Agency
Optima Infusion Pharmacy INC
Optima Infusion Pharmacy INC was paid $2.00M by Medicaid between Jan 2018 and Dec 2024, across 10 billing codes. Its largest line is S9097, Home visit for wound care — 60% of everything it billed.
33Billing provider infoOPTIMA INFUSION PHARMACY INC
DORADO, PR 00646
DORADO, PR 00646
33aNPI1063525210assigned 08/15/2006
33bProvider typeHome Health Agency
28Total paid$2.00M
24GClaims30,470
24DCodes billed10
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Home Health Agency providers in Puerto Rico
Rank by total paid#6 of 29
Median peer was paid$378K
This provider vs. median5.3×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 2,377 | $140K | |
| 2019 | 5,409 | $311K | |
| 2020 | 5,518 | $332K | |
| 2021 | 6,649 | $463K | |
| 2022 | 2,888 | $204K | |
| 2023 | 3,512 | $242K | |
| 2024incomplete | 4,117 | $308K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S9097 | Home visit for wound care | 60% | 17,452 | 2,367 | $1.19M |
| 97602 | 23% | 6,700 | 714 | $450K | |
| T1030 | Nursing care, in the home, by registered nurse, per diem | 12% | 3,426 | 450 | $244K |
| S9494 | Home infusion therapy, antibiotic, antiviral, or antifungal therapy; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with home infusion codes for hourly dosing schedules s9497-s9504) | 4.2% | 2,319 | 314 | $84K |
| T1001 | Nursing assessment / evaluation | 1.2% | 427 | 384 | $25K |
| J3370 | Injection, vancomycin hcl, 500 mg | <1% | 45 | 13 | $3K |
| M0223 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring in the home or residence; this includes a beneficiary's home that has been made provider-based to the hospital during the covid-19 public health emergency | <1% | 20 | 14 | $1K |
| 90688 | <1% | 26 | 21 | $295.72 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 26 | 21 | $60.15 |
| J2405 | Injection, ondansetron hydrochloride, per 1 mg | <1% | 29 | 26 | $27.20 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialDIAZ, MARIELY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Optima Infusion Pharmacy INC | Dorado, PR | $470K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.