Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

⚖️ Compare🖨️ Print Report

OPTUM MEDICAL CARE, P.C.

Internal Medicine, Cardiovascular Disease·MOUNT KISCO, NY·NPI: 1982643003Share
Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$105.3M

$105,259,374

Total Claims

1.3M

Beneficiaries

1.3M

1.1 claims/patient

Avg Cost/Claim

$78

Monthly Spending Trend

Yearly Spending

2018
$2.8M
+76%
2019
$4.9M
+48%
2020
$7.3M
+78%
2021
$12.9M
+73%
2022
$22.4M
+47%
2023
$32.9M
-33%
2024
$22.1M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (99213 (Office/outpatient visit, est. patient, low-mod complexity)) accounts for 33% of total spending.

99213Top 5%

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

$34.4M

291K claims · 32.7%

Your Cost: $118.33/claim|Median: $37.81
3.1× median
99214Top 5%

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

$15.9M

95K claims · 15.1%

Your Cost: $167.31/claim|Median: $53.41
3.1× median
88305Top 5%

Surgical pathology, gross and microscopic examination

$3.1M

14K claims · 2.9%

Your Cost: $218.81/claim|Median: $35.80
6.1× median
99203Top 5%

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

$2.6M

17K claims · 2.5%

Your Cost: $155.48/claim|Median: $57.85
2.7× median
76641Top 5%

Ultrasound imaging of one breast, complete

$2.6M

12K claims · 2.4%

Your Cost: $215.32/claim|Median: $49.03
4.4× median
77067Top 5%

Screening mammography, bilateral, including CAD

$2.5M

14K claims · 2.4%

Your Cost: $183.42/claim|Median: $39.33
4.7× median
99204Top 5%

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

$2.0M

9,299 claims · 1.9%

Your Cost: $220.28/claim|Median: $84.03
2.6× median
99393Top 5%

Preventive medicine, established patient, age 5-11

$1.9M

14K claims · 1.8%

Your Cost: $139.65/claim|Median: $74.82
1.9× median
87631Top 5%

Respiratory virus detection, 3-5 targets, multiplex

$1.9M

11K claims · 1.8%

Your Cost: $172.15/claim|Median: $65.45
2.6× median
99392Top 5%

Preventive medicine, established patient, age 1-4

$1.7M

12K claims · 1.6%

Your Cost: $140.94/claim|Median: $75.18
1.9× median
U0003Top 25%

Infectious disease detection (COVID-19)

$1.5M

16K claims · 1.4%

Your Cost: $91.91/claim|Median: $63.08
1.5× median
90460Normal range

Immunization administration, first vaccine/toxoid, with counseling

$1.4M

74K claims · 1.3%

Your Cost: $18.22/claim|Median: $17.85
1.0× median
76816Top 5%

Ultrasound, pregnant uterus, follow-up

$1.3M

8,048 claims · 1.3%

Your Cost: $165.90/claim|Median: $58.55
2.8× median
99391Top 5%

Preventive medicine, established patient, infant (under 1)

$1.3M

10K claims · 1.2%

Your Cost: $126.25/claim|Median: $69.35
1.8× median
87635Top 10%

COVID-19 SARS-CoV-2 amplified probe detection

$1.3M

23K claims · 1.2%

Your Cost: $56.73/claim|Median: $39.70
1.4× median
99394Top 5%

Preventive medicine, established patient, age 12-17

$1.2M

7,806 claims · 1.1%

Your Cost: $149.72/claim|Median: $80.15
1.9× median
0202UTop 5%

Proprietary lab analysis, human genomic sequencing

$1.0M

2,611 claims · 1.0%

Your Cost: $398.05/claim|Median: $144.30
2.8× median
76700Top 10%

Ultrasound, abdominal, complete

$972K

6,381 claims · 0.9%

Your Cost: $152.34/claim|Median: $50.69
3.0× median
77063Top 5%

Screening digital breast tomosynthesis, bilateral

$961K

13K claims · 0.9%

Your Cost: $74.20/claim|Median: $21.41
3.5× median
0241UTop 10%

Proprietary lab analysis, genomic sequencing

$944K

6,006 claims · 0.9%

Your Cost: $157.13/claim|Median: $91.47
1.7× median
87651Normal range

Streptococcus Group A detection, nucleic acid, amplified probe

$883K

27K claims · 0.8%

Your Cost: $32.35/claim|Median: $28.46
1.1× median
92060Top 5%

$869K

11K claims · 0.8%

Your Cost: $77.94/claim|Median: $35.83
2.2× median
76819Top 5%

Fetal biophysical profile with non-stress test

$831K

6,529 claims · 0.8%

Your Cost: $127.25/claim|Median: $49.45
2.6× median
87491Top 25%

Chlamydia detection, nucleic acid, amplified probe

$764K

19K claims · 0.7%

Your Cost: $41.18/claim|Median: $24.95
1.7× median
87591Top 25%

Neisseria gonorrhoeae detection, nucleic acid, amplified probe

$764K

19K claims · 0.7%

Your Cost: $41.19/claim|Median: $23.39
1.8× median
31231Top 5%

Nasal endoscopy, diagnostic

$667K

2,389 claims · 0.6%

Your Cost: $279.18/claim|Median: $98.77
2.8× median
76830Top 5%

Ultrasound, transvaginal

$628K

3,614 claims · 0.6%

Your Cost: $173.84/claim|Median: $57.47
3.0× median
97110Top 25%

Therapeutic exercises, each 15 min

$589K

11K claims · 0.6%

Your Cost: $52.34/claim|Median: $24.49
2.1× median
92014Top 1%

Ophthalmological exam, comprehensive, established patient

$530K

3,354 claims · 0.5%

Your Cost: $157.99/claim|Median: $47.08
3.4× median
99212Top 10%

Office/outpatient visit, low complexity

$508K

7,198 claims · 0.5%

Your Cost: $70.51/claim|Median: $25.06
2.8× median
87624Top 10%

HPV detection, high-risk types, nucleic acid

$482K

12K claims · 0.5%

Your Cost: $41.58/claim|Median: $25.57
1.6× median
99215Top 5%

Office/outpatient visit, high complexity

$478K

2,027 claims · 0.5%

Your Cost: $235.89/claim|Median: $74.09
3.2× median
A4550Top 5%

$464K

1,942 claims · 0.4%

Your Cost: $238.93/claim|Median: $4.85
49.3× median
87637Normal range

Respiratory virus detection, 3-5 targets, nucleic acid

$450K

3,549 claims · 0.4%

Your Cost: $126.73/claim|Median: $100.62
1.3× median
92004Top 1%

Ophthalmological exam, comprehensive, new patient

$446K

2,371 claims · 0.4%

Your Cost: $188.03/claim|Median: $59.72
3.1× median
97140Top 10%

Manual therapy techniques, per 15 minutes

$415K

10K claims · 0.4%

Your Cost: $41.35/claim|Median: $16.79
2.5× median
87801Top 10%

Infectious agent detection, amplified probe, multiple organisms

$387K

4,468 claims · 0.4%

Your Cost: $86.67/claim|Median: $38.79
2.2× median
71046Top 10%

Chest X-ray, 2 views

$375K

8,315 claims · 0.4%

Your Cost: $45.11/claim|Median: $8.92
5.1× median
87502Top 5%

Influenza virus detection, reverse transcription, amplified probe

$361K

3,120 claims · 0.3%

Your Cost: $115.86/claim|Median: $65.64
1.8× median
76536Top 5%

$360K

2,455 claims · 0.3%

Your Cost: $146.79/claim|Median: $44.06
3.3× median
76817Top 5%

Ultrasound, pregnant uterus, transvaginal

$354K

2,414 claims · 0.3%

Your Cost: $146.54/claim|Median: $47.65
3.1× median
81513Normal range

$349K

4,265 claims · 0.3%

Your Cost: $81.81/claim|Median: $71.32
1.1× median
88174Top 5%

$349K

12K claims · 0.3%

Your Cost: $29.23/claim|Median: $13.53
2.2× median
73721Top 25%

MRI joint of lower extremity without contrast

$348K

1,234 claims · 0.3%

Your Cost: $282.41/claim|Median: $127.34
2.2× median
87661Top 10%

Trichomonas vaginalis detection, nucleic acid, amplified probe

$344K

8,503 claims · 0.3%

Your Cost: $40.45/claim|Median: $21.08
1.9× median
76813Top 1%

Ultrasound for fetal nuchal translucency measurement

$343K

1,985 claims · 0.3%

Your Cost: $172.75/claim|Median: $70.87
2.4× median
76856Top 10%

Ultrasound, pelvic, complete

$334K

2,739 claims · 0.3%

Your Cost: $122.12/claim|Median: $47.58
2.6× median
95004Normal range

Percutaneous allergy skin tests, each

$334K

2,747 claims · 0.3%

Your Cost: $121.48/claim|Median: $134.97
0.9× median
76811Top 5%

Ultrasound, pregnant uterus, detailed, single fetus

$330K

1,320 claims · 0.3%

Your Cost: $250.02/claim|Median: $106.79
2.3× median
70551Top 25%

MRI brain without contrast

$270K

1,120 claims · 0.3%

Your Cost: $240.89/claim|Median: $85.39
2.8× median

Other Top Providers in New York

View all →

Public Partnerships LLC

Supports Brokerage

$7.18B

Freedom Care LLC

Home Health

$3.03B

American Business Institute Corp

Home Health

$1.68B

Premier Home Health Care Services INC

Home Health

$1.48B

Assistcarehome Healthcare Services

Home Health

$1.44B

Similar Providers

Other top providers in Internal Medicine, Cardiovascular Disease

William Beaumont Hospital

Royal Oak, MI

$168.0M

← All providersAll providers in New York →How we detect fraud →