Physician

Sony Thekkethala Sebastian, D.O.

According to 2025 Medicare claims, Sony Sebastian, D.O. (NPI: 1396165866) practices emergency medicine in the Huntington-Ashland, WV-KY-OH market, with the plurality of this provider's patient population coming from Boyd, KY. This provider's primary affiliated billing organization is KINGS DAUGHTERS MEDICAL SPECIALTIES INC (NPI: 1669791323; TIN: 264183569) and primary practice location at 41101-2843. Sebastian is affiliated with the Sound Physicians Long Term Care Management, LLC (ACO ID: A5220), participating under the MSSP model.

Sebastian's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 620 traditional Medicare patients, billed 1,432 HCPCS/CPT codes, and received $112,514 in Medicare payments. The top billing code was 99223 (Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes). Part D data shows 706 prescription claims across 283 beneficiaries totaling $32,677 in drug costs, led by Pantoprazole Sodium (Pantoprazole Sodium). DME data shows 111 claims. No Open Payments records. 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 did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $15,933 and ending at $32,677. In contrast, DME billing represents a smaller volume and rose steadily, from $987 to $7,339.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	226	517	$32,702
2018	843	2,110	$141,511
2019	1,055	2,396	$177,389
2020	769	1,720	$127,061
2021	843	1,692	$134,369
2022	766	1,565	$124,577
2023	644	1,439	$114,373
2024	620	1,432	$112,514

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	53	306	$15,933
2016	105	858	$49,210
2017	221	1,646	$74,031
2018	369	1,025	$49,928
2019	363	939	$66,386
2020	280	664	$51,031
2021	251	651	$25,063
2022	202	471	$28,961
2023	246	591	$30,676
2024	283	706	$32,677

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	11	$76
2019	N/R	86	$3,980
2020	25	178	$9,521
2021	N/R	131	$7,845
2022	N/R	72	$5,014
2023	N/R	137	$8,794
2024	N/R	111	$6,407

* / # = 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
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	143	151	$124
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	205	210	$94
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	69	149	$87
99239	Hospital discharge day management, more than 30 minutes	184	195	$84
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	238	693	$58

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Pantoprazole Sodium	Pantoprazole Sodium	81	2,403	$510
Cefpodoxime Proxetil	Cefpodoxime Proxetil	12	50	$274
Potassium Chloride	Potassium Chloride	17	463	$272
Cefdinir	Cefdinir	32	148	$226
Atorvastatin Calcium	Atorvastatin Calcium	27	2,010	$191

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
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	N/R	36	$4,694
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	Y	N/R	36	$827
E1392	Portable oxygen concentrator, rental	Y	N/R	12	$375
K0001	Standard wheelchair	Y	N/R	13	$373
E0570	Nebulizer, with compressor	Y	N/R	14	$139

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

Explore More Providers

FAQ

What Medicare data is available for Sony Thekkethala Sebastian, D.O.?

Tedicare shows public-source Medicare data for Sony Thekkethala Sebastian, D.O. (NPI 1396165866), 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 Sony Thekkethala Sebastian, D.O. have ACO affiliation data?

Sony Thekkethala Sebastian, D.O. is shown with ACO affiliation data for Sound Physicians Long Term Care Management, LLC (MSSP, ACO ID A5220).

What billing organization is linked to Sony Thekkethala Sebastian, D.O.?

Sony Thekkethala Sebastian, D.O. is linked to KINGS DAUGHTERS MEDICAL SPECIALTIES INC (billing NPI 1669791323) in the available physician profile data.

Does Sony Thekkethala Sebastian, D.O. have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests 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.