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OPTUM URGENT CARE, PLLC

Clinic/Center, Urgent Care·JERICHO, NY·NPI: 1285975797Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$24.8M

$24,849,603

Total Claims

254K

Beneficiaries

243K

1.0 claims/patient

Avg Cost/Claim

$98

Monthly Spending Trend

Yearly Spending

2018
$3.3M
+35%
2019
$4.4M
-30%
2020
$3.1M
+82%
2021
$5.6M
-23%
2022
$4.3M
-39%
2023
$2.7M
-45%
2024
$1.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 33 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 41% of total spending.

99213Top 5%

Office/outpatient visit, est. patient, low-mod complexity

$10.3M

85K claims · 41.5%

Your Cost: $121.27/claim|Median: $37.81
3.2× median
99214Top 5%

Office/outpatient visit, est. patient, mod-high complexity

$4.0M

27K claims · 15.9%

Your Cost: $145.43/claim|Median: $53.41
2.7× median
99203Top 5%

Office/outpatient visit, new patient, low-mod complexity

$3.8M

32K claims · 15.4%

Your Cost: $121.28/claim|Median: $57.85
2.1× median
S9083Top 1%

Global fee, urgent care centers

$3.0M

13K claims · 12.0%

Your Cost: $235.86/claim|Median: $103.99
2.3× median
99212Top 10%

Office/outpatient visit, low complexity

$995K

11K claims · 4.0%

Your Cost: $89.34/claim|Median: $25.06
3.6× median
99050Top 10%

$883K

23K claims · 3.6%

Your Cost: $38.15/claim|Median: $11.81
3.2× median
87426Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay

$775K

30K claims · 3.1%

Your Cost: $26.12/claim|Median: $30.04
0.9× median
99202Top 10%

Office/outpatient visit, new patient, low complexity

$426K

4,436 claims · 1.7%

Your Cost: $96.07/claim|Median: $40.11
2.4× median
99204Top 25%

Office/outpatient visit, new patient, mod-high complexity

$363K

2,979 claims · 1.5%

Your Cost: $121.88/claim|Median: $84.03
1.5× median
87428Normal range

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

$90K

11K claims · 0.4%

Your Cost: $7.92/claim|Median: $39.63
0.2× median
87804Normal range

Influenza virus detection, rapid test

$85K

6,202 claims · 0.3%

Your Cost: $13.75/claim|Median: $12.59
1.1× median
87635Normal range

COVID-19 SARS-CoV-2 amplified probe detection

$77K

3,838 claims · 0.3%

Your Cost: $20.10/claim|Median: $39.70
0.5× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$32K

3,263 claims · 0.1%

Your Cost: $9.81/claim|Median: $11.48
0.9× median
99215Top 25%

Office/outpatient visit, high complexity

$30K

244 claims · 0.1%

Your Cost: $121.84/claim|Median: $74.09
1.6× median
99211Top 10%

Office/outpatient visit, minimal complexity

$9K

141 claims · 0.0%

Your Cost: $60.33/claim|Median: $12.93
4.7× median
99205Normal range

Office/outpatient visit, new patient, high complexity

$6K

62 claims · 0.0%

Your Cost: $94.01/claim|Median: $111.09
0.8× median
87811Top 25%

SARS-CoV-2 COVID-19 antigen detection, rapid, instrument-read

$5K

145 claims · 0.0%

Your Cost: $37.44/claim|Median: $30.53
1.2× median
71046Normal range

Chest X-ray, 2 views

$831

270 claims · 0.0%

Your Cost: $3.08/claim|Median: $8.92
0.3× median
93000Top 25%

Electrocardiogram, complete, with interpretation and report

$480

32 claims · 0.0%

Your Cost: $15.00/claim|Median: $9.70
1.5× median
81003Normal range

Urinalysis, automated without microscopy

$418

325 claims · 0.0%

Your Cost: $1.29/claim|Median: $1.48
0.9× median
94640Normal range

Pressurized or nonpressurized inhalation treatment

$359

51 claims · 0.0%

Your Cost: $7.05/claim|Median: $10.88
0.6× median
73610Normal range

X-ray of ankle, complete, minimum three views

$275

94 claims · 0.0%

Your Cost: $2.92/claim|Median: $13.55
0.2× median
99201Normal range

Office/outpatient visit, new patient, straightforward

$273

12 claims · 0.0%

Your Cost: $22.74/claim|Median: $27.38
0.8× median
81025Normal range

Urine pregnancy test

$248

168 claims · 0.0%

Your Cost: $1.48/claim|Median: $4.81
0.3× median
73130Normal range

$45

13 claims · 0.0%

Your Cost: $3.49/claim|Median: $10.69
0.3× median
73630Normal range

X-ray, foot, complete, minimum 3 views

$42

34 claims · 0.0%

Your Cost: $1.24/claim|Median: $12.06
0.1× median
81002Normal range

Urinalysis, non-automated without microscopy

$14

22 claims · 0.0%

Your Cost: $0.63/claim|Median: $2.00
0.3× median
J7613Normal range

Albuterol inhalation solution, concentrated, per milligram

$3

51 claims · 0.0%

Your Cost: $0.05/claim|Median: $0.08
0.7× median
90715Normal range

Tdap vaccine

$0

12 claims · 0.0%

Your Cost: $0.00/claim|Median: $10.32
36415Normal range

Collection of venous blood by venipuncture

$0

14 claims · 0.0%

Your Cost: $0.00/claim|Median: $1.57
99000Normal range

$0

29 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.30
87807Normal range

$0

98 claims · 0.0%

Your Cost: $0.00/claim|Median: $10.06
99001Normal range

$0

23 claims · 0.0%

Your Cost: $0.00/claim|Median: $2.31

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