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OPTION CARE ENTERPRISES INC

Pharmacy, Home Infusion Therapy Pharmacy·MARLBOROUGH, MA·NPI: 1952440604Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$37.0M

$36,956,300

Total Claims

185K

Beneficiaries

96K

1.9 claims/patient

Avg Cost/Claim

$199

Monthly Spending Trend

Yearly Spending

2018
$1.2M
+59%
2019
$2.0M
+79%
2020
$3.6M
+61%
2021
$5.7M
+41%
2022
$8.1M
+8%
2023
$8.8M
-15%
2024
$7.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 48 distinct procedure codes. The top code (S9342 (Home infusion therapy, continuous or intermittent, per diem)) accounts for 22% of total spending.

S9342Normal range

Home infusion therapy, continuous or intermittent, per diem

$8.3M

40K claims · 22.4%

Your Cost: $204.83/claim|Median: $176.25
1.2× median
B4161Top 25%

Enteral formula, semisolid, 100 calories = 1 unit

$5.6M

8,345 claims · 15.0%

Your Cost: $665.75/claim|Median: $465.86
1.4× median
B4189Top 25%

$3.4M

3,537 claims · 9.1%

Your Cost: $953.49/claim|Median: $743.70
1.3× median
S9500Top 25%

$2.8M

12K claims · 7.6%

Your Cost: $241.74/claim|Median: $144.40
1.7× median
B4185Normal range

$2.1M

13K claims · 5.7%

Your Cost: $165.54/claim|Median: $134.70
1.2× median
B4149Normal range

Enteral formula, manufactured blenderized, per 100 calories

$1.4M

5,531 claims · 3.7%

Your Cost: $245.20/claim|Median: $300.16
0.8× median
B4160Normal range

Enteral formula, per 100 calories

$1.3M

10K claims · 3.6%

Your Cost: $131.94/claim|Median: $157.30
0.8× median
99601Normal range

$1.2M

12K claims · 3.2%

Your Cost: $98.16/claim|Median: $82.41
1.2× median
S9343Normal range

$1.1M

7,361 claims · 3.0%

Your Cost: $150.86/claim|Median: $99.47
1.5× median
S9502Top 25%

$930K

3,211 claims · 2.5%

Your Cost: $289.58/claim|Median: $165.71
1.7× median
S9501Normal range

$810K

3,216 claims · 2.2%

Your Cost: $251.90/claim|Median: $160.52
1.6× median
S9366Normal range

$802K

3,669 claims · 2.2%

Your Cost: $218.58/claim|Median: $394.05
0.6× median
B4153Normal range

$793K

2,421 claims · 2.1%

Your Cost: $327.62/claim|Median: $410.73
0.8× median
B4088Top 25%

$715K

5,902 claims · 1.9%

Your Cost: $121.07/claim|Median: $73.20
1.7× median
S9374Normal range

$706K

5,406 claims · 1.9%

Your Cost: $130.56/claim|Median: $136.10
1.0× median
B4152Normal range

Enteral formula, calorically dense, per 100 calories

$680K

7,543 claims · 1.8%

Your Cost: $90.16/claim|Median: $92.20
1.0× median
B4150Normal range

Enteral formula, nutritionally complete with fiber, per 100 calories

$603K

7,233 claims · 1.6%

Your Cost: $83.32/claim|Median: $89.79
0.9× median
B4197Normal range

$446K

748 claims · 1.2%

Your Cost: $596.03/claim|Median: $687.38
0.9× median
J1559Normal range

$391K

449 claims · 1.1%

Your Cost: $870.20/claim|Median: $811.35
1.1× median
B4154Normal range

$358K

1,729 claims · 1.0%

Your Cost: $207.21/claim|Median: $132.96
1.6× median
S9338Top 25%

$347K

3,334 claims · 0.9%

Your Cost: $104.09/claim|Median: $60.83
1.7× median
B4035Normal range

Enteral feeding supply kit, pump fed, per day

$315K

4,278 claims · 0.9%

Your Cost: $73.60/claim|Median: $117.24
0.6× median
B4155Normal range

$236K

3,230 claims · 0.6%

Your Cost: $73.09/claim|Median: $46.72
1.6× median
99602Normal range

$213K

1,876 claims · 0.6%

Your Cost: $113.72/claim|Median: $84.91
1.3× median
S9367Normal range

$211K

723 claims · 0.6%

Your Cost: $292.03/claim|Median: $270.91
1.1× median
S9542Normal range

$210K

4,781 claims · 0.6%

Your Cost: $43.82/claim|Median: $43.71
1.0× median
B4105Normal range

$180K

42 claims · 0.5%

Your Cost: $4,279.83/claim|Median: $4,164.23
1.0× median
B4103Normal range

$146K

1,450 claims · 0.4%

Your Cost: $100.39/claim|Median: $82.54
1.2× median
B4193Normal range

$140K

207 claims · 0.4%

Your Cost: $675.87/claim|Median: $569.75
1.2× median
B4224Normal range

$139K

3,019 claims · 0.4%

Your Cost: $46.19/claim|Median: $78.83
0.6× median
S9340Normal range

$77K

297 claims · 0.2%

Your Cost: $257.58/claim|Median: $196.46
1.3× median
B4220Normal range

$65K

2,986 claims · 0.2%

Your Cost: $21.88/claim|Median: $27.49
0.8× median
S9341Normal range

$65K

456 claims · 0.2%

Your Cost: $142.63/claim|Median: $142.63
1.0× median
B4162Normal range

$53K

80 claims · 0.1%

Your Cost: $657.18/claim|Median: $412.82
1.6× median
S9331Top 1%

$48K

774 claims · 0.1%

Your Cost: $62.51/claim|Median: $62.51
1.0× median
B4034Normal range

$44K

1,871 claims · 0.1%

Your Cost: $23.53/claim|Median: $46.28
0.5× median
B9002Normal range

$44K

759 claims · 0.1%

Your Cost: $57.75/claim|Median: $54.41
1.1× median
S9359Normal range

$23K

288 claims · 0.1%

Your Cost: $79.93/claim|Median: $62.59
1.3× median
S5502Top 25%

$20K

330 claims · 0.1%

Your Cost: $60.79/claim|Median: $25.28
2.4× median
J3490Top 5%

Unclassified drugs

$13K

43 claims · 0.0%

Your Cost: $301.73/claim|Median: $5.70
52.9× median
J0696Top 5%

$12K

383 claims · 0.0%

Your Cost: $30.81/claim|Median: $1.34
23.0× median
S9379Top 25%

$7K

41 claims · 0.0%

Your Cost: $159.60/claim|Median: $70.89
2.3× median
A4222Normal range

$3K

99 claims · 0.0%

Your Cost: $31.33/claim|Median: $62.70
0.5× median
B4087Normal range

$3K

74 claims · 0.0%

Your Cost: $39.75/claim|Median: $25.27
1.6× median
A4221Normal range

Supplies for maintenance of drug infusion catheter

$2K

102 claims · 0.0%

Your Cost: $17.66/claim|Median: $16.19
1.1× median
J9260Normal range

$2K

529 claims · 0.0%

Your Cost: $3.33/claim|Median: $2.14
1.6× median
B4100Normal range

$910

15 claims · 0.0%

Your Cost: $60.65/claim|Median: $67.58
0.9× median
E0776Normal range

$397

104 claims · 0.0%

Your Cost: $3.82/claim|Median: $8.13
0.5× median

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