Physician
Optimum Medical LLC
Optimum Medical LLC was paid $8.93M by Medicaid between Jan 2018 and Dec 2024, across 73 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 32% of everything it billed.
33Billing provider infoOPTIMUM MEDICAL LLC
DANBURY, CT 06810
DANBURY, CT 06810
33aNPI1720215346assigned 06/22/2009
33bProvider typePediatrics Physician
28Total paid$8.93M
24GClaims344,724
24DCodes billed73
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Connecticut
Rank by total paid#5 of 162
Median peer was paid$313K
This provider vs. median29×
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.
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 | |
|---|---|---|---|
| 2018 | 44,014 | $1.32M | |
| 2019 | 45,488 | $1.29M | |
| 2020 | 44,272 | $1.12M | |
| 2021 | 48,468 | $1.22M | |
| 2022 | 54,477 | $1.35M | |
| 2023 | 54,931 | $1.35M | |
| 2024incomplete | 53,074 | $1.28M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 32% | 40,047 | 33,206 | $2.90M |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 10% | 20,874 | 19,576 | $933K |
| 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 | 8.0% | 6,819 | 6,318 | $715K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 7.5% | 6,403 | 6,172 | $672K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.8% | 5,877 | 5,646 | $609K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 5.8% | 5,233 | 4,778 | $521K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 4.0% | 3,124 | 3,035 | $358K |
| 99174 | 4.0% | 18,614 | 17,911 | $354K | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.1% | 15,764 | 15,034 | $273K |
| 92587 | 2.3% | 6,148 | 5,852 | $205K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.1% | 4,477 | 4,331 | $192K |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | 1.5% | 3,938 | 3,649 | $134K |
61 more codes
| 96127 | 1.0% | 5,430 | $93K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 7,738 | $85K |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 7,268 | $81K |
| 99051 | <1% | 11,213 | $75K | |
| 36416 | <1% | 21,531 | $71K | |
| 96160 | <1% | 3,963 | $66K | |
| 94664 | <1% | 6,907 | $61K | |
| 94375 | <1% | 2,520 | $54K | |
| 82570 | <1% | 10,785 | $51K | |
| 94010 | <1% | 2,345 | $49K | |
| 85014 | <1% | 19,923 | $43K | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 2,248 | $40K |
| 80061 | Lipid panel | <1% | 3,037 | $37K |
| 99381 | <1% | 313 | $34K | |
| 94760 | <1% | 20,036 | $32K | |
| 87428 | <1% | 521 | $31K | |
| 81001 | <1% | 10,767 | $31K | |
| 83655 | <1% | 2,051 | $23K | |
| 87811 | Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) | <1% | 477 | $14K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 530 | $13K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 81 | $12K |
| 99401 | <1% | 344 | $12K | |
| 82947 | <1% | 3,042 | $11K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 138 | $10K |
| 88720 | <1% | 1,547 | $7K | |
| 99383 | <1% | 59 | $7K | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | <1% | 136 | $7K |
| 99242 | <1% | 112 | $6K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 47 | $5K |
| 95004 | Percutaneous tests with allergenic extracts, immediate type reaction | <1% | 31 | $3K |
| 99382 | <1% | 13 | $2K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 25 | $1K |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | <1% | 74 | $1K |
| 99460 | <1% | 13 | $597.74 | |
| 85018 | <1% | 19,873 | $168.35 | |
| 87807 | <1% | 14 | $160.30 | |
| 86580 | <1% | 26 | $154.57 | |
| 90686 | <1% | 8,653 | $76.19 | |
| 90744 | <1% | 1,868 | $26.14 | |
| 90671 | <1% | 746 | $1.13 | |
| 90670 | <1% | 2,871 | $0.06 | |
| 90685 | <1% | 707 | $0.05 | |
| 90672 | <1% | 321 | $0.01 | |
| 90696 | 0% | 596 | $0.00 | |
| 90716 | 0% | 2,278 | $0.00 | |
| 90651 | 0% | 1,930 | $0.00 | |
| 90619 | 0% | 180 | $0.00 | |
| 90680 | 0% | 2,248 | $0.00 | |
| 90656 | 0% | 884 | $0.00 | |
| 90677 | 0% | 160 | $0.00 | |
| 90674 | 0% | 1,502 | $0.00 | |
| 90700 | 0% | 3,724 | $0.00 | |
| 90734 | 0% | 974 | $0.00 | |
| 90648 | 0% | 3,739 | $0.00 | |
| 90633 | 0% | 2,441 | $0.00 | |
| 90715 | 0% | 507 | $0.00 | |
| 90713 | 0% | 2,902 | $0.00 | |
| 90681 | 0% | 184 | $0.00 | |
| 90707 | 0% | 2,266 | $0.00 | |
| 90621 | 0% | 421 | $0.00 | |
| 90661 | 0% | 126 | $0.00 |
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 officialETIENNE, JACQUES (PHYSICIAN/OWNER)