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OPTION CARE AT LEGACY HEALTH LLC

Pharmacy, Home Infusion Therapy Pharmacy·PORTLAND, OR·NPI: 1841350527Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$18.5M

$18,547,307

Total Claims

120K

Beneficiaries

70K

1.7 claims/patient

Avg Cost/Claim

$155

Monthly Spending Trend

Yearly Spending

2018
$1.5M
+26%
2019
$1.9M
+35%
2020
$2.5M
+18%
2021
$3.0M
+5%
2022
$3.1M
+2%
2023
$3.2M
+7%
2024
$3.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 33 distinct procedure codes. The top code (B4035 (Enteral feeding supply kit, pump fed, per day)) accounts for 24% of total spending.

B4035Top 25%

Enteral feeding supply kit, pump fed, per day

$4.5M

25K claims · 24.4%

Your Cost: $179.19/claim|Median: $117.24
1.5× median
B4161Normal range

Enteral formula, semisolid, 100 calories = 1 unit

$1.9M

4,120 claims · 10.0%

Your Cost: $451.72/claim|Median: $465.86
1.0× median
S9500Top 25%

$1.2M

4,526 claims · 6.3%

Your Cost: $259.24/claim|Median: $144.40
1.8× median
B4185Normal range

$1.2M

7,952 claims · 6.2%

Your Cost: $145.69/claim|Median: $134.70
1.1× median
A4223Top 10%

$1.1M

2,538 claims · 6.1%

Your Cost: $442.20/claim|Median: $60.92
7.3× median
B4153Normal range

$1.0M

2,315 claims · 5.5%

Your Cost: $438.62/claim|Median: $410.73
1.1× median
99601Top 25%

$937K

8,802 claims · 5.1%

Your Cost: $106.45/claim|Median: $82.41
1.3× median
B4160Normal range

Enteral formula, per 100 calories

$892K

5,550 claims · 4.8%

Your Cost: $160.77/claim|Median: $157.30
1.0× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$887K

8,083 claims · 4.8%

Your Cost: $109.79/claim|Median: $92.20
1.2× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$868K

2,574 claims · 4.7%

Your Cost: $337.17/claim|Median: $300.16
1.1× median
S9366Top 25%

$683K

993 claims · 3.7%

Your Cost: $687.92/claim|Median: $394.05
1.7× median
B4034Top 25%

$649K

8,135 claims · 3.5%

Your Cost: $79.80/claim|Median: $46.28
1.7× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$575K

6,864 claims · 3.1%

Your Cost: $83.78/claim|Median: $89.79
0.9× median
S9342Normal range

Home infusion therapy, continuous or intermittent, per diem

$391K

10K claims · 2.1%

Your Cost: $38.64/claim|Median: $176.25
0.2× median
S9379Normal range

$363K

3,238 claims · 2.0%

Your Cost: $112.10/claim|Median: $70.89
1.6× median
B4154Top 25%

$316K

1,514 claims · 1.7%

Your Cost: $208.53/claim|Median: $132.96
1.6× median
S9502Top 25%

$293K

1,026 claims · 1.6%

Your Cost: $285.41/claim|Median: $165.71
1.7× median
B4088Normal range

$266K

4,168 claims · 1.4%

Your Cost: $63.70/claim|Median: $73.20
0.9× median
B4036Normal range

$199K

2,287 claims · 1.1%

Your Cost: $87.14/claim|Median: $74.87
1.2× median
B4158Normal range

$109K

988 claims · 0.6%

Your Cost: $110.08/claim|Median: $145.71
0.8× median
A4221Top 25%

Supplies for maintenance of drug infusion catheter

$73K

3,010 claims · 0.4%

Your Cost: $24.15/claim|Median: $16.19
1.5× median
B4155Normal range

$59K

2,659 claims · 0.3%

Your Cost: $22.11/claim|Median: $46.72
0.5× median
B9002Normal range

$51K

1,104 claims · 0.3%

Your Cost: $46.08/claim|Median: $54.41
0.8× median
B4224Normal range

$20K

361 claims · 0.1%

Your Cost: $55.53/claim|Median: $78.83
0.7× median
B9998Normal range

Enteral/parenteral nutritional supplies, NOS

$20K

487 claims · 0.1%

Your Cost: $40.13/claim|Median: $55.51
0.7× median
B4082Normal range

$14K

432 claims · 0.1%

Your Cost: $31.90/claim|Median: $28.33
1.1× median
99602Normal range

$13K

151 claims · 0.1%

Your Cost: $87.87/claim|Median: $84.91
1.0× median
A4222Normal range

$10K

141 claims · 0.1%

Your Cost: $73.10/claim|Median: $62.70
1.2× median
B4220Normal range

$6K

329 claims · 0.0%

Your Cost: $19.51/claim|Median: $27.49
0.7× median
J0690Top 5%

$3K

102 claims · 0.0%

Your Cost: $24.91/claim|Median: $0.94
26.5× median
B4087Normal range

$1K

109 claims · 0.0%

Your Cost: $12.78/claim|Median: $25.27
0.5× median
J0696Top 10%

$1K

76 claims · 0.0%

Your Cost: $17.63/claim|Median: $1.34
13.2× median
E0776Top 5%

$1K

13 claims · 0.0%

Your Cost: $98.93/claim|Median: $8.13
12.2× median

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