Optumcare Colorado Medical Group, LLC

Optumcare Colorado Medical Group, LLC was paid $14K by Medicaid between Feb 2020 and Jan 2021, across 7 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 61% of everything it billed.

33Billing provider infoOPTUMCARE COLORADO MEDICAL GROUP, LLC
COLORADO SPRINGS, CO 80920

33aNPI1548891815assigned 01/27/2020

33bProvider typePediatrics Physician

28Total paid$14K

24GClaims317

24DCodes billed7

24AFirst – last monthFeb 2020 – Jan 2021

Compared with peers

Next to other Pediatrics Physician providers in Colorado

Rank by total paid#131 of 186

Median peer was paid$68K

This provider vs. median0.2×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official COHEN, DAVID controls 13+ related entities in our dataset. Read more

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
2020	304	$14K
2021	13	$138.32

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	61%	113	106	$8K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	29%	83	81	$4K
90460	Immunization administration through 18 years of age via any route, first or only component	5.9%	26	26	$809.34
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	2.4%	18	18	$327.59
92551		1.0%	13	13	$138.32
96110	Developmental screening, with scoring and documentation, per standardized instrument	<1%	15	12	$108.09
90686		<1%	49	49	$17.97

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 officialCOHEN, DAVID (MEDICAL DIRECTOR)

Same official

Other billing entities under COHEN, DAVID

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Optumcare Colorado Medical Group, LLC	Monument, CO	$8K
Optumcare Colorado Medical Group LLC	Colorado Springs, CO	$6K
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Optumcare Colorado Medical Group LLC	Colorado Springs, CO	$2K
Optumcare Colorado Medical Group LLC	Colorado Springs, CO	$2K
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Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.