Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Maryland for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maryland only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Maryland (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Seton Medical Group, Inc (NPI 1144409194)

Field	Value
Entity Type	Organization
Organization	Seton Medical Group, Inc
Address	6740 Alexander Bell Dr Ste 300
City	Columbia
State	MD
ZIP	21046
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 26, 2007

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

54 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	65,060	$50	$3.1M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	57,100	$40	$2.3M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,810	$60	$111.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	1,110	$80	$83.2K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	1,900	$40	$72.2K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	940	$50	$48.1K
G0008	Administration of influenza virus vaccine	1,490	$30	$47.5K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	1,380	$20	$26.2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	260	$70	$17.9K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	320	$50	$16.1K

Showing 1–10 of 54

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maryland Distribution

Seton Medical Group, Inc — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

54 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	19	3,670	680	$90	$310K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	25	3,280	610	$80	$296.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	302	330	800	$110	$228.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	283	290	730	$100	$212.2K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	8	40	150	$90	$192.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	280	320	290	$120	$128K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	29	40	100	$30	$119.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	110	1,000	200	$120	$96.3K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	163	930	110	$100	$90.1K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	445	730	110	$70	$81.9K

Showing 1–10 of 54

Related Providers

Other providers that share a Tax Identification Number (TIN) with Seton Medical Group, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Agnes Healthcare Inc	MD	Internal Medicine Physician	$0	$11.5M
St. Agnes Healthcare, Inc.	MD	General Acute Care Hospital	$0	$5.4M
Nasser Nasseri-asl	MD	Specialist	$1.2M	$0
St. Agnes Healthcare, Inc.	MD	Clinical Medical Laboratory	$147.4K	$890.8K
Richard Hudes	MD	Radiation Oncology Physician	$778.3K	$0
Sylwester Dziuba	MD	Radiation Oncology Physician	$686.4K	$0
Nina Gordon	MD	Diagnostic Radiology Physician	$496.6K	$0
Oliver Chen	MD	Diagnostic Radiology Physician	$473.5K	$0
David Strobel	MD	Dermatology Physician	$464.1K	$0
Seyed Hootan Forghani Saeidabadi	MD	Rheumatology Physician	$453.7K	$0

Nearby Providers

Other providers in the same ZIP code as Seton Medical Group, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Royal Garden Adult Medical Daycare Center Inc.	MD	Adult Companion	$0	$22.2M
Humanim Inc	MD	Mental Illness Community Based Residential Treatment Facility	$0	$18.7M
Adult Day Health, Inc.	MD	Adult Day Care Clinic/Center	$0	$12.5M
Adult Day Health, Inc.	MD	Adult Day Care Clinic/Center	$0	$12.3M
Berger And Burrow Enterprises Inc.	MD	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$6.6M	$3.8M
Option Care Enterprises, Inc.	MD	Home Infusion Therapy Pharmacy	$0	$9.5M
The Kid's Dentist, P.A.	MD	Pediatric Dentistry	$0	$6M
Autism Center Of Excellence LLC	MD	Community/Behavioral Health Agency	$0	$5.2M
M. Slutsky & Associates, Inc	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.7M
Optum Infusion Services 103, LLC	MD	Home Infusion Therapy Pharmacy	$0	$4.7M

Seton Medical Group, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References