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OPTION CARE ENTERPRISES, INC.

Pharmacy, Home Infusion Therapy Pharmacy·TUKWILA, WA·NPI: 1811085103Share
Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$18.9M

$18,930,430

Total Claims

94K

Beneficiaries

54K

1.7 claims/patient

Avg Cost/Claim

$202

Monthly Spending Trend

Yearly Spending

2018
$2.5M
+16%
2019
$2.8M
+0%
2020
$2.8M
+24%
2021
$3.5M
-10%
2022
$3.2M
-24%
2023
$2.4M
-30%
2024
$1.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 33 distinct procedure codes. The top code (A4223) accounts for 41% of total spending.

A4223Top 1%

$7.7M

9,433 claims · 40.7%

Your Cost: $815.94/claim|Median: $60.92
13.4× median
B4035Normal range

Enteral feeding supply kit, pump fed, per day

$1.9M

11K claims · 9.8%

Your Cost: $169.83/claim|Median: $117.24
1.4× median
B4185Top 10%

$1.1M

4,423 claims · 6.0%

Your Cost: $254.94/claim|Median: $134.70
1.9× median
A4222Top 25%

$1.0M

5,697 claims · 5.4%

Your Cost: $180.30/claim|Median: $62.70
2.9× median
B4153Normal range

$813K

1,641 claims · 4.3%

Your Cost: $495.61/claim|Median: $410.73
1.2× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$780K

6,698 claims · 4.1%

Your Cost: $116.51/claim|Median: $92.20
1.3× median
B4150Top 25%

Enteral formula, nutritionally complete with fiber, per 100 calories

$695K

5,256 claims · 3.7%

Your Cost: $132.22/claim|Median: $89.79
1.5× median
B4197Top 25%

$676K

580 claims · 3.6%

Your Cost: $1,165.11/claim|Median: $687.38
1.7× median
B4224Top 25%

$637K

4,738 claims · 3.4%

Your Cost: $134.46/claim|Median: $78.83
1.7× median
99601Top 25%

$624K

5,375 claims · 3.3%

Your Cost: $116.04/claim|Median: $82.41
1.4× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$586K

1,723 claims · 3.1%

Your Cost: $339.91/claim|Median: $300.16
1.1× median
B4034Top 25%

$566K

6,563 claims · 3.0%

Your Cost: $86.21/claim|Median: $46.28
1.9× median
B4154Normal range

$383K

1,864 claims · 2.0%

Your Cost: $205.61/claim|Median: $132.96
1.5× median
A4221Normal range

Supplies for maintenance of drug infusion catheter

$269K

13K claims · 1.4%

Your Cost: $21.24/claim|Median: $16.19
1.3× median
B4220Top 25%

$204K

4,672 claims · 1.1%

Your Cost: $43.72/claim|Median: $27.49
1.6× median
B4036Normal range

$165K

1,908 claims · 0.9%

Your Cost: $86.54/claim|Median: $74.87
1.2× median
J3380Top 25%

Injection, vedolizumab, one milligram

$146K

27 claims · 0.8%

Your Cost: $5,414.43/claim|Median: $4,027.41
1.3× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$110K

52 claims · 0.6%

Your Cost: $2,116.21/claim|Median: $1,587.53
1.3× median
B4199Top 1%

$109K

55 claims · 0.6%

Your Cost: $1,984.20/claim|Median: $810.01
2.4× median
B4088Normal range

$97K

1,298 claims · 0.5%

Your Cost: $75.09/claim|Median: $73.20
1.0× median
B4160Normal range

Enteral formula, per 100 calories

$94K

640 claims · 0.5%

Your Cost: $146.25/claim|Median: $157.30
0.9× median
B9002Normal range

$64K

1,140 claims · 0.3%

Your Cost: $56.50/claim|Median: $54.41
1.0× median
S9342Normal range

Home infusion therapy, continuous or intermittent, per diem

$46K

2,700 claims · 0.2%

Your Cost: $16.87/claim|Median: $176.25
0.1× median
J0696Top 10%

$32K

1,600 claims · 0.2%

Your Cost: $20.25/claim|Median: $1.34
15.1× median
B4155Normal range

$31K

1,093 claims · 0.2%

Your Cost: $27.96/claim|Median: $46.72
0.6× median
E0781Top 25%

$30K

168 claims · 0.2%

Your Cost: $179.94/claim|Median: $54.38
3.3× median
J3370Top 5%

$20K

249 claims · 0.1%

Your Cost: $80.99/claim|Median: $2.40
33.7× median
J0878Top 25%

$11K

33 claims · 0.1%

Your Cost: $346.09/claim|Median: $130.03
2.7× median
J1335Normal range

$11K

38 claims · 0.1%

Your Cost: $291.60/claim|Median: $100.54
2.9× median
99602Top 25%

$10K

82 claims · 0.1%

Your Cost: $120.41/claim|Median: $84.91
1.4× median
E0776Top 5%

$9K

114 claims · 0.0%

Your Cost: $79.06/claim|Median: $8.13
9.7× median
J7030Top 25%

Normal saline solution infusion, 1000 cc

$4K

199 claims · 0.0%

Your Cost: $17.79/claim|Median: $1.53
11.6× median
99072Normal range

$0

48 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.54

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