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WILSHIRE PHARMCARE, INC.

Pharmacy·LAGUNA HILLS, CA·NPI: 1922103142Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$31.0M

$31,047,798

Total Claims

250K

Beneficiaries

221K

1.1 claims/patient

Avg Cost/Claim

$124

Monthly Spending Trend

Yearly Spending

2018
$3.5M
+20%
2019
$4.2M
+5%
2020
$4.4M
+19%
2021
$5.2M
+3%
2022
$5.4M
-5%
2023
$5.1M
-35%
2024
$3.3M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (E0465 (Home ventilator, any type, used with invasive interface)) accounts for 42% of total spending.

E0465Normal range

Home ventilator, any type, used with invasive interface

$12.9M

18K claims · 41.7%

Your Cost: $726.17/claim|Median: $583.21
1.2× median
A7520Top 5%

$2.7M

12K claims · 8.7%

Your Cost: $230.29/claim|Median: $49.59
4.6× median
E1390Top 5%

Oxygen concentrator, single delivery port

$1.8M

15K claims · 5.8%

Your Cost: $119.22/claim|Median: $45.11
2.6× median
A7509Top 10%

$1.6M

9,244 claims · 5.0%

Your Cost: $167.93/claim|Median: $33.05
5.1× median
A4606Top 25%

$1.4M

14K claims · 4.5%

Your Cost: $100.97/claim|Median: $50.63
2.0× median
A4605Top 1%

$1.3M

2,357 claims · 4.1%

Your Cost: $542.70/claim|Median: $121.51
4.5× median
E0471Top 10%

Respiratory assist device, bi-level with backup rate

$1.2M

3,407 claims · 3.9%

Your Cost: $359.11/claim|Median: $210.29
1.7× median
A7526Top 5%

$1.1M

11K claims · 3.6%

Your Cost: $99.19/claim|Median: $33.61
3.0× median
A4624Normal range

$971K

8,609 claims · 3.1%

Your Cost: $112.81/claim|Median: $107.53
1.0× median
B4035Normal range

Enteral feeding supply kit, pump fed, per day

$689K

5,319 claims · 2.2%

Your Cost: $129.51/claim|Median: $117.24
1.1× median
B9998Normal range

Enteral/parenteral nutritional supplies, NOS

$472K

5,905 claims · 1.5%

Your Cost: $79.90/claim|Median: $55.51
1.4× median
E0601Top 25%

Continuous positive airway pressure (CPAP) device

$343K

6,533 claims · 1.1%

Your Cost: $52.52/claim|Median: $35.30
1.5× median
A9900Normal range

$328K

8,935 claims · 1.1%

Your Cost: $36.67/claim|Median: $58.14
0.6× median
S8189Top 5%

$314K

647 claims · 1.0%

Your Cost: $485.55/claim|Median: $81.07
6.0× median
A4629Normal range

$304K

5,792 claims · 1.0%

Your Cost: $52.52/claim|Median: $54.42
1.0× median
L8501Top 25%

$297K

3,206 claims · 1.0%

Your Cost: $92.64/claim|Median: $64.66
1.4× median
A4322Top 25%

$251K

7,956 claims · 0.8%

Your Cost: $31.56/claim|Median: $14.10
2.2× median
A7000Top 25%

$250K

13K claims · 0.8%

Your Cost: $19.56/claim|Median: $11.83
1.7× median
E0431Top 25%

Portable gaseous oxygen system, rental

$228K

11K claims · 0.7%

Your Cost: $20.05/claim|Median: $10.37
1.9× median
B4088Top 5%

$213K

1,365 claims · 0.7%

Your Cost: $156.28/claim|Median: $73.20
2.1× median
A4623Top 10%

$188K

1,128 claims · 0.6%

Your Cost: $166.55/claim|Median: $60.83
2.7× median
B4160Normal range

Enteral formula, per 100 calories

$172K

816 claims · 0.6%

Your Cost: $211.12/claim|Median: $157.30
1.3× median
A6402Top 25%

$171K

13K claims · 0.5%

Your Cost: $13.61/claim|Median: $7.69
1.8× median
A4628Top 25%

$167K

11K claims · 0.5%

Your Cost: $14.82/claim|Median: $7.48
2.0× median
A4927Top 25%

Gloves, non-sterile, per 100

$163K

8,368 claims · 0.5%

Your Cost: $19.54/claim|Median: $12.90
1.5× median
A7521Top 5%

$156K

549 claims · 0.5%

Your Cost: $284.43/claim|Median: $39.24
7.2× median
E0600Top 5%

$150K

558 claims · 0.5%

Your Cost: $268.03/claim|Median: $25.31
10.6× median
A7002Top 25%

$127K

14K claims · 0.4%

Your Cost: $9.27/claim|Median: $4.97
1.9× median
E0443Top 25%

$126K

2,913 claims · 0.4%

Your Cost: $43.29/claim|Median: $12.89
3.4× median
90378Normal range

$113K

309 claims · 0.4%

Your Cost: $366.58/claim|Median: $1,627.19
0.2× median
T5999Top 25%

Transportation service, not otherwise classified

$106K

1,708 claims · 0.3%

Your Cost: $62.28/claim|Median: $8.13
7.7× median
J7323Top 5%

$96K

226 claims · 0.3%

Your Cost: $425.38/claim|Median: $101.00
4.2× median
A4604Top 1%

$91K

550 claims · 0.3%

Your Cost: $165.10/claim|Median: $22.01
7.5× median
E0445Top 5%

$64K

61 claims · 0.2%

Your Cost: $1,048.63/claim|Median: $118.11
8.9× median
J0135Normal range

Injection, adalimumab, twenty milligrams

$56K

165 claims · 0.2%

Your Cost: $341.96/claim|Median: $2,044.06
0.2× median
A7525Top 5%

$54K

6,229 claims · 0.2%

Your Cost: $8.60/claim|Median: $2.06
4.2× median
A7504Top 1%

$43K

464 claims · 0.1%

Your Cost: $92.66/claim|Median: $21.00
4.4× median
A7003Top 25%

Administration set for nebulizer, with small volume

$41K

13K claims · 0.1%

Your Cost: $3.23/claim|Median: $1.48
2.2× median
A7034Top 5%

$38K

488 claims · 0.1%

Your Cost: $77.72/claim|Median: $35.90
2.2× median
A7010Top 10%

$37K

1,677 claims · 0.1%

Your Cost: $22.04/claim|Median: $12.55
1.8× median
E0570Top 5%

Nebulizer, with compressor

$37K

355 claims · 0.1%

Your Cost: $102.93/claim|Median: $16.16
6.4× median
B4161Normal range

Enteral formula, semisolid, 100 calories = 1 unit

$33K

55 claims · 0.1%

Your Cost: $598.74/claim|Median: $465.86
1.3× median
J7324Top 10%

$27K

61 claims · 0.1%

Your Cost: $437.87/claim|Median: $56.65
7.7× median
A7007Normal range

Large volume nebulizer, disposable, unfilled

$22K

4,078 claims · 0.1%

Your Cost: $5.44/claim|Median: $4.18
1.3× median
A4670Normal range

$21K

476 claims · 0.1%

Your Cost: $44.09/claim|Median: $50.23
0.9× median
J0897Normal range

Injection, denosumab, one milligram

$21K

70 claims · 0.1%

Your Cost: $296.55/claim|Median: $493.25
0.6× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$16K

40 claims · 0.1%

Your Cost: $403.81/claim|Median: $470.36
0.9× median
90750Top 1%

$12K

45 claims · 0.0%

Your Cost: $259.75/claim|Median: $96.16
2.7× median
A7038Top 5%

$11K

698 claims · 0.0%

Your Cost: $15.39/claim|Median: $3.53
4.4× median
A7012Normal range

$10K

3,244 claims · 0.0%

Your Cost: $2.94/claim|Median: $3.80
0.8× median

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$6.78B

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Community/Behavioral Health

$1.73B

County of Riverside

Community/Behavioral Health

$1.40B

City & County of San Francisco

Community/Behavioral Health

$1.34B

Los Angeles County Department of Public Health

Public Health or Welfare

$1.13B

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