Physician
Seton Medical Group, INC
Seton Medical Group, INC was paid $5.85M by Medicaid between Jan 2018 and Dec 2024, across 54 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 52% of everything it billed.
33Billing provider infoSETON MEDICAL GROUP, INC
COLUMBIA, MD 21046
COLUMBIA, MD 21046
33aNPI1144409194assigned 10/26/2007
33bProvider typeFamily Medicine Physician
28Total paid$5.85M
24GClaims142,711
24DCodes billed54
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Maryland
Rank by total paid#4 of 287
Median peer was paid$78K
This provider vs. median75×
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 | 3,627 | $222K | |
| 2019 | 3,990 | $172K | |
| 2020 | 14,262 | $664K | |
| 2021 | 34,734 | $864K | |
| 2022 | 28,582 | $1.51M | |
| 2023 | 31,910 | $1.47M | |
| 2024incomplete | 25,606 | $957K |
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 | 52% | 65,057 | 37,093 | $3.06M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 39% | 57,104 | 31,791 | $2.29M |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.9% | 1,805 | 1,007 | $112K |
| 87637 | Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV | 1.4% | 1,109 | 645 | $83K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 1.2% | 1,901 | 1,744 | $73K |
| 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 | <1% | 943 | 438 | $48K |
| G0008 | Administration of influenza virus vaccine | <1% | 1,485 | 1,294 | $47K |
| 93000 | <1% | 1,379 | 1,206 | $26K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 259 | 164 | $18K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 323 | 171 | $16K |
| 0012A | <1% | 838 | 479 | $9K | |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 64 | 63 | $8K |
42 more codes
| 0011A | <1% | 943 | $8K | |
| 99205 | Prolong outpt/office vis | <1% | 79 | $6K |
| 90686 | <1% | 1,294 | $5K | |
| 90674 | <1% | 349 | $5K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 442 | $5K |
| 99385 | <1% | 75 | $3K | |
| G0009 | Administration of pneumococcal vaccine | <1% | 91 | $3K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 78 | $3K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 561 | $3K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,358 | $3K |
| 0001A | <1% | 280 | $3K | |
| 90653 | <1% | 56 | $3K | |
| 0002A | <1% | 225 | $2K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 60 | $2K |
| 81025 | <1% | 475 | $2K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 12 | $1K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 23 | $1K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 127 | $981.95 |
| 81002 | <1% | 125 | $946.34 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 25 | $881.58 |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 174 | $757.98 |
| 99495 | <1% | 15 | $654.39 | |
| 0031A | <1% | 47 | $533.20 | |
| 99417 | Prolong home eval add 15m | <1% | 13 | $513.83 |
| 90661 | <1% | 64 | $470.27 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 48 | $455.68 |
| 90688 | <1% | 39 | $445.94 | |
| 99407 | <1% | 30 | $404.22 | |
| 3044F | <1% | 17 | $389.64 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | <1% | 63 | $363.26 |
| 90662 | <1% | 648 | $340.50 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 53 | $331.10 |
| 90656 | <1% | 12 | $231.00 | |
| 99441 | <1% | 37 | $210.74 | |
| 99173 | <1% | 23 | $43.81 | |
| 99442 | <1% | 20 | $40.00 | |
| 90670 | <1% | 50 | $0.10 | |
| 91301 | <1% | 1,749 | $0.01 | |
| 91303 | 0% | 20 | $0.00 | |
| Q2035 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) | 0% | 15 | $0.00 |
| 91300 | 0% | 599 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 30 | $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 officialHIGGINBOTHAM, WILLIAM (PRESIDENT/CEO)
Parent organizationASCENSION HEALTH
| Provider | Location | Paid |
|---|---|---|
| ST Agnes Healthcare INC | Baltimore, MD | $11.53M |
| ST. Agnes Healthcare, INC. | Baltimore, MD | $962K |
| ST. Agnes Healthcare, INC. | Baltimore, MD | $13K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.