Physician
Somers Orthopaedic Surgery & Sports Medicine Group PLLC
Somers Orthopaedic Surgery & Sports Medicine Group PLLC was paid $96K by Medicaid between Jan 2019 and Jul 2024, across 6 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 95% of everything it billed.
33Billing provider infoSOMERS ORTHOPAEDIC SURGERY & SPORTS MEDICINE GROUP PLLC
CARMEL, NY 10512
CARMEL, NY 10512
33aNPI1720028384assigned 06/08/2006
33bProvider typeAdult Reconstructive Orthopaedic Surgery Physician
28Total paid$96K
24GClaims3,236
24DCodes billed6
24AFirst – last monthJan 2019 – Jul 2024
Compared with peers
Next to other Adult Reconstructive Orthopaedic Surgery Physician providers in New York
Rank by total paid#5 of 25
Median peer was paid$6K
This provider vs. median16×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2019 | 128 | $14K | |
| 2020 | 359 | $8K | |
| 2021 | 1,169 | $28K | |
| 2022 | 410 | $17K | |
| 2023 | 763 | $24K | |
| 2024incomplete | 407 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 95% | 1,564 | 1,436 | $90K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 4.9% | 405 | 333 | $5K |
| 72100 | <1% | 15 | 15 | $531.45 | |
| 99072 | 0% | 1,196 | 986 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 0% | 40 | 37 | $0.00 |
| 99024 | 0% | 16 | 14 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBUCHALTER, JOEL (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Somers Orthopaedic Surgery & Sports Medicine Group PLLC | Danbury, CT | $68K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.