Physician

Prithipal S Sethi, M.D.

According to 2025 Medicare claims, Prithipal Sethi, M.D. (NPI: 1174710578) practices urology in the Sacramento-Roseville-Folsom, CA market, with the plurality of this provider's patient population coming from Sacramento, CA. This provider's primary affiliated billing organization is PRITHIPAL S. SETHI M.D., INC. (NPI: 1295921518; TIN: 260852144) and primary practice location at 95823-7921.

Sethi's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 923 traditional Medicare patients, billed 148,750 HCPCS/CPT codes, and received $1,402,425 in Medicare payments. The top billing code was 52000 (Diagnostic exam of bladder and urethra using an endoscope). Part D data shows 1,092 prescription claims across 491 beneficiaries totaling $530,658 in drug costs, led by Xtandi (Enzalutamide). DME data shows 125 claims. Open Payments data shows 47 records totaling $120,950. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has moved from a lower plateau to a higher plateau, from $675,950 to $1,402,425. Similarly, Part D prescription costs have moved sharply higher in recent years, from $123,580 to $530,658. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $2,586 to $863.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	1,045	52,213	$675,950
2016	924	36,920	$739,162
2017	969	46,003	$632,996
2018	955	61,226	$1,331,084
2019	924	50,081	$1,748,095
2020	908	94,613	$1,867,421
2021	987	151,817	$2,308,483
2022	1,018	144,799	$2,304,489
2023	904	103,347	$1,158,076
2024	923	148,750	$1,402,425

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	664	2,374	$123,580
2016	594	2,062	$153,265
2017	647	2,378	$130,541
2018	769	2,692	$434,738
2019	741	2,458	$554,814
2020	640	1,700	$626,126
2021	680	1,873	$1,689,510
2022	653	2,387	$4,018,726
2023	497	1,327	$1,109,405
2024	491	1,092	$530,658

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	13	125	$17,274
2016	15	135	$19,528
2017	N/R	178	$25,247
2018	13	124	$25,646
2019	11	123	$33,752
2020	N/R	177	$39,272
2021	14	88	$26,814
2022	N/R	43	$24,655
2023	11	56	$31,315
2024	15	125	$35,619

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
52000	Diagnostic exam of bladder and urethra using an endoscope	244	268	$198
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	451	741	$96
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	671	1,395	$67
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	743	1,410	$12
51798	Ultrasound measurement of bladder capacity after voiding	625	1,187	$9

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Xtandi	Enzalutamide	21	630	$270,772
Orgovyx	Relugolix	56	1,680	$141,711
Gemtesa	Vibegron	51	2,070	$33,018
Methenamine Hippurate	Methenamine Hippurate	57	2,250	$2,493
Nitrofurantoin Mono-Macro	Nitrofurantoin Monohyd/M-Cryst	79	2,796	$2,055

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
A4352	Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, silicone elastomeric, or hydrophilic, etc.), each	N	N/R	30	$27,197
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	N	15	54	$7,678
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	N	N/R	16	$404
A4358	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	N	N/R	13	$238
A4402	Lubricant, per ounce	N	N/R	12	$103

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	42	$20,587	Olympus America Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	5	$100,362	Olympus Corporation of the Americas
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Prithipal S. Sethi, M.D.?

Tedicare shows public-source Medicare data for Prithipal S. Sethi, M.D. (NPI 1174710578), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Prithipal S. Sethi, M.D. have ACO affiliation data?

No ACO affiliation record is shown in the available Tedicare data for this profile.

What billing organization is linked to Prithipal S. Sethi, M.D.?

Prithipal S. Sethi, M.D. is linked to PRITHIPAL S. SETHI M.D., INC. (billing NPI 1295921518) in the available physician profile data.

Does Prithipal S. Sethi, M.D. have Open Payments data?

Prithipal S. Sethi, M.D. has 47 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.