Is OPTIMUS HEALTH CARE flagged for Medicaid fraud?

OPTIMUS HEALTH CARE (NPI: 1992871875) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does OPTIMUS HEALTH CARE bill Medicaid?

OPTIMUS HEALTH CARE received $0.0B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Clinic/Center, Mental Health (Including Community Mental Health Center) provider. Located in BRIDGEPORT, CT.

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OPTIMUS HEALTH CARE

Clinic/Center, Mental Health (Including Community Mental Health Center)·BRIDGEPORT, CT·NPI: 1992871875Share

Compared to Clinic/Center, Mental Health (Including Community Mental Health Center) Peers

Total spending distribution among 44 providers in this specialty

P25MedianP75P90

This provider's total spending of $33.2M is at the 50th percentile among 44 Clinic/Center, Mental Health (Including Community Mental Health Center) providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$33.2M

$33,153,278

Total Claims

438K

Beneficiaries

243K

1.8 claims/patient

Avg Cost/Claim

$76

Monthly Spending Trend

Yearly Spending

2018

$3.9M

-5%

2019

$3.7M

+29%

2020

$4.8M

+16%

2021

$5.5M

+6%

2022

$5.9M

+10%

2023

$6.4M

-54%

2024

$3.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 21 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 97% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

T1015Clinic visit/encounter, all-inclusiveSee all providers →

$32.2M

212K claims

$151.96

$121.16

1.3×

Normal range

T1015Normal range

Clinic visit/encounter, all-inclusive

$32.2M

212K claims · 97.2%

Your Cost: $151.96/claim|Median: $121.16

1.3× median

G2025 See all providers →

$665K

12K claims

$54.85

$15.63

3.5×

Top 25%

G2025Top 25%

$665K

12K claims · 2.0%

Your Cost: $54.85/claim|Median: $15.63

3.5× median

G0470Chronic care management services, FQHC/RHCSee all providers →

$170K

12K claims

$14.52

$45.95

0.3×

Normal range

G0470Normal range

Chronic care management services, FQHC/RHC

$170K

12K claims · 0.5%

Your Cost: $14.52/claim|Median: $45.95

0.3× median

G0467Federally qualified health center visit, mental healthSee all providers →

$38K

2,525 claims

$15.07

$21.91

0.7×

Normal range

G0467Normal range

Federally qualified health center visit, mental health

$38K

2,525 claims · 0.1%

Your Cost: $15.07/claim|Median: $21.91

0.7× median

90832Psychotherapy, 30 minutesSee all providers →

$23K

124K claims

$0.18

$41.28

0.0×

Normal range

90832Normal range

Psychotherapy, 30 minutes

$23K

124K claims · 0.1%

Your Cost: $0.18/claim|Median: $41.28

0.0× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$21K

42K claims

$0.49

$37.81

0.0×

Normal range

99213Normal range

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

$21K

42K claims · 0.1%

Your Cost: $0.49/claim|Median: $37.81

0.0× median

90792Psychiatric diagnostic evaluation with medical servicesSee all providers →

$3K

6,003 claims

$0.52

$108.91

0.0×

Normal range

90792Normal range

Psychiatric diagnostic evaluation with medical services

$3K

6,003 claims · 0.0%

Your Cost: $0.52/claim|Median: $108.91

0.0× median

90853Group psychotherapySee all providers →

$2K

7,547 claims

$0.22

$25.02

0.0×

Normal range

90853Normal range

Group psychotherapy

$2K

7,547 claims · 0.0%

Your Cost: $0.22/claim|Median: $25.02

0.0× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$935

4,206 claims

$0.22

$53.41

0.0×

Normal range

99214Normal range

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

$935

4,206 claims · 0.0%

Your Cost: $0.22/claim|Median: $53.41

0.0× median

90834Psychotherapy, 45 minutesSee all providers →

$766

6,597 claims

$0.12

$63.65

0.0×

Normal range

90834Normal range

Psychotherapy, 45 minutes

$766

6,597 claims · 0.0%

Your Cost: $0.12/claim|Median: $63.65

0.0× median

90791Psychiatric diagnostic evaluationSee all providers →

$583

5,815 claims

$0.10

$99.21

0.0×

Normal range

90791Normal range

Psychiatric diagnostic evaluation

$583

5,815 claims · 0.0%

Your Cost: $0.10/claim|Median: $99.21

0.0× median

90837Psychotherapy, 60 minutesSee all providers →

$187

34 claims

$5.51

$85.66

0.1×

Normal range

90837Normal range

Psychotherapy, 60 minutes

$187

34 claims · 0.0%

Your Cost: $5.51/claim|Median: $85.66

0.1× median

99215Office/outpatient visit, high complexitySee all providers →

$83

433 claims

$0.19

$74.09

0.0×

Normal range

99215Normal range

Office/outpatient visit, high complexity

$83

433 claims · 0.0%

Your Cost: $0.19/claim|Median: $74.09

0.0× median

G0511RHC/FQHC visit, psychiatric collaborative care modelSee all providers →

113 claims

$0.00

$11.35

—

Normal range

G0511Normal range

RHC/FQHC visit, psychiatric collaborative care model

113 claims · 0.0%

Your Cost: $0.00/claim|Median: $11.35

99442Telephone E/M by physician, 11-20 minutesSee all providers →

428 claims

$0.00

$22.44

—

Normal range

99442Normal range

Telephone E/M by physician, 11-20 minutes

428 claims · 0.0%

Your Cost: $0.00/claim|Median: $22.44

98967 See all providers →

552 claims

$0.00

$18.97

—

Normal range

98967Normal range

552 claims · 0.0%

Your Cost: $0.00/claim|Median: $18.97

90863 See all providers →

484 claims

$0.00

$29.71

—

Normal range

90863Normal range

484 claims · 0.0%

Your Cost: $0.00/claim|Median: $29.71

90838Psychotherapy, 60 min, add-on to E/MSee all providers →

22 claims

$0.00

$67.05

—

Normal range

90838Normal range

Psychotherapy, 60 min, add-on to E/M

22 claims · 0.0%

Your Cost: $0.00/claim|Median: $67.05

90847Family psychotherapy with patient, 50 minSee all providers →

55 claims

$0.00

$77.33

—

Normal range

90847Normal range

Family psychotherapy with patient, 50 min

55 claims · 0.0%

Your Cost: $0.00/claim|Median: $77.33

S9480Intensive outpatient psychiatric services, per diemSee all providers →

159 claims

$0.00

$135.70

—

Normal range

S9480Normal range

Intensive outpatient psychiatric services, per diem

159 claims · 0.0%

Your Cost: $0.00/claim|Median: $135.70

98968 See all providers →

1,269 claims

$0.00

$28.39

—

Normal range

98968Normal range

1,269 claims · 0.0%

Your Cost: $0.00/claim|Median: $28.39

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$1.08B

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$533.3M

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$400.1M

Hartford Hospital

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$316.3M

Cornell Scott Hill Health Corporation

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$294.2M

Similar Providers

Other top providers in Clinic/Center, Mental Health (Including Community Mental Health Center)

Los Angeles County Department of Mental Health

Los Angeles, CA

$6.78B

County of Sonoma

Santa Rosa, CA

$195.1M

County of Washtenaw

Ypsilanti, MI

$153.3M

County of Muskegon

Muskegon, MI

$151.1M

Fraser Child and Family Center

Minneapolis, MN

$149.8M

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