Physician

Adam B Semegran, MD

According to 2025 Medicare claims, Adam Semegran, MD (NPI: 1811978406) practices general surgery in the New York-Jersey City-White Plains, NY-NJ market, with the plurality of this provider's patient population coming from Putnam, NY. This provider's primary affiliated billing organization is OPTUM MEDICAL CARE, P.C. (NPI: 1982643003; TIN: 133544120) and primary practice location at 10512-3997. Semegran is affiliated with the CareMount Value Partners IPA (ACO ID: D0019), participating under the REACH model.

Semegran's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 272 traditional Medicare patients, billed 1,401 HCPCS/CPT codes, and received $135,036 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 103 prescription claims across 72 beneficiaries totaling $23,306 in drug costs, led by Santyl (Collagenase Clostridium Hist.). DME data shows 85 claims. Open Payments data shows 18 records totaling $589. 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 $8,678 and ending at $23,306. For DME billing, reported payments moved from a lower plateau to a higher plateau, from $20,206 to $47,165.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	374	2,045	$163,819
2016	369	1,806	$156,777
2017	348	1,590	$129,032
2018	309	1,634	$123,691
2019	274	1,471	$106,363
2020	216	1,025	$92,055
2021	289	1,365	$138,548
2022	270	1,495	$134,571
2023	270	1,407	$123,080
2024	272	1,401	$135,036

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	97	146	$8,678
2016	87	123	$1,916
2017	90	121	$3,402
2018	87	121	$4,948
2019	66	93	$6,886
2020	78	103	$6,810
2021	79	109	$3,833
2022	71	101	$5,856
2023	65	89	$10,051
2024	72	103	$23,306

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	86	$17,566
2016	N/R	68	$6,446
2017	N/R	74	$16,391
2018	N/R	43	$13,407
2019	12	108	$15,417
2020	N/R	109	$18,445
2021	37	69	$15,710
2022	47	90	$25,867
2023	63	148	$45,313
2024	35	85	$19,292

* / # = 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	123	123	$130
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	70	100	$94
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	39	39	$77
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	103	274	$58
11042	Removal of skin and tissue, 20.0 sq cm or less	39	150	$50

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Santyl	Collagenase Clostridium Hist.	19	415	$21,710
Cephalexin	Cephalexin	13	87	$338
Oxycodone Hcl	Oxycodone Hcl	25	67	$64

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
A6196	Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing	N	19	31	$7,628
A6021	Collagen dressing, sterile, size 16 sq. in. or less, each	N	N/R	13	$6,950
A6545	Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each	N	16	17	$2,278
A6212	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing	N	N/R	12	$1,870
E0295	Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress	Y	N/R	12	$565

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	18	$589	Davol Inc.
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

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FAQ

What Medicare data is available for Adam B. Semegran, MD?

Tedicare shows public-source Medicare data for Adam B. Semegran, MD (NPI 1811978406), 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 Adam B. Semegran, MD have ACO affiliation data?

Adam B. Semegran, MD is shown with ACO affiliation data for CareMount Value Partners IPA (REACH, ACO ID D0019).

What billing organization is linked to Adam B. Semegran, MD?

Adam B. Semegran, MD is linked to OPTUM MEDICAL CARE, P.C. (billing NPI 1982643003) in the available physician profile data.

Does Adam B. Semegran, MD have Open Payments data?

Adam B. Semegran, MD has 18 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.