Physician

Michelle Jo Semins, MD

According to 2025 Medicare claims, Michelle Semins, MD (NPI: 1578609277) practices urology in the Wheeling, WV-OH market, with the plurality of this provider's patient population coming from Ohio, WV. This provider's primary affiliated billing organization is WHEELING HOSPITAL INC (NPI: 1548923923; TIN: 55-0357057) and primary practice location at 26003-6379. Semins is affiliated with the ACO West Virginia (ACO ID: A3563), participating under the MSSP model.

Semins' data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 276 traditional Medicare patients, billed 682 HCPCS/CPT codes, and received $56,925 in Medicare payments. The top billing code was 52310 (Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope). Part D data shows 700 prescription claims across 244 beneficiaries totaling $35,581 in drug costs, led by Myrbetriq (Mirabegron). DME data shows 35 claims. Open Payments data shows 10 records totaling $1,491. 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 up and down with repeated peaks and valleys, starting at $48,921 and ending at $56,925. Concurrently, Part D prescription costs have moved up and down with repeated peaks and valleys, starting at $102,981 and ending at $35,581. In contrast, DME billing represents a smaller volume and started with an early spike, then settled into a lower baseline, moving from $2,286 to $138.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	203	770	$48,921
2016	180	512	$30,156
2017	145	1,288	$44,653
2018	193	3,180	$67,959
2019	153	1,950	$42,651
2020	168	2,765	$56,691
2021	235	2,990	$80,424
2022	195	804	$35,737
2023	213	528	$46,040
2024	276	682	$56,925

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	203	967	$102,981
2016	205	1,007	$138,289
2017	234	1,357	$197,007
2018	241	1,430	$229,417
2019	227	1,374	$210,296
2020	220	1,311	$166,754
2021	293	1,598	$217,113
2022	263	1,004	$171,056
2023	178	464	$23,487
2024	244	700	$35,581

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	43	$12,728
2016	N/R	74	$5,925
2017	N/R	101	$16,313
2018	N/R	101	$13,823
2019	N/R	32	$4,188
2020	N/R	24	$8,611
2021	N/R	47	$4,057
2022	N/R	12	$2,071
2023	N/R	N/R	N/R
2024	N/R	35	$5,350

* / # = 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
52310	Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	33	33	$110
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	87	96	$73
52000	Diagnostic exam of bladder and urethra using an endoscope	75	86	$54
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	75	85	$49
74420	Imaging of urinary tract following injection of a contrast agent	52	69	$17

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Myrbetriq	Mirabegron	21	810	$11,616
Potassium Citrate Er	Potassium Citrate	130	5,810	$6,898
Methenamine Hippurate	Methenamine Hippurate	16	1,110	$1,681
Tamsulosin Hcl	Tamsulosin Hcl	115	6,409	$1,297
Chlorthalidone	Chlorthalidone	75	4,698	$893

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
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	N	N/R	24	$5,208
A4358	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	N	N/R	11	$142

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	10	$1,491	Boston Scientific Corporation
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

Explore More Providers

Urology providers in the Wheeling, WV-OH market
Providers within practice ZIP code 26003-6379
Providers whose plurality patient county is Ohio, WV
Providers in West Virginia whose primary affiliated billing organization is WHEELING HOSPITAL INC
Providers in West Virginia affiliated with ACO West Virginia (MSSP)

FAQ

What Medicare data is available for Michelle Jo Semins, MD?

Tedicare shows public-source Medicare data for Michelle Jo Semins, MD (NPI 1578609277), 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 Michelle Jo Semins, MD have ACO affiliation data?

Michelle Jo Semins, MD is shown with ACO affiliation data for ACO West Virginia (MSSP, ACO ID A3563).

What billing organization is linked to Michelle Jo Semins, MD?

Michelle Jo Semins, MD is linked to WHEELING HOSPITAL INC (billing NPI 1548923923) in the available physician profile data.

Does Michelle Jo Semins, MD have Open Payments data?

Michelle Jo Semins, MD has 10 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.