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Sentara Health Plans (Optima Health)

Last updated: March 2026

Sentara Health Plans (Optima Health) is a health insurer. They report 2.6K insurance plans covering 99K providers across 21K billing codes.

Data Version

Price Transparency Machine-Readable Files Snapshot
March 2026
Overview
2.6K

Plans

99K

Providers (NPIs)

16K

Tax IDs

21K

Billing Codes

260M

Data Rows

Geographic Coverage

Top states by provider count:

Virginia (43K)
North Carolina (10K)
Maryland (7.5K)
Florida (4.3K)
Data Breakdown
Plans Type (HIOS vs EIN)

HIOS

190

EIN

2.4K

NPIs

Individual

96K

Group

3.7K

Tax IDs

EIN

16K

Billing Code Type
CodesRows

CPT

12K

180M

HCPCS

7.5K

69M

CDT

700

7.8M

RC

560

380K

MS-DRG

950

280K

NDC

1

290

CSTM-ALL

1

62

Billing Class
Rows

Institutional

130M

Professional

130M

Negotiated Type
Rows

Fee Schedule

260M

Percentage

3.4M

Per Diem

320K

Top States by # NPIs

Virginia

43K

North Carolina

10K

Maryland

7.5K

Florida

4.3K

Tennessee

4K

Top Taxonomies by # NPIs

Family Nurse Practitioner

6.3K

Diagnostic Radiology Physician

5.9K

Physician Assistant

5.2K

Family Medicine Physician

5.1K

Internal Medicine Physician

5.1K

Want to explore Sentara Health Plans (Optima Health)'s actual negotiated rates?

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Historical Metrics
MonthPlansNPIsTax IDsBilling CodesData Rows
March 2026
2.6K99K16K21K260M
January 2026

September 2025

August 2025

July 2025

Show all 9 months

Data Coverage Scorecard
6/6 — Good

This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.

Professional & Institutional Rates

Data includes both professional and institutional billing class rates

Valid Tax IDs

More than 80% of Tax IDs are EIN or NPI (Organization) type

HIOS Plan

Data includes at least one HIOS-identified plan

Low Derived/Percentage Rates

Less than 10% of negotiation entries are derived or percentage type

Standard Code Coverage

Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries

Common Taxonomies

NPIs in the dataset cover at least 50 distinct provider taxonomies

Methodology

The scorecard evaluates each payer's monthly price transparency data against six quality criteria:

  • If 5–6 criteria pass, the overall rating is Good.

  • If 3–4 criteria pass, the rating is Acceptable.

  • If 0–2 criteria pass, the rating is Poor.

Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.

PRICE TRANSPARENCY DATA

Explore Sentara Health Plans (Optima Health) negotiated rates.