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 New Jersey for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Englewood Hospital And Medical Center (NPI 1083612881)

Field	Value
Entity Type	Organization
Organization	Englewood Hospital And Medical Center
Address	350 Engle St
City	Englewood
State	NJ
ZIP	07631
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 14, 2005

Payer Source	Total Paid
Medicaid	$136.9M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available claims data: there is no Medicare billing on file and the provider reports $136.9M in lifetime Medicaid revenue, so Medicaid dominates reported reimbursement activity and operational scale. Analysts should treat findings as Medicaid‑centric when evaluating service mix and competitive positioning.

Revenue is concentrated in a small set of high‑revenue procedures: the precomputed top three Medicaid codes account for 29.6% of the provider's total Medicaid revenue. Those top three are 93306 ($9.5M, 12.7%), 43239 ($7.4M, 9.9%), and 99285 ($5.2M, 7.0%), indicating a meaningful reliance on cardiac imaging, endoscopy with biopsy, and high‑acuity ED visits for Medicaid revenue.

The code mix signals a full‑service acute care operation with strong cardiac, gastroenterology, and emergency capabilities: 93306 (echocardiography) and 93017 (stress ECG readings, $3.4M) together point to high cardiology diagnostic throughput, while 43239 ($7.4M) and colonoscopy codes 45378/45380 (each in the $1.3–1.5M range and ranked in high percentiles) indicate substantial endoscopy/gastroenterology volume. These procedure types are consistent with a hospital offering inpatient and high‑volume outpatient specialty services.

The provider shows dominant statewide standing for multiple cardiac and cardiac‑imaging codes: 93306 ranks #3 of 325 in‑state (99th percentile; labeled an extreme outlier) and 93017 ranks #1 of 61 (100th percentile; extreme outlier), and 78452 ranks #1 of 131 (100th percentile; extreme outlier). These rankings indicate that Englewood Hospital is a major statewide hub for echocardiography, stress testing, and nuclear cardiology services.

Gastroenterology and endoscopy volumes are also atypically high for the state: 43239 ranks #5 of 284 (99th percentile; extreme outlier) and 45378/45380 both rank in the upper percentiles (#4 of 109 at 97th and #4 of 169 at 98th respectively, described as notably above typical). This pattern reinforces a competitive advantage in procedural GI care and diagnostic biopsy services.

Oncology infusion services are material but not uniformly dominant: J9271 (pembrolizumab) produced $5M (6.7% of Medicaid revenue) and ranks #4 of 11 in‑state (70th percentile) while 96413 chemotherapy generated $2.1M (2.8%) and ranks #8 of 77 (91st percentile). These figures show a visible oncology infusion program with some high‑ranked chemotherapy activity but fewer comparable statewide peer concentrations for newer immunotherapy dispensing.

Emergency department activity is a substantive revenue driver with a broad acuity mix: 99285 ($5.2M, 7.0%) ranks #35 of 282 (88th percentile; typical), and lower‑acuity ED codes 99284/99283/99282 collectively add multiple millions in revenue. Combined with observation services (G0378 at $1.9M) and high imaging/diagnostic throughput, the data describe a busy ED that handles both high‑complexity and routine emergency care for Medicaid patients.

High claim counts for laboratory and routine diagnostic panels indicate large throughput across inpatient and outpatient settings: 80053 shows 201.8K claims for $2.4M (3.3%) and 85025 shows 203.3K claims for $1.4M (1.9%), while 84443 accounts for 86.2K claims and $1.8M (2.4%). These volumes, together with the provider's NPI tenure (enumerated 2005-07-14, ~21 years ago), support the conclusion that Englewood Hospital is an established, high‑volume Medicaid hospital with sustained diagnostic and procedural capacity statewide.

Medicaid: Complete Services Breakdown

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

564 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	31,650	$300	$9.5M
43239	The 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.	7,000	$1,060	$7.4M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	27,860	$190	$5.2M
J9271	Injection, pembrolizumab, 1 mg	850	$5,910	$5M
OP279	N/A	25,790	$180	$4.7M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	21,410	$190	$4M
93017	The provider records the electrical activity of the heart to examine for any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular intervals with the…	20,000	$170	$3.4M
OP278	N/A	1,660	$1,980	$3.3M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	13,140	$210	$2.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	13,460	$200	$2.7M

Showing 1–10 of 564

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

Englewood Hospital And Medical Center — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

564 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	55	80	6,290	$690	$6.6M
J9271	Injection, pembrolizumab, 1 mg	4	10	340	$6,690	$4.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	94	260	4,240	$220	$4.1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	111	320	580	$230	$4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	22	30	9,660	$310	$3.4M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	35	280	920	$200	$2.6M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	29	40	590	$20	$1.9M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	105	150	3,680	$30	$1.5M
J2505	Injection, pegfilgrastim, 6 mg	3	10	170	$3,180	$1.4M
86480	The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.	9	40	810	$30	$1.4M

Showing 1–10 of 564

Nearby Providers

Other providers in the same ZIP code as Englewood Hospital And Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical Associates Of Englewood, PC	NJ	Internal Medicine Physician	$0	$36.9M
Our Home Adult Day Care, LLC	NJ	Adult Day Care Clinic/Center	$0	$28.5M
L&l Staffing And Home Care Services, Inc.	NJ	Home Health Agency	$0	$25.4M
Nj Eye And Ear LLC	NJ	Ophthalmology Physician	$0	$23.6M
Vantage Health System, Inc.	NJ	Community/Behavioral Health Agency	$0	$8.2M
Benjamin Freilich	NJ	Ophthalmology Physician	$1.5M	$111.3K
Patient Care Associates, LLC	NJ	Clinic/Center	$1.1M	$0
Joseph Schwartz	NJ	Endocrinology, Diabetes & Metabolism Physician	$953.3K	$0
Kurt Wengerter	NJ	Vascular Surgery Physician	$584.8K	$0
Donald Liss	NJ	Physical Medicine & Rehabilitation Physician	$575.1K	$0

Englewood Hospital And Medical Center — Billing Profile & Reimbursement Data

Sign up for Englewood Hospital And Medical Center — Billing Profile & Reimbursement Data policy alerts

Englewood Hospital And Medical Center — Billing Profile & Reimbursement Data

Sign up for Englewood Hospital And Medical Center — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References