Seton Health System, INC
Seton Health System, INC was paid $129K by Medicaid between Jan 2018 and Dec 2018, across 20 billing codes. Its largest line is 77067, Screening mammography, bilateral, including computer-aided detection — 27% of everything it billed.
TROY, NY 12180
Next to other Family Medicine Physician providers in New York
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 4,425 | $129K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 77067 | Screening mammography, bilateral, including computer-aided detection | 27% | 369 | 369 | $35K |
| 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 | 23% | 799 | 789 | $30K |
| 76830 | Ultrasound, transvaginal | 7.4% | 159 | 159 | $10K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | 6.5% | 151 | 151 | $8K |
| 76856 | Ultrasound, pelvic (nonobstetric), real time with image documentation; complete | 5.6% | 131 | 130 | $7K |
| 76811 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed | 5.4% | 96 | 96 | $7K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 5.0% | 191 | 191 | $6K |
| 76641 | 4.5% | 177 | 176 | $6K | |
| 77063 | Screening digital breast tomosynthesis, bilateral | 3.6% | 361 | 361 | $5K |
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 2.7% | 59 | 49 | $4K |
| 76801 | 2.7% | 62 | 59 | $3K | |
| 77066 | Tomosynthesis, mammo | 1.9% | 25 | 25 | $2K |
8 more codes
| 85610 | 1.1% | 346 | $1K | |
| 93975 | <1% | 19 | $1K | |
| 71046 | Radiologic examination, chest; 2 views | <1% | 164 | $1K |
| 76705 | Ultrasound, abdominal, real time with image documentation; limited | <1% | 25 | $1K |
| 77062 | <1% | 12 | $900.12 | |
| 94760 | <1% | 591 | $34.52 | |
| S9401 | Anticoagulation clinic, inclusive of all services except laboratory tests, per session | 0% | 342 | $0.00 |
| 36416 | 0% | 346 | $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.
Who's on the registration
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.