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

Why is the Medicaid comparison limited to Pennsylvania 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. Pennsylvania (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.

St. Luke's Hospital Monroe Campus (NPI 1396194197)

Field	Value
Entity Type	Organization
Organization	St. Luke's Hospital Monroe Campus
Address	100 St Luke's Ln
City	Stroudsburg
State	PA
ZIP	18360
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 13, 2016

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

199 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.	25,750	$90	$2.4M
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.	18,950	$120	$2.3M
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.	7,260	$170	$1.2M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	11,800	$80	$955.4K
G0378	Hospital observation service, per hour	760	$910	$695.1K
T1015	Clinic visit/encounter, all-inclusive	15,220	$40	$578.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,970	$180	$537.4K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	4,700	$110	$503.3K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	18,550	$10	$185.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	3,160	$50	$170.5K

Showing 1–10 of 199

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

St. Luke's Hospital Monroe Campus — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

199 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	62	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	176	1,690	760	$170	$1.2M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	110	130	310	$60	$769.3K
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.	115	210	730	$40	$689.7K
S9083	Global fee urgent care centers	212	400	360	$110	$571.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	70	200	990	$70	$517.5K
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.	71	1,600	270	$120	$409.7K
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.	28	1,060	150	$130	$405.4K
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.	90	1,230	250	$130	$284K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	97	100	330	$40	$166K

Showing 1–10 of 199

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Luke's Hospital Monroe Campus, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Dolansky	PA	Family Medicine Physician	$182.8K	$0
Stacey Connell	PA	Nurse Practitioner	$118.1K	$0
Nancy Gabana	PA	Emergency Medicine Physician	$99K	$0

Nearby Providers

Other providers in the same ZIP code as St. Luke's Hospital Monroe Campus, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carbon Monroe Pike Mh Ds	PA	Community/Behavioral Health Agency	$0	$13.1M
Pocono Ambulatory Surgery Center Ltd	PA	Ambulatory Surgical Clinic/Center	$966.6K	$7.8K
Shobin Oommen	PA	Psychiatry Physician	$345.8K	$396K
Thomas Kislan	PA	Optometrist	$597K	$0
Abbey Boyd	PA	Foot & Ankle Surgery Podiatrist	$209.5K	$0
Umesh Dalal	PA	Nephrology Physician	$192.9K	$0
Matthew Voluck	PA	Foot & Ankle Surgery Podiatrist	$182.9K	$0
Jwalant Patel	PA	Nephrology Physician	$143.8K	$0
Brian Olzinski	PA	Optometrist	$141.4K	$0
Allison Froehlich	PA	Endocrinology, Diabetes & Metabolism Physician	$114.6K	$0

St. Luke's Hospital Monroe Campus — Billing Profile & Reimbursement Data

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St. Luke's Hospital Monroe Campus — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References