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Dr. Seth  Braunstein  Md image

Dr. Seth Braunstein Md

1500 Physicians Dr
Wilmington NC 28401
910 413-3300
Medical School: New York University School Of Medicine - 1972
Accepts Medicare: Yes
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #:
NPI: 1427080720
Taxonomy Codes:
207RE0101X

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Awards & Recognitions

About Us

Practice Philosophy

Conditions

Dr. Seth Braunstein is associated with these group practices

Procedure Pricing

HCPCS Code Description Average Price Average Price
Allowed By Medicare
HCPCS Code:99205 Description:Office/outpatient visit new Average Price:$365.00 Average Price Allowed
By Medicare:
$190.64
HCPCS Code:99223 Description:Initial hospital care Average Price:$340.00 Average Price Allowed
By Medicare:
$188.41
HCPCS Code:99233 Description:Subsequent hospital care Average Price:$216.00 Average Price Allowed
By Medicare:
$96.79
HCPCS Code:99204 Description:Office/outpatient visit new Average Price:$269.00 Average Price Allowed
By Medicare:
$153.15
HCPCS Code:J0834 Description:Cosyntropin cortrosyn inj Average Price:$160.00 Average Price Allowed
By Medicare:
$68.13
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$220.44 Average Price Allowed
By Medicare:
$134.16
HCPCS Code:99214 Description:Office/outpatient visit est Average Price:$183.53 Average Price Allowed
By Medicare:
$99.49
HCPCS Code:84443 Description:Assay thyroid stim hormone Average Price:$103.00 Average Price Allowed
By Medicare:
$23.08
HCPCS Code:80053 Description:Comprehen metabolic panel Average Price:$90.00 Average Price Allowed
By Medicare:
$11.75
HCPCS Code:80061 Description:Lipid panel Average Price:$90.00 Average Price Allowed
By Medicare:
$12.24
HCPCS Code:84481 Description:Free assay (FT-3) Average Price:$99.00 Average Price Allowed
By Medicare:
$24.00
HCPCS Code:82306 Description:Vitamin d 25 hydroxy Average Price:$110.00 Average Price Allowed
By Medicare:
$41.94
HCPCS Code:84439 Description:Assay of free thyroxine Average Price:$79.00 Average Price Allowed
By Medicare:
$12.77
HCPCS Code:82607 Description:Vitamin B-12 Average Price:$87.00 Average Price Allowed
By Medicare:
$21.35
HCPCS Code:71020 Description:Chest x-ray Average Price:$77.00 Average Price Allowed
By Medicare:
$18.85
HCPCS Code:99215 Description:Office/outpatient visit est Average Price:$167.00 Average Price Allowed
By Medicare:
$112.79
HCPCS Code:83036 Description:Glycosylated hemoglobin test Average Price:$55.00 Average Price Allowed
By Medicare:
$13.75
HCPCS Code:85025 Description:Complete cbc w/auto diff wbc Average Price:$51.00 Average Price Allowed
By Medicare:
$11.02
HCPCS Code:84146 Description:Assay of prolactin Average Price:$64.00 Average Price Allowed
By Medicare:
$27.45
HCPCS Code:96372 Description:Ther/proph/diag inj sc/im Average Price:$56.00 Average Price Allowed
By Medicare:
$22.75
HCPCS Code:85652 Description:Rbc sed rate automated Average Price:$32.00 Average Price Allowed
By Medicare:
$3.83
HCPCS Code:83002 Description:Gonadotropin (LH) Average Price:$52.00 Average Price Allowed
By Medicare:
$26.23
HCPCS Code:81001 Description:Urinalysis auto w/scope Average Price:$29.00 Average Price Allowed
By Medicare:
$4.48
HCPCS Code:36415 Description:Routine venipuncture Average Price:$25.00 Average Price Allowed
By Medicare:
$3.00
HCPCS Code:82043 Description:Microalbumin quantitative Average Price:$29.00 Average Price Allowed
By Medicare:
$8.19
HCPCS Code:86376 Description:Microsomal antibody Average Price:$39.00 Average Price Allowed
By Medicare:
$19.63
HCPCS Code:84550 Description:Assay of blood/uric acid Average Price:$22.00 Average Price Allowed
By Medicare:
$3.14
HCPCS Code:83540 Description:Assay of iron Average Price:$28.00 Average Price Allowed
By Medicare:
$9.18
HCPCS Code:83550 Description:Iron binding test Average Price:$30.00 Average Price Allowed
By Medicare:
$12.38
HCPCS Code:82570 Description:Assay of urine creatinine Average Price:$24.00 Average Price Allowed
By Medicare:
$7.33
HCPCS Code:83001 Description:Gonadotropin (FSH) Average Price:$37.00 Average Price Allowed
By Medicare:
$26.32
HCPCS Code:G0008 Description:Admin influenza virus vac Average Price:$29.00 Average Price Allowed
By Medicare:
$22.75
HCPCS Code:Q2038 Description:Fluzone vacc, 3 yrs & >, im Average Price:$18.00 Average Price Allowed
By Medicare:
$12.52

HCPCS Code Definitions

71020
Radiologic examination, chest, 2 views, frontal and lateral
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99215
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
96372
Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
99214
Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99205
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99204
Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99233
Subsequent hospital care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.
99223
Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission are of high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.
Q2038
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone)
G0008
Administration of influenza virus vaccine
J0834
Injection, cosyntropin (cortrosyn), 0.25 mg

Medical Malpractice Cases

None Found

Medical Board Sanctions

None Found

Referrals

NPI
Doctor Name
Specialty
Count
1790897262
Internal Medicine
1,056
1093728883
Gastroenterology
968
1346295417
Nephrology
922
1265540298
Cardiovascular Disease (Cardiology)
788
1457345928
Endocrinology
690
1740240324
Cardiovascular Disease (Cardiology)
676
1619085545
Neurology
661
1073510657
Diagnostic Radiology
623
1972544492
Nephrology
602
1205941432
Vascular Surgery
565
*These referrals represent the top 10 that Dr. Braunstein has made to other doctors

Publications

Measurement of waist circumference predicts coronary atherosclerosis beyond plasma adipokines. - Obesity (Silver Spring, Md.)
The association of plasma adipokines beyond waist circumference (WC) with coronary artery calcification (CAC), a measure of subclinical atherosclerosis, is unknown.Asymptomatic Caucasian individuals from two community-based cross-sectional studies (n = 1,285) were examined and multivariate analysis of traditional risk factors was performed, then WC and adipokines (adiponectin and leptin) were added. Incremental value of each was tested with likelihood ratio testing.Beyond traditional risk factors, WC (Tobit regression ratio 1.69, P < 0.001) and plasma leptin (1.57, P < 0.001) but not plasma adiponectin (P = 0.75) were independently associated with CAC. In nested models, neither adiponectin (χ(2) = 0.76, P = 0.38) nor leptin (χ(2) = 1.32, P = 0.25) added value to WC beyond traditional risk factors, whereas WC added incremental value to adiponectin (χ(2) = 28.02, P < 0.0001) and leptin (χ(2) = 13.58, P = 0.0002).In the face of important biomarkers such as plasma adiponectin and leptin, WC remained a significant predictor of CAC beyond traditional risk factors underscoring the importance of WC measurement during cardiovascular risk assessment.Copyright © 2012 The Obesity Society.
Usefulness of insulin resistance estimation and the metabolic syndrome in predicting coronary atherosclerosis in type 2 diabetes mellitus. - The American journal of cardiology
Metabolic syndrome (MS) definitions predict cardiovascular events beyond traditional risk factors in patients with type 2 diabetes mellitus (DM) as well as subjects without DM. It has been shown that apolipoprotein B (apoB) and non-high-density lipoprotein cholesterol are associated with coronary artery calcification in DM. However, the relative value of MS, apoB lipoproteins, and estimates of insulin resistance is unknown in predicting atherosclerosis in DM. Cross-sectional analyses of white subjects in 2 community-based studies were performed (n = 611 patients with DM, n = 803 subjects without DM) using multivariate analysis of traditional risk factors and then adding MS, apoB, and homeostasis model assessment of insulin resistance (HOMA-IR). Incremental value was tested using likelihood ratio testing. Beyond traditional risk, HOMA-IR (tobit regression ratio 1.86, p = 0.002), apoB (tobit regression ratio 1.55, p = 0.001), and MS (tobit regression ratio 2.37, p = 0.007) were independently associated with coronary artery calcification in DM. In nested models, HOMA-IR added value to apoB (tobit regression ratio 1.72, p = 0.008), MS (tobit regression ratio 1.72, p = 0.011), and apoB and MS (tobit regression ratio 1.64, p = 0.021). ApoB showed a similar pattern when added to HOMA-IR (tobit regression ratio 1.51, p = 0.004), MS (tobit regression ratio 1.46, p = 0.005), and HOMA-IR and MS (tobit regression ratio 1.48, p = 0.006). MS added to apoB (tobit regression ratio 1.99, p = 0.032) but not HOMA-IR (tobit regression ratio 1.54, p = 0.221) or apoB and HOMA-IR (tobit regression ratio 1.32, p = 0.434). In conclusion, insulin resistance estimates add value to MS and apoB in predicting coronary artery calcification scores in DM and warrant further evaluation in clinic for identification of patients with DM at higher risk for atherosclerotic cardiovascular disease.Copyright © 2011 Elsevier Inc. All rights reserved.
Type 2 diabetes does not attenuate racial differences in coronary calcification. - Diabetes research and clinical practice
Coronary artery calcification (CAC) is a strong predictor of atherosclerotic cardiovascular disease (CVD). Whites appear to have a higher prevalence of CAC than African-Americans (AAs), but it is unknown if type 2 diabetes, a major cardiovascular risk factor, attenuates this difference. We investigated the relationship of race and CAC in a sample of patients with type 2 diabetes without clinical CVD.multivariable analyses of self-reported ethnicity and CAC scores, stratified by gender, in 861 subjects [32% AA, 66.9% male] with type 2 diabetes.AA race was associated with lower CAC scores in age-adjusted models in males [Tobit ratio for AAs vs. Whites 0.14 (95% CI 0.08-0.24, p<0.001)] and females [Tobit ratio 0.26 (95% CI 0.09-0.77, p=0.015)]. This persisted in men after adjustment for traditional, metabolic and inflammatory risk factors, but adjustment for plasma triglycerides [0.48 (95% CI 0.15-1.49, p=0.201)] and HOMA-IR [0.28 (95% CI 0.08-1.03, p=0.055)] partially attenuated the association in women.relative to African-Americans, White race is a strong predictor of CAC, even in the presence of type 2 diabetes. The relationship in women appears less robust possibly due to gender differences in metabolic risk factors.2010. Published by Elsevier Ireland Ltd.
Relation of plasma fatty acid binding proteins 4 and 5 with the metabolic syndrome, inflammation and coronary calcium in patients with type-2 diabetes mellitus. - The American journal of cardiology
Fatty acid-binding proteins (FABPs) 4 and 5 play coordinated roles in rodent models of inflammation, insulin resistance, and atherosclerosis, but little is known of their role in human disease. The aim of this study was to examine the hypothesis that plasma adipocyte and macrophage FABP4 and FABP5 levels would provide additive value in the association with metabolic and inflammatory risk factors for cardiovascular disease as well as subclinical atherosclerosis. Using the Penn Diabetes Heart Study (PDHS; n = 806), cross-sectional analysis of FABP4 and FABP5 levels with metabolic and inflammatory parameters and with coronary artery calcium, a measure of subclinical coronary atherosclerosis, was performed. FABP4 and FABP5 levels had strong independent associations with the metabolic syndrome (for a 1-SD change in FABP levels, odds ratio [OR] 1.85, 95% confidence interval [CI] 1.43 to 2.23, and OR 1.66, 95% CI 1.41 to 1.95, respectively) but had differential associations with metabolic syndrome components. FABP4 and FABP5 were also independently associated with C-reactive protein and interleukin-6 levels. FABP4 (OR 1.26, 95% CI 1.05 to 1.52) but not FABP5 (OR 1.13, 95% CI 0.97 to 1.32) was associated with the presence of coronary artery calcium. An integrated score combining FABP4 and FABP5 quartile data had even stronger associations with the metabolic syndrome, C-reactive protein, interleukin-6, and coronary artery calcium compared to either FABP alone. In conclusion, this study provides evidence for an additive relation of FABP4 and FABP5 with the metabolic syndrome, inflammatory cardiovascular disease risk factors, and coronary atherosclerosis in type 2 diabetes mellitus. These findings suggest that FABP4 and FABP5 may represent mediators of and biomarkers for metabolic and cardiovascular disease in type 2 diabetes mellitus.Copyright © 2010. Published by Elsevier Inc.
Gender differences in the association of C-reactive protein with coronary artery calcium in type-2 diabetes. - Clinical endocrinology
Plasma C-reactive protein (CRP) is associated with cardiovascular disease (CVD), but effects may vary by gender and degree of CVD risk. Whether CRP has value as a CVD risk marker in type-2 diabetes (T2DM) is unclear. We examined whether CRP has gender differences in association with coronary artery calcium (CAC) in diabetic and nondiabetic samples without clinical CVD.We performed cross-sectional analyses of gender influence on CRP association with CAC in the Penn Diabetes Heart Study (N = 1299 with T2DM), the Study of Inherited Risk of Coronary Atherosclerosis (N = 860 nondiabetic subjects) and a combined sample.Female gender was associated with higher plasma CRP in diabetic and nondiabetic samples after adjustment for covariates. There was a strong interaction by gender in the association of CRP with CAC (interaction P < 0·001). In diabetic women, CRP was associated with higher CAC even after further adjustment for age, race, medications, metabolic syndrome, Framingham risk score and body mass index [Tobit ratio 1·60, 95% CI (1·03-2·47)]. Although this relationship was attenuated in nondiabetic women, the combined sample maintained this association in fully adjusted models [1·44, 95% CI (1·13-1·83)]. There was no association of CRP with CAC in either diabetic or nondiabetic men.CRP may be a useful marker of cardiovascular risk in women, particularly in diabetic women who otherwise have no known CVD. Prospective studies are needed to better assess the gender differences in CRP utility and the use of CRP in T2DM.© 2010 Blackwell Publishing Ltd.
Trends in the management of type 2 diabetes: an emerging role for insulin. - Journal of managed care pharmacy : JMCP
This review is intended to explore the pathophysiology of type 2 diabetes, examine the role of insulin as a means of achieving glycemic control in people with type 2 diabetes, and provide a practical approach for insulin use in type 2 diabetes in the managed care setting.This manuscript is based on the results of a MEDLINE literature search and presentations by the authors at a symposium titled, "Emerging Changes in Diabetes Management," that took place on October, 14, 2004, at the Academy of Managed Care Pharmacy's 2004 Educational Conference in Baltimore, Maryland.Despite advances in oral treatment, type 2 diabetes remains a substantial source of microvascular and macrovascular complications that cause unacceptable levels of morbidity, mortality, and cost. Accumulating clinical evidence suggests that insulin treatment, both basal and prandial, can advance the treatment of type 2 diabetes and reduce the risks for serious sequelae by providing consistent and optimal glycemic control. By more closely mimicking the actions of endogenous insulin, in terms of onset and duration of action, insulin analogues offer clear advantages over their regular insulin counterparts.
New developments in type 2 diabetes mellitus: combination therapy with a thiazolidinedione. - Clinical therapeutics
Diabetes mellitus (DM) is a serious, chronic metabolic disease affecting approximately 17 million Americans. The microvascular and macrovascular complications of DM are associated with considerable morbidity and mortality.This article reviews the importance of normalizing blood glucose values to reduce the risk of microvascular and macrovascular complications, discusses available treatment options for type 2 DM, and explores the rationale for combination therapy that includes a thiazolidinedione.Relevant articles were selected from published reports and conference presentations from the last 10 years on oral agents for monotherapy and combination therapy for type 2 DM. Other sources were identified from the reference lists of selected articles.Choices for the pharmacologic treatment of hyperglycemia in patients with type 2 DM include thiazolidinediones, insulin secretagogues, biguanides, and alpha-glucosidase inhibitors. Each of these drug classes is effective in lowering blood glucose concentrations; however, they have distinctly different mechanisms of action that target various pathophysiologic causes of type 2 DM and have different adverse-event profiles. in addition, several of these agents provide unique benefits unrelated to their hypoglycemic effects. Thiazolidinediones offer the therapeutic benefits of increasing insulin sensitivity and perhaps preserving beta-cell function. Use of a thiazolidinedione from the time type 2 DM is diagnosed improves insulin sensitivity, thereby improving glycemic control and minimizing complications. Over time, however, many patients with type 2 DM are unable to maintain adequate glycemic control (ie, glycosylated hemoglobin [HbA(1c)] <7%) with monotherapy. Combination therapy with agents from different classes may be necessary to achieve blood glucose control through an additive reduction in HbA(1c). The combination of a thiazolidinedione and a biguanide reduces hyperglycemia, hyperinsulinemia, and insulin resistance and improves factors that have been implicated in the pathogenesis of cardiovascular complications.Patients with type 2 DM who are not able to maintain their HbA(1c). <7% with monotherapy should be considered candidates for combination therapy. Appropriate combination therapy includes treatment with 2 or more agents with different, complementary mechanisms of action. For example, the combination of a thiazolidinedione and a biguanide improves insulin sensitivity and lowers blood glucose through complementary pathways, and therefore produces an additive effect.
Economic model of first-line drug strategies to achieve recommended glycaemic control in newly diagnosed type 2 diabetes mellitus. - PharmacoEconomics
To assess the short-term direct medical costs and effectiveness associated with achieving recommended glycaemic goals using commonly prescribed first-line oral antihyperglycaemic medications in type 2 diabetes mellitus.A literature-based, decision-tree model was developed to project the number of patients achieving glycosylated haemoglobin values of <7% on oral therapies and the associated costs over a 3-year timeframe. For each first-line strategy, patients could progress to combination therapy using two or more agents prior to the introduction of insulin. The overall cost of treatment included costs (2001/2002 values; US dollars) of comprehensive medical care, laboratory tests, patient education, drug therapy, home glucose monitoring and adverse events.At 3 years, the overall cost of treatment for the various first-line strategies was 6,106 US dollars for glipizide gastrointestinal therapeutic system, 6,727 US dollars for metformin immediate release, 6,826 US dollars for metformin extended release, 7,141 US dollars for glibenclamide (glyburide)/metformin, 7,759 US dollars for rosiglitazone and 9,298 US dollars for repaglinide. Costs of comprehensive routine medical care ranged from approximately 1,538-2,128 US dollars in year 1 and from approximately 952-1,543 US dollars in subsequent years, for controlled and uncontrolled patients, respectively. Adverse events represented <1%, and drug therapies represented approximately 50%, of the overall cost, respectively. Substantial cost differences between the strategies were seen within the first year. Regardless of first-line therapy, patients progressed quickly to combination therapies, with effectiveness among the agents being similar.Short-term costs required to provide comprehensive diabetes care and achieve glycemic goals can be substantial. The model suggests a sulphonylurea strategy may provide similar effectiveness with cost savings over other agents and should be considered when selecting an initial drug therapy in newly diagnosed patients with type 2 diabetes mellitus.
Constructing an algorithm for managing type 2 diabetes. Focus on role of the thiazolidinediones. - Postgraduate medicine
With the understanding of type 2 diabetes mellitus constantly evolving, and with the introduction of many new agents during the past few years, it is often difficult to keep up to date with the management of type 2 diabetes. This article reviews the pathophysiology of type 2 diabetes, oral pharmacologic treatment, and proposed diabetes treatment algorithms, which aim to guide clinicians in the use of thiazolidinediones (TZDs) earlier in the course of diabetes. This is important because studies indicate that sulfonylureas, biguanides, and insulin do not protect the beta cell and cannot provide sustainable glycemic control. The basis for TZD use earlier in diabetes is 2-fold: to preserve beta-cell function while maintaining appropriate glycemic control for a longer duration than is usually attained through monotherapy with a secretagogue or biguanide, and to prevent or reverse the insulin resistance phenomenon of reduced insulin utilization that appears even prior to the clinical diagnosis of diabetes. Notably, decreasing insulin resistance also may reduce the incidence of adverse atherosclerotic consequences.
Cardiovascular disease and benefits of thiazolidinediones. - Postgraduate medicine
Thiazolidinediones (TZDs) directly improve insulin resistance and appear to preserve beta-cell function. Research has demonstrated beneficial changes in several cardiovascular risk factors, including decreased levels of proinsulin, free fatty acids, diastolic blood pressure, and microalbuminuria, as well as improvement in lipid parameters. TZDs decrease plasminogen activator inhibitor type 1, inhibit vascular smooth muscle cell proliferation, reduce carotid artery intimal-medial thickness, and improve endothelial function. These actions directly improve the vasculature and should decrease cardiovascular risk. Atherosclerosis is an inflammatory process, and TZDs reduce inflammatory markers, such as C-reactive protein, monocyte chemoattractant-1, and p47phox. The data suggest that TZDs may reduce the risk of cardiovascular disease when used in patients with type 2 diabetes.

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1500 Physicians Dr Wilmington, NC 28401
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