Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidPremier Health Associates, LLC
    Ask Trek AI about this page

    Premier Health Associates, LLC — Billing Profile & Reimbursement Data

    NPI 1881882785 · Sparta, NJ · Clinic/Center

    Customize your policy alerts

    Sign up for Premier Health Associates, LLC — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Premier Health Associates, LLC is a clinic/center provider located in Sparta, New Jersey. This profile covers 15 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPremier Health Associates, LLC
    Address532 Lafayette Rd
    CitySparta
    StateNJ
    ZIP07871
    TaxonomyClinic/Center
    NPI EnumeratedOctober 5, 2007

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

    Payer SourceTotal Paid
    Medicare$440.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    45380The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…250$490$121.5K
    45385The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…140$490$70.6K
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.180$340$60.9K
    G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk90$440$40K
    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).80$360$29.3K
    64493The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…70$350$25.3K
    64635Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.40$700$24.4K
    G0105Colorectal cancer screening; colonoscopy on individual at high risk50$440$23.1K
    49505The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it.10$1,370$16.4K
    62323The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…40$280$9.6K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    453855456050$320$25.4K
    453803559060$230$21.3K
    6448312733060$230$20.3K
    432398161080$160$18.5K
    646356918030$440$18.2K
    G01056428030$320$13.9K
    C929012104,060$1$12.7K
    644937227050$210$12.6K
    G01212129020$330$11.4K
    49505304020$570$10.9K

    Showing 1–10 of 15

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Premier Health Associates, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Haroon SarwarNJRheumatology Physician$363.9K$0
    Jesus VergaraPAInternal Medicine Physician$336.7K$0
    Samir ShahNJPulmonary Disease Physician$289.3K$0
    Nick DebitettoNJInternal Medicine Physician$286.6K$0
    Sameer StasNJEndocrinology, Diabetes & Metabolism Physician$284.9K$0
    Joseph CasellaNJFamily Medicine Physician$277.8K$0
    Glen BradishNJOrthopaedic Surgery Physician$232.6K$0
    Sean WilkinsonNJOrthopaedic Surgery Physician$224.2K$0
    David YoussefNJPain Medicine Physician$147.6K$0
    David MedunickAZFamily Medicine Physician$65.7K$0

    Nearby Providers

    Other providers in the same ZIP code as Premier Health Associates, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Broadstep Academy-new Jersey, Inc.NJIntellectual and/or Developmental Disabilities Residential Treatment Facility$0$137.1M
    May Abdo-matkiwskyNJHematology & Oncology Physician$2.6M$0
    Jumana ChatiwalaNJInternal Medicine Physician$1.3M$0
    Kathy LoNJRadiation Oncology Physician$1.2M$0
    Specialty Surgical Center LLCNJClinic/Center$739.7K$0
    Anthony PapadopoulosNJDermatology Physician$505K$0
    Hector CorderoNJDiagnostic Radiology Physician$491.7K$0
    Alex ShinNJOrthopaedic Surgery Physician$376.6K$0
    Frederick CorioNJDiagnostic Radiology Physician$338K$0
    Matthew SkallaNJDiagnostic Radiology Physician$336.1K$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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. New Jersey Distribution
    Premier Health Associates, LLC — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Jersey