Physician

Carlos Antonio Sesin, M.D.

According to 2025 Medicare claims, Carlos Sesin, M.D. (NPI: 1659304707) practices rheumatology in the Miami-Miami Beach-Kendall, FL market, with the plurality of this provider's patient population coming from Miami-Dade, FL. This provider's primary affiliated billing organization is CARLOS A. SESIN, MD, PA (NPI: 1639364144; TIN: 542141388) and primary practice location at 33134-4418.

Sesin's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 647 traditional Medicare patients, billed 94,688 HCPCS/CPT codes, and received $1,198,957 in Medicare payments. The top billing code was 99204 (New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more). Part D data shows 3,244 prescription claims across 690 beneficiaries totaling $3,861,580 in drug costs, led by Prolia (Denosumab). 2022 DME data shows 11 claims. Open Payments data shows 372 records totaling $3,248,552. 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 $742,764 to $1,198,957. Similarly, Part D prescription costs have moved from a lower plateau to a higher plateau, from $1,646,005 to $3,861,580. In contrast, DME billing represents a smaller volume and fell sharply in recent years, from $927 to $595.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	891	63,164	$742,764
2016	878	52,870	$764,720
2017	960	66,714	$971,497
2018	871	72,517	$1,155,735
2019	886	93,922	$1,356,539
2020	953	158,383	$1,902,038
2021	1,017	184,989	$2,290,556
2022	777	137,779	$1,492,444
2023	657	93,071	$1,086,805
2024	647	94,688	$1,198,957

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	608	4,228	$1,646,005
2016	621	4,189	$2,029,005
2017	630	3,687	$2,305,337
2018	602	3,352	$2,805,858
2019	606	3,036	$3,313,893
2020	717	3,557	$3,578,479
2021	805	3,828	$4,127,692
2022	816	3,872	$4,498,260
2023	739	3,494	$4,755,158
2024	690	3,244	$3,861,580

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	$473
2019	N/R	23	$372
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	11	$514
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = 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
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	103	103	$133
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	538	920	$99
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	106	151	$71
96401	Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle	274	778	$56
J0897	Injection, denosumab, 1 mg	237	24,120	$19

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Prolia	Denosumab	388	69,480	$677,700
Enbrel Sureclick	Etanercept	53	1,484	$388,724
Taltz Autoinjector	Ixekizumab	50	1,416	$333,467
Xeljanz Xr	Tofacitinib Citrate	55	1,650	$312,532
Humira(Cf) Pen	Adalimumab	30	840	$214,151

Top 5 DME services in 2024

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

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	224	$43,660	Janssen Biotech, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	148	$3,204,892	ModernaTX, Inc.
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 Carlos Antonio Sesin, M.D.?

Tedicare shows public-source Medicare data for Carlos Antonio Sesin, M.D. (NPI 1659304707), 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 Carlos Antonio Sesin, 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 Carlos Antonio Sesin, M.D.?

Carlos Antonio Sesin, M.D. is linked to CARLOS A. SESIN, MD, PA (billing NPI 1639364144) in the available physician profile data.

Does Carlos Antonio Sesin, M.D. have Open Payments data?

Carlos Antonio Sesin, M.D. has 372 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.