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Dr. Todd A. Michener, MD

Accepting New Patients

(839 Ratings)

Specializes in: Sports Medicine and Orthopedics/Orthopedic Surgery

Vanderbilt University School of Medicine

Professional interests include: wrist injury, knee pain, hip pain, and more.

455 West Woodview Road Penn Medicine Southern Chester County
West Grove, PA 19390

1-800-789-7366

Dr. Todd A. Michener, MD is a sports medicine doctor in Kennett Square, PA specializing in sports medicine and orthopedics/orthopedic surgery. He graduated from Vanderbilt University School of Medicine. Dr. Todd A. Michener, MD is affiliated with Premier Orthopaedics.

Office Locations

400 Mcfarlan Road Suite 100
Kennett Square, PA 19348

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455 West Woodview Road Penn Medicine Southern Chester County
West Grove, PA 19390

1-800-789-7366

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915 Old Fern Hill Road Suite 1, Building A
West Chester, PA 19380

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Some issues Dr. Todd A. Michener, MD can help you with:

Hip Replacement

Hip replacement is a surgical procedure to replace parts of the hip joint that are damaged by disease or injury. It is most often done to treat arthritis, a common condition that causes stiffness and pain in the joints. Surgery is used only after other, less invasive treatments have failed to work.

The type of hip replacement patients receive is based on their age and the extent of damage to their hip. The hip joint has two parts: the femoral head, or hip ball, and the acetabulum, or hip socket. The hip ball is located on the upper end of the femur (thigh bone), and the hip socket is part of the pelvis. Depending on whether one or both parts require replacement, patients may need one of the following procedures:

Partial hip replacement, which is generally recommended in the case of hip fractures or other hip injuries. If a patient is having a partial hip replacement, only the hip ball will be replaced.
Total hip replacement, which is often used to treat the hip joint when it has become damaged due to arthritis. Both the hip socket and hip ball are replaced.
Hip resurfacing, which is usually performed for younger patients. A hip resurfacing procedure reshapes the hip ball and only replaces its surface. This preserves more bone and makes future surgeries easier. If a patient is having a partial hip resurfacing, only the hip ball is resurfaced and replaced. If a patient is having a total hip resurfacing, the hip socket will be replaced as well.

During hip replacement surgery, an incision is made along the side of the hip. The surgeon may access the joint directly through this incision, or by using small tools and a lighted tube called an arthroscope to see and treat the joint. The diseased tissue is removed, and the bones are smoothed out and fitted with metal ends. The metal pieces may be cemented in place, or they may have a porous structure that encourages bone to grow into them and hold them securely. A smooth plastic cushion is placed between the two bones to replace the cartilage and allow the joint to move freely.

Hip replacement surgery takes one to two hours, and afterwards patients may stay in the hospital for several days. When patients go home, they will have to use a cane, walker, or crutches at first. Patients will likely have physical therapy to improve their ability to move with their new hip. After the first few weeks, light exercise such as bike riding or swimming will help them heal, but certain actions, such as climbing stairs or bending over at the waist, may be difficult at first. It will take several weeks before they can drive or return to work. Full recovery may take six to 12 months.

Shoulder Arthritis

Shoulder arthritis is a very common condition that causes pain, stiffness, or a grinding sensation in the shoulder. Some patients may hear a clicking or popping noise, and all symptoms are more noticeable when moving. Arthritis occurs when the cartilage that cushions joints becomes damaged.

Normally, when two bones come together inside a joint, they are separated by a layer of tough, smooth cartilage. The cartilage allows the bones to glide across each other, which makes movement easier. Cartilage can be damaged by an injury, by an illness such as rheumatoid arthritis, or by simple wear and tear (osteoarthritis). In the shoulder, the two joints most commonly affected are the AC joint (where the shoulder blade and collarbone connect at the outside edge of the shoulder), and the glenohumeral joint (where the arm bone meets the shoulder blade).

Treatment for shoulder arthritis may include:

Ice and rest
Exercise and physical therapy
Over-the-counter pain medications
Corticosteroid injections
Surgery

Surgical treatments include the removal of inflamed tissue and joint reconstruction. The type of arthritis and severity of the damage will determine which treatment is most appropriate.

Noteworthy Medicare Patient Procedures Performed by Dr. Todd A. Michener, MD in 2023

Click on any procedure below to see further details on volume and pricing among Medicare patients.

Top 5%

By Volume:

major joint aspiration

major joint injection

In 2023, Dr. Todd A. Michener, MD performed more major joint aspiration, and major joint injection procedures for Medicare patients than 95% of providers in related specialties within Pennsylvania.

Top 10%

By Affordability:

decompression surgery

In 2023, Dr. Todd A. Michener, MD had a list price for decompression surgery that was lower than the list prices billed to Medicare by 90% of providers in related specialties within Pennsylvania. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Top 25%

By Volume:

minimally invasive surgery

shoulder surgery

By Affordability:

acromial resection

acromioplasty

arthroscopic acromioplasty

arthroscopic subacromial decompression

subacromial decompression

In 2012, among providers in related specialties within Pennsylvania, Dr. Todd A. Michener, MD performed more minimally invasive surgery, and shoulder surgery procedures for Medicare patients than 75% of them and he also had a list price for acromial resection, acromioplasty, arthroscopic acromioplasty, arthroscopic subacromial decompression, and subacromial decompression that was lower than the list prices billed to Medicare by 75% of them. Actual amounts paid by patients can vary widely depending on a number of factors, including insurance coverage. A lower list price, however, might mean lower fees when paying without insurance.

Medicare Procedure and Patient Information

2012 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2012 were injections, aspiration, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	280
decompression surgery	15
doctor visit	443
hospital care	14
injections	295
inpatient care	14
joint surgery	28
minimally invasive procedures	28
musculoskeletal imaging	59
upper extremity surgery	28
X-rays	59

Medicare Procedure and Patient Information

2013 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2013 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	358
decompression surgery	21
doctor visit	409
hospital care	16
injections	358
inpatient care	16
joint surgery	42
minimally invasive procedures	42
musculoskeletal imaging	67
upper extremity surgery	42
X-rays	67

2013 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	149
Female	227

**Ethnicity**
Non-Hispanic White	336
Black	19
Hispanic	0
Asian	0
Other	0
Native American	0

**Age**
From 65 to 74	208
From 75 to 84	79
85 and over	57
Less than 65	32

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2013

Hypertension	65
High Cholesterol	66
Stroke	5
Ischemic Heart Disease	33
Depression	21
Chronic Kidney Disease	17
Asthma	7
Osteoperosis	12
Atrial Fibrilation	9
Heart Failure	14
Chronic Obstructive Pulmonary Disease	12
Diabetes	28
Dementia	8
Cancer	14

Medicare Procedure and Patient Information

2014 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2014 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	467
decompression surgery	22
doctor visit	542
injections	467
joint surgery	43
minimally invasive procedures	43
musculoskeletal imaging	111
upper extremity surgery	43
X-rays	111

2014 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	150
Female	257

**Ethnicity**
Non-Hispanic White	363
Black	16
Hispanic	0
Asian	0
Other	13
Native American	0

**Age**
From 65 to 74	206
From 75 to 84	95
85 and over	67
Less than 65	39

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2014

Hypertension	62
High Cholesterol	64
Stroke	6
Ischemic Heart Disease	31
Depression	22
Chronic Kidney Disease	16
Asthma	10
Osteoperosis	13
Atrial Fibrilation	12
Heart Failure	13
Chronic Obstructive Pulmonary Disease	12
Diabetes	23
Dementia	8
Cancer	14

Medicare Procedure and Patient Information

2015 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2015 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	561
decompression surgery	26
doctor visit	673
injections	561
joint surgery	64
minimally invasive procedures	49
musculoskeletal imaging	118
reconstructive surgery	15
upper extremity surgery	64
X-rays	118

2015 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	408
Female	512

**Ethnicity**
Non-Hispanic White	822
Black	46
Hispanic	0
Asian	0
Other	24
Native American	0

**Age**
From 65 to 74	502
From 75 to 84	272
85 and over	70
Less than 65	76

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2015

Hypertension	63
High Cholesterol	68
Stroke	5
Ischemic Heart Disease	32
Depression	20
Chronic Kidney Disease	18
Asthma	10
Osteoperosis	8
Atrial Fibrilation	10
Heart Failure	12
Chronic Obstructive Pulmonary Disease	11
Diabetes	26
Dementia	8
Cancer	11

Medicare Procedure and Patient Information

2016 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2016 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	632
decompression surgery	23
doctor visit	708
injections	632
joint surgery	69
lower extremity surgery	11
minimally invasive procedures	54
musculoskeletal imaging	133
reconstructive surgery	15
upper extremity surgery	58
X-rays	133

2016 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	212
Female	291

**Ethnicity**
Non-Hispanic White	453
Black	17
Hispanic	0
Asian	0
Other	18
Native American	0

**Age**
From 65 to 74	267
From 75 to 84	145
85 and over	59
Less than 65	32

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2016

Hypertension	65
High Cholesterol	63
Stroke	5
Ischemic Heart Disease	36
Depression	24
Chronic Kidney Disease	21
Asthma	16
Osteoperosis	7
Atrial Fibrilation	14
Heart Failure	16
Chronic Obstructive Pulmonary Disease	13
Diabetes	25
Dementia	8
Cancer	11

Medicare Procedure and Patient Information

2017 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2017 were aspiration, injections, joint surgery and upper extremity surgery.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	618
debridement (removal of unhealthy tissue)	13
decompression surgery	40
doctor visit	699
injections	618
joint surgery	98
minimally invasive procedures	86
musculoskeletal imaging	76
reconstructive surgery	12
upper extremity surgery	98
X-rays	76

2017 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	220
Female	277

**Ethnicity**
Non-Hispanic White	449
Black	0
Hispanic	0
Asian	0
Other	25
Native American	0

**Age**
From 65 to 74	289
From 75 to 84	131
85 and over	50
Less than 65	27

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2017

Hypertension	66
High Cholesterol	63
Stroke	4
Ischemic Heart Disease	35
Depression	23
Chronic Kidney Disease	21
Asthma	8
Osteoperosis	13
Atrial Fibrilation	11
Heart Failure	10
Chronic Obstructive Pulmonary Disease	6
Diabetes	27
Dementia	8
Cancer	11

Medicare Procedure and Patient Information

2018 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2018 were aspiration, injections, minimally invasive procedures and joint surgery.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	677
debridement (removal of unhealthy tissue)	11
decompression surgery	31
doctor visit	752
hospital care	11
injections	677
inpatient care	11
joint surgery	71
minimally invasive procedures	71
musculoskeletal imaging	71
upper extremity surgery	71
X-rays	71

2018 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	221
Female	299

**Ethnicity**
Non-Hispanic White	474
Black	12
Hispanic	0
Asian	0
Other	21
Native American	0

**Age**
From 65 to 74	291
From 75 to 84	149
85 and over	52
Less than 65	28

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2018

Hypertension	61
High Cholesterol	68
Stroke	4
Ischemic Heart Disease	35
Depression	25
Chronic Kidney Disease	21
Asthma	8
Osteoperosis	11
Atrial Fibrilation	12
Heart Failure	14
Chronic Obstructive Pulmonary Disease	11
Diabetes	28
Dementia	7
Cancer	11

Medicare Procedure and Patient Information

2019 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2019 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	595
decompression surgery	29
doctor visit	765
hospital care	13
injections	595
inpatient care	13
joint surgery	63
minimally invasive procedures	50
musculoskeletal imaging	88
reconstructive surgery	13
upper extremity surgery	63
X-rays	88

2019 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	200
Female	314

**Ethnicity**
Non-Hispanic White	464
Black	0
Hispanic	0
Asian	0
Other	24
Native American	0

**Age**
From 65 to 74	287
From 75 to 84	163
85 and over	39
Less than 65	25

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2019

Hypertension	61
High Cholesterol	65
Stroke	4
Ischemic Heart Disease	30
Depression	25
Chronic Kidney Disease	22
Asthma	10
Osteoperosis	10
Atrial Fibrilation	12
Heart Failure	11
Chronic Obstructive Pulmonary Disease	10
Diabetes	23
Dementia	8
Cancer	10

Medicare Procedure and Patient Information

2020 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2020 were aspiration, injections, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	449
closed (non-surgical) treatment of fracture	11
decompression surgery	23
doctor visit	628
injections	449
joint surgery	56
minimally invasive procedures	43
musculoskeletal imaging	88
reconstructive surgery	13
upper extremity surgery	56
X-rays	88

2020 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	167
Female	252

**Ethnicity**
Non-Hispanic White	381
Black	0
Hispanic	0
Asian	0
Other	18
Native American	0

**Age**
From 65 to 74	249
From 75 to 84	113
85 and over	36
Less than 65	21

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2020

Hypertension	57
High Cholesterol	67
Stroke	5
Ischemic Heart Disease	26
Depression	23
Chronic Kidney Disease	24
Asthma	9
Osteoperosis	11
Atrial Fibrilation	11
Heart Failure	8
Chronic Obstructive Pulmonary Disease	7
Diabetes	21
Dementia	7
Cancer	12

Medicare Procedure and Patient Information

2021 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2021 were injections, aspiration, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	787
decompression surgery	17
doctor visit	788
injections	806
joint surgery	49
minimally invasive procedures	31
musculoskeletal imaging	124
reconstructive surgery	18
upper extremity surgery	49
X-rays	124

2021 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	207
Female	285

**Ethnicity**
Non-Hispanic White	435
Black	0
Hispanic	0
Asian	0
Other	33
Native American	0

**Age**
From 65 to 74	285
From 75 to 84	145
85 and over	43
Less than 65	19

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2021

Hypertension	58
High Cholesterol	69
Stroke	5
Ischemic Heart Disease	29
Depression	24
Chronic Kidney Disease	22
Asthma	9
Osteoperosis	11
Atrial Fibrilation	8
Heart Failure	10
Chronic Obstructive Pulmonary Disease	8
Diabetes	22
Dementia	7
Cancer	13

Medicare Procedure and Patient Information

2022 Medicare Procedure Volume

The top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA during 2022 were injections, aspiration, X-rays and musculoskeletal imaging.

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

aspiration	763
decompression surgery	34
doctor visit	884
injections	787
joint surgery	102
lower extremity surgery	14
minimally invasive procedures	83
musculoskeletal imaging	127
reconstructive surgery	19
upper extremity surgery	88
X-rays	127

2022 Medicare Patient Data

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	216
Female	326

**Ethnicity**
Non-Hispanic White	488
Black	20
Hispanic	0
Asian	0
Other	22
Native American	0

**Age**
From 65 to 74	305
From 75 to 84	172
85 and over	48
Less than 65	17

Conditions of Medicare patients treated by Dr. Todd A. Michener, MD in 2022

Hypertension	70
High Cholesterol	75
Stroke	8
Ischemic Heart Disease	27
Depression	21
Chronic Kidney Disease	19
Asthma	11
Osteoperosis	15
Atrial Fibrilation	13
Heart Failure	9
Chronic Obstructive Pulmonary Disease	10
Diabetes	24
Dementia	3
Cancer	17

Medicare Procedure and Patient Information

Average Medicare Procedure Volume From 2012 - 2022

Volume of procedures performed by Dr. Todd A. Michener, MD for Medicare patients.

The highest averages for the top procedures that Dr. Todd A. Michener, MD treated as a sports medicine doctor in Kennett Square, PA were injections, aspiration, musculoskeletal imaging and X-rays.

aspiration	562
closed (non-surgical) treatment of fracture	11
debridement (removal of unhealthy tissue)	12
decompression surgery	25
doctor visit	662
hospital care	13
injections	567
inpatient care	13
joint surgery	62
lower extremity surgery	12
minimally invasive procedures	52
musculoskeletal imaging	96
reconstructive surgery	15
upper extremity surgery	60
X-rays	96

Average Medicare Patient Data From 2012 - 2022

Information about Medicare patients treated by Dr. Todd A. Michener, MD.

**Gender**
Male	195
Female	276

**Ethnicity**
Black / African American	11
Asian / Pacific Islander	0
Non-Hispanic White	424
Native American / Alaskan Native	0
Hispanic	0
Other	18

**Age**
75 to 84	133
85 and over	47
Less than 65	28
65 to 74	262

Average of Total of Conditions of Medicare patients treated by Dr. Todd A. Michener, MD From 2012 - 2022

The highest averages of the most common conditions of Medicare patients that Dr. Todd A. Michener, MD treated were high cholesterol, hypertension, ischemic heart disease and diabetes.

Hypertension	57
High Cholesterol	60
Stroke	4
Ischemic Heart Disease	28
Depression	20
Chronic Kidney Disease	18
Asthma	8
Osteoporosis	10
Heart Failure	10
Chronic Obstructive Pulmonary Disease	9
Diabetes	22
Atrial Fibrillation	10
Dementia	6
Cancer	11

Education & Training

Dr. Todd A. Michener, MD graduated from Vanderbilt University School of Medicine. He completed residency at University of Pennsylvania Affiliated Hospitals. He is certified by the Board certifications: Orthopaedic Surgery and has a state license in South Carolina.

Medical School: Vanderbilt University School of Medicine

Residency: University of Pennsylvania Affiliated Hospitals

Board Certification: Board certifications: Orthopaedic Surgery (2009)

Licensed In: South Carolina

Affiliations & Hospitals

Dr. Todd A. Michener, MD is associated with these hospitals and organizations:

Premier Orthopaedics

Ratings & Reviews

Dr. Todd A. Michener, MD has an exceptional overall rating with an average of 4.99 out of 5 stars based on 839 ratings. We collect ratings and reviews of Dr. Todd A. Michener, MD from all over the web to help you find the right in Kennett Square, PA.

4.99

Overall Rating

(839 Ratings)

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General Payments

These charts describe general payments received by Dr. Todd A. Michener, MD. Doctors may receive payments for a number of reasons, including meal compensation, travel compensation, and consulting.

**Payments by Company**
Liberty Surgical, Inc	$4,103 $4,103
Arthrex, Inc.	$2,612 $2,612
Eclipse Technology Solutions Inc.	$704 $704
DePuy Synthes Sales Inc.	$499 MONOVISC $151	ORTHOVISC $135	Early Intervention $118	PEAK $47	BRISTOW-LATARJET $34	Other $14
Iroko Pharmaceuticals, LLC	$314 ZORVOLEX $314
Other	$1,294 EUFLEXXA $196	Gel-One Cross-linked Hyaluronate $119	Duexis $111	Persona $82	TRAUMA & EXTREMITIES $82	Other $704

**Types of Payments**
Education	$5,061
Food and Beverage	$2,247
Travel and Lodging	$2,219

Ownership and Interest Payments

This table describes ownership payments received by Dr. Todd A. Michener, MD.

Rapid Pathogen Screening, Inc.	2014	$66,600.00	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2015	$66,600.00	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2016	$49,950.00	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2013	$49,950.00	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2021	$18.90	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2020	$18.90	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2018	$16.20	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2017	$16.20	Physician Covered Recipient	common stock
Rapid Pathogen Screening, Inc.	2019	$16.20	Physician Covered Recipient	common stock

Biography

Dr. Todd Michener's medical specialty is orthopedics/orthopedic surgery and sports medicine. Dr. Michener is rated highly by his patients. Clinical interests for Dr. Michener include meniscus surgery, knee arthritis, and femur (thigh bone) fracture. Before performing his residency at a hospital affiliated with the University of Pennsylvania, Dr. Michener attended Vanderbilt University School of Medicine. Dr. Michener has received the following distinction: Recognized annually in Philadelphia Magazine's Top Docs issue from through. He is affiliated with Chester County Hospital and Premier Orthopaedics. His practice in Kennett Square, PA is open to new patients as reported by Penn Medicine.