Physician

Sean Michael Sumsion, M.D.

According to 2025 Medicare claims, Sean Sumsion, M.D. (NPI: 1538504469) practices ophthalmology in the Redding, CA market, with the plurality of this provider's patient population coming from Shasta, CA. This provider's primary affiliated billing organization is RIVERSIDE EYECARE PROFESSIONALS INC A MEDICAL CORPORATION (NPI: 1265158703; TIN: 850972618) and primary practice location at 96001-2822.

Sumsion's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 1,445 traditional Medicare patients, billed 22,329 HCPCS/CPT codes, and received $2,889,458 in Medicare payments. The top billing code was 99214 (Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more). Part D data shows 1,127 prescription claims across 340 beneficiaries totaling $1,582,547 in drug costs, led by Acthar (Corticotropin). Open Payments data shows 33 records totaling $884. 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 sharply higher in recent years, from $38,418 to $2,889,458. Similarly, Part D prescription costs have risen steadily, from $558 to $1,582,547. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

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

Part B Carrier Billing Trend. X-axis: year 2015-2024. Y-axis: Medicare payment, unit: USD. Field: Tot_Mdcr_Pymt_Amt. Source: Medicare Physician & Other Practitioners by Provider.0$1.4M$2.9M2016 Medicare payment: $38,418 (USD; Tot_Mdcr_Pymt_Amt)2017 Medicare payment: $473,299 (USD; Tot_Mdcr_Pymt_Amt)2018 Medicare payment: $1,079,296 (USD; Tot_Mdcr_Pymt_Amt)2019 Medicare payment: $1,536,216 (USD; Tot_Mdcr_Pymt_Amt)2020 Medicare payment: $1,588,379 (USD; Tot_Mdcr_Pymt_Amt)2021 Medicare payment: $1,628,446 (USD; Tot_Mdcr_Pymt_Amt)2022 Medicare payment: $1,928,382 (USD; Tot_Mdcr_Pymt_Amt)2023 Medicare payment: $2,487,968 (USD; Tot_Mdcr_Pymt_Amt)2024 Medicare payment: $2,889,458 (USD; Tot_Mdcr_Pymt_Amt)2015201620172018201920202021202220232024
YearPatientsClm LinesPayment
2015N/RN/RN/R
2016168394$38,418
20179104,731$473,299
20181,1969,725$1,079,296
20191,16810,772$1,536,216
20201,21710,796$1,588,379
20211,20010,673$1,628,446
20221,30512,563$1,928,382
20231,33615,753$2,487,968
20241,44522,329$2,889,458

Part D Events Trend

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

Part D Events Trend. X-axis: year 2015-2024. Y-axis: Drug cost, unit: USD. Field: Tot_Drug_Cst. Source: Medicare Part D Prescribers by Provider.0$791K$1.6M2015 Drug cost: $558 (USD; Tot_Drug_Cst)2016 Drug cost: $8,698 (USD; Tot_Drug_Cst)2017 Drug cost: $101,528 (USD; Tot_Drug_Cst)2018 Drug cost: $118,789 (USD; Tot_Drug_Cst)2019 Drug cost: $136,613 (USD; Tot_Drug_Cst)2020 Drug cost: $273,556 (USD; Tot_Drug_Cst)2021 Drug cost: $196,162 (USD; Tot_Drug_Cst)2022 Drug cost: $262,630 (USD; Tot_Drug_Cst)2023 Drug cost: $234,261 (USD; Tot_Drug_Cst)2024 Drug cost: $1,582,547 (USD; Tot_Drug_Cst)2015201620172018201920202021202220232024
YearPatientsClaimsDrug Cost
2015N/R21$558
201655133$8,698
2017277984$101,528
2018290765$118,789
2019330981$136,613
20203151,060$273,556
20213461,139$196,162
20223871,241$262,630
20233621,287$234,261
20243401,127$1,582,547

DME Billing Trend

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

No connected DME records

No connected DME records

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

Top 5 Part B carrier billing codes in 2024

By total payments.

CodeDescriptionPatientsClm LinesTotal Payment
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more880953$88
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more4031,175$76
92134Imaging of retina9662,109$32
83861Microfluid analysis of tears4371,129$22
83516Analysis of substance using immunoassay technique, multiple step method4461,157$11

Top 5 Part D drugs in 2024

By total drug costs.

DrugGenericClaimsTotal Day SupplyTotal Drug Cost
ActharCorticotropin15300$881,307
LumiganBimatoprost984,570$43,976
MieboPerfluorohexyloctane/Pf511,536$39,551
RestasisCyclosporine431,920$39,188
XiidraLifitegrast311,410$31,417

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

CategoryDefinitionRecordsTotal Reported AmountTop Related Entity
General PaymentsReported payment or transfer-of-value amount.33$884ABBVIE INC.
Research PaymentsReported research-related payment or transfer-of-value amount.0$0N/R
Ownership / Investment InterestsReported value of ownership or investment interests.0$0N/R

FAQ

What Medicare data is available for Sean Michael Sumsion, M.D.?

Tedicare shows public-source Medicare data for Sean Michael Sumsion, M.D. (NPI 1538504469), 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 Sean Michael Sumsion, 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 Sean Michael Sumsion, M.D.?

Sean Michael Sumsion, M.D. is linked to RIVERSIDE EYECARE PROFESSIONALS INC A MEDICAL CORPORATION (billing NPI 1265158703) in the available physician profile data.

Does Sean Michael Sumsion, M.D. have Open Payments data?

Sean Michael Sumsion, M.D. has 33 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.