Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Delaware for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Delaware only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Delaware (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Premier Orthopaedic Bone & Joint Care (NPI 1417251257)

Premier Orthopaedic Bone & Joint Care is a orthopaedic surgery physician provider located in Milford, Delaware. This profile covers 0 Medicare and 18 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Premier Orthopaedic Bone & Joint Care
Address	329 Mullet Run
City	Milford
State	DE
ZIP	19963
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	January 10, 2011

Payer Source	Total Paid
Medicaid	$501.4K
Medicare	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The 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…	6,770	$30	$223.3K
99203	The 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…	2,410	$50	$120.7K
20610	In 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…	3,430	$30	$92.6K
73560	In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	1,980	$10	$19.8K
73565	In this procedure, the provider takes X–ray images of a patient’s knees while the patient is in a standing position facing the X–ray machine to check for any fracture, swelling, or reason for pain in…	1,150	$10	$13.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	550	$30	$13.7K
J1030	Injection, methylprednisolone acetate, 40 mg	1,570	$1	$6.3K
99214	The 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…	50	$80	$3.8K
99204	The 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…	20	$130	$2K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	10	$120	$1.5K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Premier Orthopaedic Bone & Joint Care — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The 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…	440	500	1,130	$50	$235.1K
99213	The 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…	90	540	1,100	$40	$185.3K
99204	The 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…	161	180	220	$90	$101.5K
99203	The 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…	26	190	240	$60	$90.8K
20610	In 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…	6	10	1,860	$20	$90K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	11	10	240	$80	$55.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	56	180	180	$20	$24.4K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	4	10	450	$40	$23.5K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	17	20	880	$20	$22.3K
73030	This particular procedure is for a minimum of 2 X–ray views of the complete shoulder.	20	20	1,480	$10	$22.2K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$39.5M
Banyan Delaware LLC	DE	Substance Abuse Rehabilitation Facility	$0	$30.9M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$28.5M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$19.3M
Delaware Pediatric Dentistry	DE	Pediatric Dentistry	$0	$18.1M
Kent-sussex Industries	DE	Developmentally Disabled Services Day Training Agency	$0	$11.7M
Nurses 'n Kids Of Milford, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$9.5M
Prn Staffers Inc	DE	Home Health Agency	$0	$7.6M
People's Place Ii, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.9M
Bayhealth Medical Center, Inc.	DE	Clinic/Center	$0	$3.7M

Premier Orthopaedic Bone & Joint Care — Billing Profile & Reimbursement Data

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Premier Orthopaedic Bone & Joint Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Barrish	DE	Physical Medicine & Rehabilitation Physician	$964.3K	$0
Joseph Farrell	DE	Orthopaedic Surgery Physician	$576.7K	$0
Wilson Choy	DE	Orthopaedic Surgery Physician	$402K	$0
Henry Mensack	DE	Physician Assistant	$385.9K	$0
Patrick Kane	DE	Orthopaedic Surgery Physician	$352.7K	$0
Amanda Moore	DE	Physician Assistant	$287.3K	$0
Paul Harriott	DE	Orthopaedic Surgery Physician	$286.4K	$0
Jennifer Hazzard	DE	Physician Assistant	$279.2K	$0
Bryan Pepper	DE	Physician Assistant	$192.3K	$0