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NPI 1558343129 · Chelmsford, MA · Nephrology Physician
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Sebastian Sepulveda is a nephrology physician provider located in Chelmsford, Massachusetts. This profile covers 13 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Sebastian Sepulveda |
| Address | 9 North Rd |
| City | Chelmsford |
| State | MA |
| ZIP | 01824 |
| Taxonomy | Nephrology Physician |
| NPI Enumerated | November 18, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $355.2K |
| Medicaid | $12.4K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 2,140 | $70 | $143.2K |
| 90960 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the… | 220 | $300 | $64.5K |
| 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… | 560 | $100 | $55.5K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 290 | $150 | $41.5K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 330 | $70 | $23K |
| 90961 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the… | 40 | $250 | $9K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 50 | $140 | $7.5K |
| 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… | 50 | $70 | $3.4K |
| 99205 | The provider sees a new 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 provider… | 20 | $170 | $2.6K |
| 90935 | Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally… | 40 | $60 | $2.3K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
13 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 90960 | 27 | 120 | 140 | $290 | $49.4K |
| 90961 | 87 | 110 | 60 | $240 | $20K |
| 99214 | 930 | 15,410 | 110 | $80 | $15.6K |
| G0439 | 1,977 | 3,350 | 70 | $120 | $11.9K |
| 99232 | 13 | 5,400 | 70 | $60 | $9.3K |
| 99213 | 8,468 | 13,700 | 70 | $60 | $8.8K |
| 99223 | 80 | 4,430 | 30 | $140 | $7.6K |
| 90935 | 133 | 180 | 70 | $60 | $6.1K |
| 99204 | 5,602 | 5,870 | 30 | $120 | $5.6K |
| 99205 | 1,747 | 2,430 | 30 | $160 | $5.5K |
Showing 1–10 of 13
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 190 | $50 | $9.9K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 50 | $50 | $2.5K |
How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Massachusetts median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 213 | 390 | 270 | $30 | $124.3K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 79 | 130 | 90 | $40 | $27.8K |
Other providers in the same ZIP code as Sebastian Sepulveda, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Incompass Human Services, Inc. | MA | Developmentally Disabled Services Day Training Agency | $0 | $21.2M |
| Incompass Human Services, Inc. | MA | In Home Supportive Care Agency | $0 | $11.9M |
| American Adult Daycare Of Middlesex Inc | MA | Adult Day Care Clinic/Center | $0 | $10.1M |
| Patriot Ambulance, Inc. | MA | Ambulance | $1.4M | $5.9M |
| Golden Living Homecare, Inc. | MA | Home Health Agency | $0 | $7M |
| Angela Ahuja | MA | Allergy & Immunology Physician | $2.3M | $0 |
| West Suburban Eye Surgery Center LLC | MA | Ambulatory Surgical Clinic/Center | $1.3M | $191K |
| Christine Hayes | MA | MOHS-Micrographic Surgery Physician | $579.4K | $0 |
| Joe Joseph | MA | Internal Medicine Physician | $358.6K | $0 |
| David Yi | MA | Ophthalmology Physician | $330.3K | $290 |
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