Dr. Sean Lai, MD
2001 Santa Monica Blvd, Suite 1286w, Santa Monica, CA 90404 • +1-806-555-9396
Medical Education: Accredited U.S. Medical School (Class of 1994)
What This Doctor Actually Performs: CMS Medicare Utilization & Santa Monica Percentiles
NPI #1396739470 • CBSA Regional • Gastroenterology
Within the Santa Monica, CA (CBSA local) Gastroenterology cohort, Dr. Sean Lai, MD with sub-specialty concentration in 29 Active CMS HCPCS Codes ranks at the 86.67th municipal percentile and 86.22th CA percentile (+0.16σ Z-score) based on 2,664 billed procedures for 454 patients.
Fee-schedule auditing of NPI 1396739470 highlights 986 annual claims for 99214 (86.67th Santa Monica percentile; $197–$270 self-pay corridor) plus 666 encounters under 45380 and 559 under 43239.
Uninsured and high-deductible cash patients visiting Dr. Sean Lai in Santa Monica (90404) face an estimated $239.00 initial evaluation fee at 2001 Santa Monica Blvd, Suite 1286w (hybrid in-clinic and telehealth video consults; 11-minute average reception wait; bedside manner 4.81/5 from 23 verified reports).
Patients evaluating Dr. Sean Lai in ZIP 90404 note 32 years of post-doctoral tenure (null, 1994) alongside 5.9 annual CMS procedures per patient.
Compared against Santa Monica, CA Gastroenterology peers
2,664 annual services across 454 beneficiaries
Standard deviations from CA Gastroenterology mean utilization
Top Billed HCPCS/CPT Procedures & GPCI Self-Pay Cash Benchmarks
| HCPCS | Clinical Procedure Description | Annual Volume | Local Pct | Est. Cash Range |
|---|---|---|---|---|
| 99214 | Established Gastroenterology, GERD & IBD Evaluation | 986 | 86.67th | $197 – $270 |
| 45380 | Diagnostic Colonoscopy w/ Mucosal Tissue Biopsy | 666 | 85.67th | $475 – $651 |
| 43239 | Upper GI Esophagogastroduodenoscopy (EGD) w/ Biopsy | 559 | 81.67th | $394 – $540 |
| 45385 | Colonoscopy w/ Snare Polypectomy Lesion Removal | 266 | 82.67th | $528 – $724 |
| 99204 | New Patient Digestive & Hepatology Consultation | 186 | 90.67th | $278 – $380 |
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Dr. Sean Lai, MD Fair Cash-Pay & Waiting-Room Scorecard
| Metric | Verified Benchmark | Source |
|---|---|---|
| Dr. Lai National Provider Identifier | NPI #1396739470 (MD) | CMS NPPES Registry (90404) |
| Dr. Lai Santa Monica CMS Volume Rank | 86.67th Pct (2,664 CMS svcs; Z +0.163σ) | CMS Medicare Part B (CA Gastroenterology) |
| Fair Cash-Pay New-Patient Benchmark | $239.00 (CPT 99204 GPCI Benchmark) | CMS Geographic Practice Cost Index (Santa Monica, CA) |
| Waiting-Room Wait Time & Cash Friendliness | $239.00 avg paid • 11 min lobby wait | 23 Anonymous Patient Reports |
| Listens Without Rushing & Modern Protocol Score | 4.81/5 Listening • 4.81/5 Modern Labs | CMS Provider Practice Cohort |
“Waiting Room” Patient Reality Scorecard
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