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    OpenPayerNPI Medicare & MedicaidPremier Orthopaedic And Sports Medicine Associates…
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    Premier Orthopaedic And Sports Medicine Associates, Ltd — Billing Profile & Reimbursement Data

    NPI 1215987243 · Newtown Square, PA · Orthopaedic Surgery Physician

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    Premier Orthopaedic And Sports Medicine Associates, Ltd is a orthopaedic surgery physician provider located in Newtown Square, Pennsylvania. This profile covers 0 Medicare and 44 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPremier Orthopaedic And Sports Medicine Associates, Ltd
    Address3809 W Chester Pike
    CityNewtown Square
    StatePA
    ZIP19073
    TaxonomyOrthopaedic Surgery Physician
    NPI EnumeratedMay 11, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$7.1M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    44 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive29,150$120$3.4M
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…18,510$60$1.2M
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…13,320$60$786K
    73721In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.990$610$607.2K
    99203The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…6,080$70$425.8K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…1,180$160$187.1K
    20610In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…4,090$30$118.5K
    97112Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…22,570$1$67.7K
    97140Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…32,660$1$65.3K
    97161The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…480$120$57.6K

    Showing 1–10 of 44

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Pennsylvania median

    44 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive1051,690760$170$1.2M
    97530The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.581710320$40$241.4K
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…3111,280390$40$104.8K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…628,160210$60$68.4K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…1688,870240$40$56.1K
    73721In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material.10140120$150$49.4K
    97112Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…8490180$20$45.9K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…6461,210100$90$45K
    64483This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).576050$270$36.9K
    97140Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…6560280$20$32K

    Showing 1–10 of 44

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Premier Orthopaedic And Sports Medicine Associates, Ltd, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jennifer Kwan-morleyPARheumatology Physician$2.5M$0
    Michael ShriverOHDiagnostic Radiology Physician$1.1M$0
    Stephanie MorrisPARheumatology Physician$742.6K$0
    Stephen PomeranzOHDiagnostic Radiology Physician$642.3K$0
    Cheston SimmonsPAOrthopaedic Surgery Physician$570.3K$0
    Nikos PavlidesPAOrthopaedic Surgery Physician$448.3K$0
    Larry ChouPAPhysical Medicine & Rehabilitation Physician$444.8K$0
    Andrew OldPAOrthopaedic Surgery Physician$420.7K$0
    Kevin WalshPASports Medicine (Family Medicine) Physician$336.4K$0
    Todd MichenerPAOrthopaedic Surgery Physician$307.6K$0

    Nearby Providers

    Other providers in the same ZIP code as Premier Orthopaedic And Sports Medicine Associates, Ltd, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Institute For Dermatopathology, Inc.PAClinical Medical Laboratory$8.3M$635.6K
    Main Line HealthcarePAFamily Medicine Physician$0$8.2M
    Bayada Home Health Care, Inc.PAHome Health Agency$0$5.5M
    Kimberly KubekPADiagnostic Radiology Physician$433.6K$0
    Elizabeth Coch BenstockPADermatology Physician$283.1K$0
    Pennsylvania Cvs Pharmacy, L.L.C.PAPharmacy$267.7K$0
    Tricia BeattyPASports Medicine (Family Medicine) Physician$234K$0
    Robert ElliottPANeurological Surgery Physician$158.6K$0
    Allen HarrisPAFamily Medicine Physician$125K$0
    Renee FreilichPAAdult Psychiatric/Mental Health Clinical Nurse Specialist$113.2K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Pennsylvania Providers
    3 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Pennsylvania Distribution
    Premier Orthopaedic And Sports Medicine Associates, Ltd — 7 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania