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Optum Women's and Children's Health, LLC

Home Health·Marietta, GA·NPI: 1073561825Share

Compared to Home Health Peers

Total spending distribution among 322 providers in this specialty

P25MedianP75P90

This provider's total spending of $160.4M is at the 50th percentile among 322 Home Health providers.

Active Billing Period:2018-01→2024-12(84 months)
Sharp billing drop in final month

Total Paid

$160.4M

$160,438,333

Total Claims

637K

Beneficiaries

123K

5.2 claims/patient

Avg Cost/Claim

$252

#645 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Optum Women's and Children's Health, LLC is a Home Health provider based in Marietta, GA. From the 2018–2024 period, this provider received $160.4M in Medicaid payments across 637K claims.

Why This Matters

This provider received $160.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 20,054 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 35% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$23.2M
+6%
2019
$24.6M
-11%
2020
$22.0M
+35%
2021
$29.7M
-11%
2022
$26.5M
-27%
2023
$19.5M
-23%
2024
$15.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 28 distinct procedure codes. The top code (S9351) accounts for 46% of total spending.

S9351Top 25%

$74.1M

170K claims · 46.2%

Your Cost: $434.88/claim|Median: $268.01
1.6× median
J1726Normal range

$32.7M

31K claims · 20.4%

Your Cost: $1,048.42/claim|Median: $789.74
1.3× median
S9560Normal range

$16.0M

127K claims · 10.0%

Your Cost: $125.33/claim|Median: $119.30
1.1× median
99601Top 25%

$7.6M

67K claims · 4.7%

Your Cost: $113.39/claim|Median: $82.41
1.4× median
S9211Top 1%

$6.6M

112K claims · 4.1%

Your Cost: $58.77/claim|Median: $55.26
1.1× median
S9214Top 1%

$3.9M

22K claims · 2.5%

Your Cost: $182.20/claim|Median: $140.04
1.3× median
J1729Normal range

$3.9M

8,656 claims · 2.4%

Your Cost: $452.92/claim|Median: $462.84
1.0× median
S9379Top 5%

$3.5M

16K claims · 2.2%

Your Cost: $224.83/claim|Median: $70.89
3.2× median
S9353Normal range

$2.0M

7,130 claims · 1.3%

Your Cost: $287.46/claim|Median: $287.46
1.0× median
S9213Top 1%

$2.0M

14K claims · 1.2%

Your Cost: $136.73/claim|Median: $127.43
1.1× median
S9376Normal range

$1.9M

18K claims · 1.2%

Your Cost: $105.43/claim|Median: $105.43
1.0× median
J2405Top 1%

Injection, ondansetron HCl, per one milligram

$1.6M

14K claims · 1.0%

Your Cost: $118.65/claim|Median: $0.58
204.6× median
S9373Top 1%

$978K

4,232 claims · 0.6%

Your Cost: $230.99/claim|Median: $104.15
2.2× median
96372Top 1%

Therapeutic injection, subcutaneous/intramuscular

$954K

6,836 claims · 0.6%

Your Cost: $139.55/claim|Median: $9.56
14.6× median
S9123Normal range

Nursing care, in the home, by RN, per 15 minutes

$784K

7,030 claims · 0.5%

Your Cost: $111.52/claim|Median: $124.86
0.9× median
99506Normal range

$597K

5,222 claims · 0.4%

Your Cost: $114.25/claim|Median: $114.25
1.0× median
S9212Top 1%

$321K

1,348 claims · 0.2%

Your Cost: $237.83/claim|Median: $237.83
1.0× median
S9542Top 25%

$318K

1,858 claims · 0.2%

Your Cost: $170.95/claim|Median: $43.71
3.9× median
S9140Top 1%

$216K

474 claims · 0.1%

Your Cost: $455.33/claim|Median: $451.71
1.0× median
96369Top 1%

$182K

480 claims · 0.1%

Your Cost: $379.40/claim|Median: $70.59
5.4× median
H1000Normal range

Prenatal care, at-risk assessment

$87K

1,216 claims · 0.1%

Your Cost: $71.33/claim|Median: $50.36
1.4× median
T1030Normal range

Nursing care, in the home, by RN, per diem

$48K

786 claims · 0.0%

Your Cost: $61.43/claim|Median: $85.62
0.7× median
H1005Normal range

$46K

112 claims · 0.0%

Your Cost: $408.32/claim|Median: $326.47
1.3× median
T1002Top 25%

RN services, per 15 minutes

$34K

305 claims · 0.0%

Your Cost: $111.08/claim|Median: $37.42
3.0× median
G0299Normal range

Skilled nursing services, home health, per visit, RN

$15K

169 claims · 0.0%

Your Cost: $85.80/claim|Median: $51.67
1.7× median
99600Top 25%

Unlisted home visit service or procedure

$6K

36 claims · 0.0%

Your Cost: $161.97/claim|Median: $111.99
1.4× median
J2765Top 5%

$1K

57 claims · 0.0%

Your Cost: $17.77/claim|Median: $0.45
39.5× median
S9460Normal range

$90

13 claims · 0.0%

Your Cost: $6.92/claim|Median: $97.87
0.1× median

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