Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

OPTION CARE ENTERPRISES INC

Pharmacy·LOUISVILLE, KY·NPI: 1902182637Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$39.1M

$39,066,123

Total Claims

327K

Beneficiaries

102K

3.2 claims/patient

Avg Cost/Claim

$120

Monthly Spending Trend

Yearly Spending

2018
$2.6M
+86%
2019
$4.8M
+32%
2020
$6.3M
+23%
2021
$7.8M
-2%
2022
$7.7M
-19%
2023
$6.2M
-42%
2024
$3.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (S9342 (Home infusion therapy, continuous or intermittent, per diem)) accounts for 17% of total spending.

S9342Normal range

Home infusion therapy, continuous or intermittent, per diem

$6.5M

79K claims · 16.5%

Your Cost: $81.66/claim|Median: $176.25
0.5× median
S9500Normal range

$3.6M

29K claims · 9.2%

Your Cost: $124.54/claim|Median: $144.40
0.9× median
J0878Top 25%

$3.2M

7,403 claims · 8.1%

Your Cost: $426.35/claim|Median: $130.03
3.3× median
B4161Normal range

Enteral formula, semisolid, 100 calories = 1 unit

$3.1M

12K claims · 8.0%

Your Cost: $260.70/claim|Median: $465.86
0.6× median
B4035Normal range

Enteral feeding supply kit, pump fed, per day

$2.1M

13K claims · 5.3%

Your Cost: $163.14/claim|Median: $117.24
1.4× median
99601Normal range

$2.0M

25K claims · 5.2%

Your Cost: $81.66/claim|Median: $82.41
1.0× median
A4223Top 25%

$1.7M

8,244 claims · 4.3%

Your Cost: $201.60/claim|Median: $60.92
3.3× median
B4153Normal range

$1.6M

6,315 claims · 4.1%

Your Cost: $251.04/claim|Median: $410.73
0.6× median
B4185Normal range

$1.4M

9,383 claims · 3.7%

Your Cost: $153.72/claim|Median: $134.70
1.1× median
S9502Normal range

$1.3M

7,814 claims · 3.3%

Your Cost: $165.30/claim|Median: $165.71
1.0× median
S9501Normal range

$1.2M

7,678 claims · 3.0%

Your Cost: $154.14/claim|Median: $160.52
1.0× median
B4160Normal range

Enteral formula, per 100 calories

$1.0M

9,233 claims · 2.7%

Your Cost: $112.98/claim|Median: $157.30
0.7× median
S9366Normal range

$954K

2,837 claims · 2.4%

Your Cost: $336.22/claim|Median: $394.05
0.9× median
S9374Normal range

$911K

6,952 claims · 2.3%

Your Cost: $131.01/claim|Median: $136.10
1.0× median
J0696Top 1%

$908K

5,738 claims · 2.3%

Your Cost: $158.23/claim|Median: $1.34
118.1× median
J3370Top 5%

$782K

4,751 claims · 2.0%

Your Cost: $164.66/claim|Median: $2.40
68.6× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$761K

5,945 claims · 1.9%

Your Cost: $128.09/claim|Median: $300.16
0.4× median
S9379Normal range

$679K

6,087 claims · 1.7%

Your Cost: $111.47/claim|Median: $70.89
1.6× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$579K

9,105 claims · 1.5%

Your Cost: $63.55/claim|Median: $92.20
0.7× median
S9343Normal range

$511K

12K claims · 1.3%

Your Cost: $41.55/claim|Median: $99.47
0.4× median
B4105Normal range

$482K

143 claims · 1.2%

Your Cost: $3,367.93/claim|Median: $4,164.23
0.8× median
B4034Top 25%

$458K

5,826 claims · 1.2%

Your Cost: $78.68/claim|Median: $46.28
1.7× median
B4154Normal range

$421K

2,858 claims · 1.1%

Your Cost: $147.28/claim|Median: $132.96
1.1× median
A4222Normal range

$345K

4,063 claims · 0.9%

Your Cost: $84.95/claim|Median: $62.70
1.4× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$306K

4,991 claims · 0.8%

Your Cost: $61.24/claim|Median: $89.79
0.7× median
S9494Normal range

$240K

1,209 claims · 0.6%

Your Cost: $198.67/claim|Median: $169.66
1.2× median
B4036Top 25%

$224K

1,816 claims · 0.6%

Your Cost: $123.42/claim|Median: $74.87
1.6× median
S9341Normal range

$221K

3,090 claims · 0.6%

Your Cost: $71.45/claim|Median: $142.63
0.5× median
J3380Top 25%

Injection, vedolizumab, one milligram

$180K

28 claims · 0.5%

Your Cost: $6,428.75/claim|Median: $4,027.41
1.6× median
B4155Normal range

$177K

4,127 claims · 0.5%

Your Cost: $42.78/claim|Median: $46.72
0.9× median
B4224Normal range

$161K

2,409 claims · 0.4%

Your Cost: $66.78/claim|Median: $78.83
0.8× median
J2260Top 10%

$156K

2,028 claims · 0.4%

Your Cost: $76.95/claim|Median: $35.65
2.2× median
A4221Normal range

Supplies for maintenance of drug infusion catheter

$144K

8,229 claims · 0.4%

Your Cost: $17.56/claim|Median: $16.19
1.1× median
B4088Normal range

$143K

3,933 claims · 0.4%

Your Cost: $36.37/claim|Median: $73.20
0.5× median
S9542Normal range

$138K

2,273 claims · 0.4%

Your Cost: $60.93/claim|Median: $43.71
1.4× median
S9351Normal range

$66K

376 claims · 0.2%

Your Cost: $174.73/claim|Median: $268.01
0.7× median
B9998Top 10%

Enteral/parenteral nutritional supplies, NOS

$62K

429 claims · 0.2%

Your Cost: $145.08/claim|Median: $55.51
2.6× median
99602Normal range

$61K

822 claims · 0.2%

Your Cost: $73.94/claim|Median: $84.91
0.9× median
S9345Normal range

$60K

1,803 claims · 0.2%

Your Cost: $33.09/claim|Median: $41.98
0.8× median
A4305Normal range

$56K

901 claims · 0.1%

Your Cost: $62.30/claim|Median: $76.95
0.8× median
S9348Normal range

$53K

217 claims · 0.1%

Your Cost: $244.46/claim|Median: $141.48
1.7× median
B4220Normal range

$49K

2,461 claims · 0.1%

Your Cost: $20.05/claim|Median: $27.49
0.7× median
S9338Top 10%

$45K

337 claims · 0.1%

Your Cost: $134.35/claim|Median: $60.83
2.2× median
B9002Normal range

$17K

844 claims · 0.0%

Your Cost: $20.45/claim|Median: $54.41
0.4× median
J0692Top 1%

$17K

91 claims · 0.0%

Your Cost: $185.71/claim|Median: $2.04
91.0× median
J0690Top 5%

$9K

241 claims · 0.0%

Your Cost: $39.38/claim|Median: $0.94
41.9× median
J2405Top 10%

Injection, ondansetron HCl, per one milligram

$9K

958 claims · 0.0%

Your Cost: $9.53/claim|Median: $0.58
16.4× median
S9375Normal range

$8K

55 claims · 0.0%

Your Cost: $140.31/claim|Median: $165.98
0.8× median
A4213Normal range

$7K

770 claims · 0.0%

Your Cost: $9.59/claim|Median: $9.01
1.1× median
J2543Top 1%

$4K

29 claims · 0.0%

Your Cost: $147.61/claim|Median: $2.87
51.4× median

Other Top Providers in Kentucky

View all →

University of Kentucky

General Acute Care Hospital

$716.4M

Norton Hospitals INC

General Acute Care Hospital

$419.6M

Seven Counties Services Inc.

Clinic/Center Developmental Disabilities

$375.8M

Cumberland River Behavioral Health INC

Community/Behavioral Health

$349.2M

Addiction Recovery Care LLC

Community Based Residential Treatment Facility, Me

$309.0M

Similar Providers

Other top providers in Pharmacy

Hhsc Wic Program

Austin, TX

$244.6M

Accredo Health Group INC

Memphis, TN

$165.6M

Memorial Hospital for Cancer and Allied Diseases

New York, NY

$135.1M

← All providersAll providers in Kentucky →How we detect fraud →