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.

University Hospital (NPI 1215998323)

Field	Value
Entity Type	Organization
Organization	University Hospital
Address	150 Bergen St
City	Newark
State	NJ
ZIP	07103
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 29, 2006

Payer Source	Total Paid
Medicaid	$363.2M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-centric hospital: there is no Medicare billing on file while total Medicaid revenue is $363.2M, so Medicaid is the de facto sole payer driving the hospital’s billed activity and revenue. Analysts should treat the entity as a single-payer (Medicaid) exposure when evaluating payer mix and contract risk.

Revenue is highly concentrated in a few emergency- and observation-focused services: the top three Medicaid codes (99283 at 16.4%, G0378 at 14.6%, and 99284 at 13.4%) together account for 44.4% of this provider’s total Medicaid revenue. These codes are emergency department E/M visits (low and moderate complexity) and hospital observation hours, indicating the hospital’s revenue base is centered on acute-care throughput and short-term observation stays.

The provider is a statewide outlier for ambulance emergency transport volume and revenue. A0429 shows 137.1K claims and $25.2M revenue (9.7% of Medicaid revenue) and ranks #1 of 264 providers in-state (100th percentile), described in the data as an "extreme outlier, far above typical state volume," and A0427 also posts elevated volume ($11.3M, 4.3% of Medicaid revenue; rank #3 of 29, 93th percentile), reinforcing a business profile with unusually high EMS/transport intake.

Ambulatory/low‑complexity office visits are another major revenue stream, suggesting a high-volume outpatient front door. Code 99212 has 232K claims and $22.7M revenue (8.7% of Medicaid revenue) and ranks #1 of 1519 providers in-state (100th percentile), labeled an "extreme outlier, far above typical state volume," which points to large-scale clinic or triage visit throughput that complements ED activity.

The provider shows broad high-volume use of imaging, diagnostics, and procedural services consistent with a full-service acute hospital. Examples include 70450 (CT head) with 18.3K claims and $4.2M revenue, 74177 (CT abdomen/pelvis) with 13.3K claims and $2.2M revenue, and 70553 (brain MRI) with $3M revenue; most of these codes are ranked in the upper percentiles but characterized as "typical, unremarkable volume," signaling capacity for advanced diagnostics at scale.

Several codes beyond the top three are labeled as notable outliers in the state, indicating concentrated market leadership in specific lines: U0002 (COVID testing) with 52.7K claims and $2M revenue ranks #1 of 84 (100th percentile, "extreme outlier"), OP279 ranks #1 of 41 providers (100th percentile, "extreme outlier"), and OP259 is ranked #2 of 56 providers (98th percentile, "extreme outlier, far above typical state volume"). These rankings underscore disproportionate volume in discrete service buckets.

From a competitive-stance perspective, the provider is a major statewide participant for emergency, observation, ambulance, and high-volume low-complexity outpatient visits. Multiple codes place the hospital in the top percentiles for the state (96th–100th percentiles for many high-revenue codes), which supports characterizing the facility as a dominant local hub for acute and emergency-driven Medicaid care rather than a modest participant.

The provider has a long-established billing presence, with an NPI enumerated on 2006-03-29 (~20 years ago). Combined with concentrated Medicaid revenue (top three codes = 44.4% of Medicaid revenue), the tenure plus the code mix suggests an entrenched operational model focused on emergency throughput and related services; this also implies sensitivity to Medicaid policy or rate changes that affect ED, observation, or ambulance reimbursement.

Medicaid: Complete Services Breakdown

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

717 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	96,410	$440	$42.8M
G0378	Hospital observation service, per hour	28,040	$1,360	$38M
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.	68,580	$510	$35M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	137,140	$180	$25.2M
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.	33,790	$680	$23M
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,…	231,980	$100	$22.7M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	30,870	$370	$11.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,810	$2,490	$7M
OP370	N/A	22,860	$300	$6.9M
OP279	N/A	41,460	$160	$6.5M

Showing 1–10 of 717

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

University Hospital — 9 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

717 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	7	80	6,290	$690	$6.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	10	10	680	$1,920	$5.1M
J9271	Injection, pembrolizumab, 1 mg	6	10	340	$6,690	$4.9M
81420	The lab analyst performs a genomic sequence analysis panel to evaluate circulating cell free fetal DNA in maternal blood for genetic sequences of at least the genes on chromosomes 13, 18, and 21,…	4	10	5,420	$280	$4.1M
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.	11	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.	22	320	580	$230	$4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	3	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.	30	280	920	$200	$2.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	5	30	860	$1,530	$2.1M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	2	10	4,920	$270	$2.1M

Showing 1–10 of 717

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Sullivan	NJ	Foot & Ankle Surgery Podiatrist	$187K	$0
Matthugh Bennett	WV	Certified Registered Nurse Anesthetist	$9.9K	$0
Julie Rose Montalbano	NJ	Certified Registered Nurse Anesthetist	$7.5K	$0
Nisha Vijay	NJ	Certified Registered Nurse Anesthetist	$7.2K	$0

Nearby Providers

Other providers in the same ZIP code as University Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Physician Associates Of New Jersey Inc	NJ	Surgery Physician	$0	$41.8M
University Physician Associates Of New Jersey Inc	NJ	Internal Medicine Physician	$0	$36.6M
University Physician Associates Of New Jersey Inc	NJ	Pediatrics Physician	$0	$34.1M
Rutgers-university Behavioral Health Care	NJ	Community/Behavioral Health Agency	$0	$20.7M
Eli Eliav	NJ	Dentist	$0	$19.5M
All Health Services PC	NJ	Internal Medicine Physician	$0	$18.5M
University Physician Associates Of New Jersey Inc	NJ	Obstetrics & Gynecology Physician	$0	$10.2M
Rutgers-university Behavioral Health Care	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$9.7M
Unique Home Care & Companionship Services	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.5M
Bio-medical Applications Of New Jersey, Inc.	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8.8M

University Hospital — Billing Profile & Reimbursement Data

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University Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References