088Top 25%

$969K

8,279 claims · 2.1%

Your Cost: $117.04/claim|Median: $73.20
1.6× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$775K

7,202 claims · 1.7%

Your Cost: $107.54/claim|Median: $89.79
1.2× median
B4034Normal range

$644K

22K claims · 1.4%

Your Cost: $29.45/claim|Median: $46.28
0.6× median
B9002Top 25%

$475K

5,857 claims · 1.0%

Your Cost: $81.14/claim|Median: $54.41
1.5× median
B4036Normal range

$471K

14K claims · 1.0%

Your Cost: $33.48/claim|Median: $74.87
0.4× median
S5501Normal range

$353K

8,520 claims · 0.8%

Your Cost: $41.38/claim|Median: $43.74
0.9× median
B4158Normal range

$210K

2,533 claims · 0.5%

Your Cost: $82.71/claim|Median: $145.71
0.6× median
A4221Normal range

Supplies for maintenance of drug infusion catheter

$206K

11K claims · 0.5%

Your Cost: $19.46/claim|Median: $16.19
1.2× median
B4155Normal range

$156K

4,212 claims · 0.3%

Your Cost: $37.08/claim|Median: $46.72
0.8× median
E0781Normal range

$130K

15K claims · 0.3%

Your Cost: $8.63/claim|Median: $54.38
0.2× median
B4220Normal range

$47K

2,571 claims · 0.1%

Your Cost: $18.47/claim|Median: $27.49
0.7× median
B4197Normal range

$35K

91 claims · 0.1%

Your Cost: $382.66/claim|Median: $687.38
0.6× median
A6402Normal range

$29K

3,746 claims · 0.1%

Your Cost: $7.73/claim|Median: $7.69
1.0× median
B4082Normal range

$28K

2,158 claims · 0.1%

Your Cost: $13.06/claim|Median: $28.33
0.5× median
A4305Normal range

$28K

378 claims · 0.1%

Your Cost: $74.01/claim|Median: $76.95
1.0× median
E0776Normal range

$18K

2,756 claims · 0.0%

Your Cost: $6.58/claim|Median: $8.13
0.8× median
A4452Normal range

$10K

2,941 claims · 0.0%

Your Cost: $3.32/claim|Median: $9.98
0.3× median
B4185Normal range

$6K

286 claims · 0.0%

Your Cost: $19.70/claim|Median: $134.70
0.1× median
A6234Normal range

$5K

305 claims · 0.0%

Your Cost: $16.21/claim|Median: $42.35
0.4× median
A6257Normal range

$4K

298 claims · 0.0%

Your Cost: $12.94/claim|Median: $10.48
1.2× median
B9998Top 10%

Enteral/parenteral nutritional supplies, NOS

$3K

16 claims · 0.0%

Your Cost: $158.48/claim|Median: $55.51
2.9× median
A4402Normal range

$3K

1,360 claims · 0.0%

Your Cost: $1.85/claim|Median: $4.15
0.4× median
A4450Normal range

$1K

940 claims · 0.0%

Your Cost: $1.38/claim|Median: $3.14
0.4× median
A4930Normal range

$387

68 claims · 0.0%

Your Cost: $5.69/claim|Median: $3.61
1.6× median
A4927Normal range

Gloves, non-sterile, per 100

$132

16 claims · 0.0%

Your Cost: $8.28/claim|Median: $12.90
0.6× median

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