20 people, including an NYPD surgeon, are charged with allegedly scamming Medicare, Medicaid, and other insurers out of nearly $150 million and using the cash to pay for extravagant homes, vacations, and jewelry. And prosecutors say it all happened in Brooklyn. NY1's Lindsay Tuchman filed the following report.

High-end handbags, designer watches, million-dollar homes, luxury travel — purchased, prosecutors said, with the proceeds of a gigantic health insurance scam in Brooklyn that defrauded Medicaid, Medicare, and Managed Care Organizations like Healthfirst of at least $146 million over three years.

"We believe that this sum, while exorbitant and our biggest case to date in the Brooklyn DA's office, only represents a small portion of the amount of money they've stolen from taxpayers," Acting Brooklyn District Attorney Eric Gonzalez said.

20 people, including several doctors, are charged in the alleged scheme, which was detailed in a staggering 452-page indictment Tuesday.

It charges that the defendants took a "cradle-to-grave approach to health care fraud," using recruiters to scout low-income areas for Medicaid and Medicare recipients and paying those recipients to undergo costly and medically unnecessary tests like sonograms and echocardiograms at six Brooklyn clinics, like one seen in the video above.

The insurers were then billed for the tests and many more that were not even performed.

"The defendants, including four doctors, callously preyed upon the city's most vulnerable population and used them as pawns to enrich themselves at the expense of taxpayers by stealing millions of dollars from Medicare and Medicaid," said Special Agent Scott Lampert of the Office of the New York Inspector General.

The alleged leader, 35-year-old Kristina Mirbabayeva of Downtown Brooklyn, has Instagram posts portraying a lavish lifestyle.

Also arrested was NYPD Surgeon Dr. Robert Vaccarino, one of the four doctors who allegedly authorized the unnecessary tests or falsely certified that they administered them.

One doctor was recorded talking to Mirbabayeva about falling behind on falsely certifying 15,000 tests.

"These doctors were not present when many of these tests were performed, as they would have been had these been legitimate procedures," Gonzalez said.

In addition to the recruiters and doctors, managers, billers, and money launderers were also indicted. They face multiple charges ranging from health care fraud to grand larceny.

If convicted, the defendants face up to 25 years in prison.