Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

PRITHIPAL S. SETHI M.D., INC.

NPI: 1295921518 · SACRAMENTO, CA 95823 · Urology Physician · NPI assigned 09/20/2007

$365K
Total Medicaid Paid
68,226
Total Claims
63,949
Beneficiaries
52
Codes Billed
2018-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialSETHI, PRITHIPAL (OWNER/PRESIDENT)
NPI Enumeration Date09/20/2007

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,605 $62K
2019 3,142 $16K
2020 9,637 $21K
2021 13,346 $12K
2022 17,288 $27K
2023 13,026 $60K
2024 10,182 $168K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 12,329 11,578 $102K
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 8,073 7,502 $47K
J0585 Injection, onabotulinumtoxina, 1 unit 252 252 $45K
52442 456 455 $21K
51798 10,771 9,834 $18K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 4,066 4,028 $17K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism 1,655 1,628 $15K
J0897 Injection, denosumab, 1 mg 50 48 $13K
52441 455 455 $12K
52287 293 292 $12K
52000 2,361 2,346 $11K
51703 1,062 885 $9K
87801 Infectious agent detection by nucleic acid; amplified probe, multiple organisms 1,652 1,626 $6K
51710 438 372 $6K
87481 1,650 1,624 $6K
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) 2,189 1,978 $4K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1,568 1,332 $3K
51728 567 562 $2K
88305 Level IV - Surgical pathology, gross and microscopic examination 264 125 $2K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 55 55 $1K
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe 1,659 1,622 $1K
87640 1,654 1,627 $1K
87500 1,651 1,625 $1K
87641 1,651 1,626 $1K
87653 1,664 1,625 $1K
52281 60 60 $1K
81000 3,783 3,704 $774.47
J9217 Leuprolide acetate (for depot suspension), 7.5 mg 13 13 $744.81
99490 Ccm add 20min 69 69 $698.78
64566 641 340 $662.08
88108 1,442 1,233 $637.25
99205 Prolong outpt/office vis 379 378 $514.41
51741 763 746 $419.02
J1580 Injection, garamycin, gentamicin, up to 80 mg 114 105 $345.58
99245 78 78 $336.66
99244 Office or other outpatient consultation, moderate to high complexity 21 21 $190.51
99439 14 14 $136.26
J1071 Injection, testosterone cypionate, 1 mg 187 124 $95.17
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r 111 110 $75.00
99426 39 39 $48.24
88313 1,442 1,233 $34.93
51705 14 13 $25.28
96402 25 25 $9.71
86328 262 261 $0.00
55700 13 13 $0.00
93980 12 12 $0.00
76942 13 13 $0.00
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 110 109 $0.00
76872 27 27 $0.00
99024 38 36 $0.00
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe 59 59 $0.00
54235 12 12 $0.00