Setzen, Gavin

Setzen, Gavin was paid $11K by Medicaid between May 2019 and Nov 2024, across 7 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 49% of everything it billed.

33Billing provider infoSETZEN, GAVIN
ALBANY, NY 12205

33aNPI1063419232assigned 07/03/2005

33bProvider typeFacial Plastic Surgery Physician

28Total paid$11K

24GClaims743

24DCodes billed7

24AFirst – last monthMay 2019 – Nov 2024

Compared with peers

Next to other Facial Plastic Surgery Physician providers in New York

Rank by total paid#11 of 14

Median peer was paid$32K

This provider vs. median0.3×

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
2019	78	$667.40
2020	93	$673.09
2021	39	$557.77
2022	13	$34.00
2023	334	$6K
2024incomplete	186	$3K

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	49%	397	386	$5K
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	36%	149	143	$4K
31231		4.6%	14	14	$491.65
69210		4.4%	61	59	$470.91
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	2.9%	14	14	$309.81
95117		2.3%	94	38	$243.84
92567		<1%	14	13	$69.54

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.