Physician
Carlos A. Sesin, MD, PA
Carlos A. Sesin, MD, PA was paid $5K by Medicaid between Jan 2018 and Apr 2022, across 17 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 30% of everything it billed.
33Billing provider infoCARLOS A. SESIN, MD, PA
MIAMI BEACH, FL 33140
MIAMI BEACH, FL 33140
33aNPI1639364144assigned 09/07/2007
33bProvider typeRheumatology Physician
28Total paid$5K
24GClaims11,154
24DCodes billed17
24AFirst – last monthJan 2018 – Apr 2022
Compared with peers
Next to other Rheumatology Physician providers in Florida
Rank by total paid#39 of 55
Median peer was paid$43K
This provider vs. median0.1×
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 | 4,582 | $2K | |
| 2019 | 5,338 | $2K | |
| 2020 | 714 | $863.48 | |
| 2021 | 435 | $85.74 | |
| 2022 | 85 | $0.00 |
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 | 30% | 1,721 | 1,454 | $1K |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 20% | 1,040 | 650 | $938.36 |
| 1123F | 9.8% | 1,407 | 952 | $453.18 | |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 9.3% | 1,804 | 1,235 | $428.49 |
| 20610 | 8.0% | 555 | 187 | $369.92 | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.8% | 633 | 507 | $361.44 |
| 1036F | 7.7% | 1,483 | 1,014 | $358.11 | |
| G8783 | Normal blood pressure reading documented, follow-up not required | 2.7% | 943 | 648 | $123.24 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.6% | 246 | 67 | $120.07 |
| G8950 | Elevated or hypertensive blood pressure reading documented, and the indicated follow-up is documented | 2.1% | 363 | 281 | $95.19 |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 96 | 64 | $2.50 |
| 0518F | 0% | 107 | 100 | $0.00 |
5 more codes
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 officialSESIN, CARLOS (DIRECTOR)