Physician
Prithipal S. Sethi M.D., INC.
Prithipal S. Sethi M.D., INC. was paid $365K by Medicaid between Jan 2018 and Nov 2024, across 52 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 28% of everything it billed.
33Billing provider infoPRITHIPAL S. SETHI M.D., INC.
SACRAMENTO, CA 95823
SACRAMENTO, CA 95823
33aNPI1295921518assigned 09/20/2007
33bProvider typeUrology Physician
28Total paid$365K
24GClaims68,226
24DCodes billed52
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Urology Physician providers in California
Rank by total paid#31 of 171
Median peer was paid$20K
This provider vs. median18×
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 | 1,605 | $62K | |
| 2019 | 3,142 | $16K | |
| 2020 | 9,637 | $21K | |
| 2021 | 13,346 | $12K | |
| 2022 | 17,288 | $27K | |
| 2023 | 13,026 | $60K | |
| 2024incomplete | 10,182 | $168K |
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 | 28% | 12,329 | 11,578 | $102K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 13% | 8,073 | 7,502 | $47K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 12% | 252 | 252 | $45K |
| 52442 | 5.8% | 456 | 455 | $21K | |
| 51798 | 4.9% | 10,771 | 9,834 | $18K | |
| 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 | 4.6% | 4,066 | 4,028 | $17K |
| 87798 | Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism | 4.0% | 1,655 | 1,628 | $15K |
| J0897 | Injection, denosumab, 1 mg | 3.6% | 50 | 48 | $13K |
| 52441 | 3.3% | 455 | 455 | $12K | |
| 52287 | 3.3% | 293 | 292 | $12K | |
| 52000 | 3.0% | 2,361 | 2,346 | $11K | |
| 51703 | 2.6% | 1,062 | 885 | $9K |
40 more codes
| 87801 | Infectious agent detection by nucleic acid; amplified probe, multiple organisms | 1.7% | 1,652 | $6K |
| 51710 | 1.6% | 438 | $6K | |
| 87481 | 1.5% | 1,650 | $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) | 1.0% | 2,189 | $4K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,568 | $3K |
| 51728 | <1% | 567 | $2K | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | <1% | 264 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 55 | $1K |
| 87651 | Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe | <1% | 1,659 | $1K |
| 87640 | <1% | 1,654 | $1K | |
| 87500 | <1% | 1,651 | $1K | |
| 87641 | <1% | 1,651 | $1K | |
| 87653 | <1% | 1,664 | $1K | |
| 52281 | <1% | 60 | $1K | |
| 81000 | <1% | 3,783 | $774.47 | |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | <1% | 13 | $744.81 |
| 99490 | Ccm add 20min | <1% | 69 | $698.78 |
| 64566 | <1% | 641 | $662.08 | |
| 88108 | <1% | 1,442 | $637.25 | |
| 99205 | Prolong outpt/office vis | <1% | 379 | $514.41 |
| 51741 | <1% | 763 | $419.02 | |
| J1580 | Injection, garamycin, gentamicin, up to 80 mg | <1% | 114 | $345.58 |
| 99245 | <1% | 78 | $336.66 | |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 21 | $190.51 |
| 99439 | <1% | 14 | $136.26 | |
| J1071 | Injection, testosterone cypionate, 1 mg | <1% | 187 | $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 | <1% | 111 | $75.00 |
| 99426 | <1% | 39 | $48.24 | |
| 88313 | <1% | 1,442 | $34.93 | |
| 51705 | <1% | 14 | $25.28 | |
| 96402 | <1% | 25 | $9.71 | |
| 86328 | 0% | 262 | $0.00 | |
| 55700 | 0% | 13 | $0.00 | |
| 93980 | 0% | 12 | $0.00 | |
| 76942 | 0% | 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 | 0% | 110 | $0.00 |
| 76872 | 0% | 27 | $0.00 | |
| 99024 | 0% | 38 | $0.00 | |
| 87635 | Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe | 0% | 59 | $0.00 |
| 54235 | 0% | 12 | $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 officialSETHI, PRITHIPAL (OWNER/PRESIDENT)