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.

Monmouth Medical Center Inc (NPI 1609983790)

Field	Value
Entity Type	Organization
Organization	Monmouth Medical Center Inc
Address	300 2nd Avenue
City	Long Branch
State	NJ
ZIP	07740
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 24, 2006

Payer Source	Total Paid
Medicaid	$110M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $110M in Medicaid revenue, making it effectively a single‑payer (Medicaid) hospital in our dataset. Analysts should treat Medicaid trends here as the primary revenue signal rather than any Medicare activity.

Revenue is highly concentrated in a small group of service lines: the top three Medicaid codes (G0378, 99283, 99284) account for 48.0% of the provider's total Medicaid revenue, with G0378 at $15.4M (17.6%), 99283 at $15M (17.1%), and 99284 at $11.7M (13.4%). This concentration indicates a small number of high‑revenue service categories drive nearly half of Medicaid income.

The code mix points to an emergency‑department and observation–center operational footprint: G0378 (Hospital observation service) has 16.6K claims and 99283/99284 have 40.3K and 28.9K claims respectively, and 99285 appears as well with 16.8K claims. Those volumes suggest high ED throughput with substantial short‑term observation stays and a meaningful share of higher‑acuity ED encounters.

Behavioral health services are a clear specialty outlier: T2034 (Crisis intervention, waiver; per diem) generates $7.4M (8.4% of Medicaid revenue) and ranks #1 of 21 providers in‑state, described as “notably above typical state volume.” The presence of S9480 and H0035 alongside that ranking reinforces a significant investment or market role in crisis and intensive outpatient psychiatric care.

Competitive standing for routine ED and observation codes is solid but not dominant statewide: G0378 ranks in the ~83rd percentile (#14 of 78), 99283 is in the 84th percentile (#42 of 262), and 99284 is in the ~82nd percentile (#59 of 319) and are labeled as typical or unremarkable volume for their cohorts. In short, MONMOUTH MEDICAL CENTER is a significant regional ED/observation provider but not an outlier leader for those codes statewide.

Service breadth is consistent with a full‑service acute hospital: high claim and revenue contributions for lab/diagnostic and procedural codes such as 80053 (51.7K claims, $1.6M), 93306 ($1.6M), 96413 ($2.1M), and 43239 ($1.5M) indicate routine imaging, chemotherapy administration, endoscopy/biopsy, and comprehensive lab work are meaningful revenue sources. This mix supports a general acute care profile with inpatient/emergency, oncology infusion, and diagnostic capabilities.

The provider’s case mix includes both high‑volume, low‑unit‑price outpatient activity and lower‑volume, high‑unit‑price procedures: OP250 appears with 95.2K claims and $4M revenue (low average paid/claim), while codes such as 41899 ($5M revenue with $2439 avg paid/claim) and 43239 ($1810 avg paid/claim) point to episodic, higher‑paid procedural work. That contrast implies parallel strategies of high throughput outpatient services plus targeted higher‑intensity procedural billing.

The NPI tenure (enumerated 2006-08-24, ~20 years ago) indicates an established provider presence in the Long Branch, NJ market. Combined with its Medicaid concentration and a state‑leading role in crisis intervention services, the profile suggests a mature general acute care hospital that is heavily reliant on Medicaid and occupies a notable niche in behavioral health within the state.

Medicaid: Complete Services Breakdown

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

405 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0378	Hospital observation service, per hour	16,630	$930	$15.4M
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.	40,300	$370	$15M
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.	28,870	$410	$11.7M
T2034	Crisis intervention, waiver; per diem	8,620	$860	$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.	16,830	$420	$7.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,070	$2,440	$5M
OP250	N/A	95,210	$40	$4M
S9480	Intensive outpatient psychiatric services, per diem	3,840	$800	$3.1M
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.	8,820	$260	$2.3M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	4,330	$480	$2.1M

Showing 1–10 of 405

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

Monmouth Medical Center Inc — 1 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

405 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	14	80	6,290	$690	$6.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	118	170	21,080	$100	$4.2M
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…	91	130	3,180	$60	$4.2M
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.	42	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.	59	320	580	$230	$4M
S9480	Intensive outpatient psychiatric services, per diem	14	30	3,840	$770	$3.3M
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.	58	280	920	$200	$2.6M
T2034	Crisis intervention, waiver; per diem	1	20	2,220	$860	$2.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	30	860	$1,530	$2.1M
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.	73	150	3,680	$30	$1.5M

Showing 1–10 of 405

Related Providers

Other providers that share a Tax Identification Number (TIN) with Monmouth Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monmouth Medical Center Inc	NJ	General Acute Care Hospital	$0	$60.1M
Isaac Omoloyin	NJ	Psychiatric/Mental Health Nurse Practitioner	$355.5K	$24.2K

Nearby Providers

Other providers in the same ZIP code as Monmouth Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andrew Kwak	NJ	Diagnostic Radiology Physician	$808.5K	$0
Shilpan Shah	NJ	Internal Medicine Physician	$323K	$0
Alexander King	NJ	Diagnostic Radiology Physician	$300.6K	$0
Jonathan Kristan	NJ	Ophthalmology Physician	$272.3K	$0
Glenn Zwerin	NJ	Geriatric Medicine (Internal Medicine) Physician	$188.9K	$0
Todd Traina	NJ	Clinical Psychologist	$181K	$5.9K
Sang Sim	NJ	Radiation Oncology Physician	$178.5K	$0
Lisa Gastan	NJ	Family Nurse Practitioner	$177.3K	$0
George Constantinopoulos	NJ	Surgery Physician	$162.6K	$0
Vincent Lanteri	NJ	Urology Physician	$157K	$0

Monmouth Medical Center Inc — 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