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.

St Josephs University Medical Center Inc. (NPI 1669462420)

Field	Value
Entity Type	Organization
Organization	St Josephs University Medical Center Inc.
Address	703 Main St
City	Paterson
State	NJ
ZIP	07503
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 24, 2005

Payer Source	Total Paid
Medicaid	$322.3M
Medicare	$0

Key Findings

ST JOSEPHS UNIVERSITY MEDICAL CENTER INC. reports no Medicare billing on file and $322.3M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer Medicaid based on the available claims data. This concentration implies that analyses of this facility’s financial and utilization patterns should be interpreted through the Medicaid lens rather than a mixed Medicare/Medicaid profile.

Revenue is highly concentrated in emergency department evaluation-and-management codes: 99284 ($59.3M, 25.9%), 99283 ($53.8M, 23.5%), and 99285 ($33.4M, 14.6%) together account for 64.0% of this provider’s total Medicaid revenue. That precomputed top‑three share signals a dominant revenue dependency on ED services rather than a broad distribution across many outpatient or inpatient DRGs.

Operationally the code mix and volumes point to a high-throughput, ED-centric acute hospital: 99283 has 182.2K claims and ranks #1 in-state (100th percentile, extreme outlier), 99284 has 168K claims and ranks #4 (99th percentile, extreme outlier), and 99285 has 67K claims and ranks #11 (96th percentile, notably above typical). These counts and statewide ranks indicate sustained, large-scale emergency care throughput across low-, moderate- and high‑severity visits.

Competitive standing in New Jersey is especially strong for emergency and basic diagnostic services: the provider ranks at the top of the state for several high-volume codes (e.g., 99283 rank #1 100th percentile; 99281 rank #1 100th percentile; 93005 rank #1 100th percentile), and several other ED and imaging codes sit in the 96th–99th percentiles. Descriptions labeling many of these volumes as "extreme outlier" or "notably above typical" support characterizing the hospital as a major regional player for ED and frontline diagnostic care.

Beyond ED care, the provider shows substantial procedural and imaging capacity: 43239 ($5.1M, rank #2 100th percentile) and 45380 ($2.8M, rank #2 99th percentile) indicate high volumes of upper endoscopy and colonoscopy procedures, while CT codes such as 70450 ($3.5M, 96th percentile) and 74177 ($3.3M, 96th percentile) further reflect significant radiology throughput. These patterns are consistent with a full‑service acute hospital that receives and evaluates many patients requiring diagnostic procedures.

Behavioral health and outpatient psychiatric programs are material but more mixed in relative standing: 90832 has 51.4K claims and $5.6M revenue (rank #4, 99th percentile, extreme outlier), while H0035 ($4.8M) and S9480 ($4.6M) sit at more typical mid‑range state percentiles (49th and 79th respectively). This suggests sizeable psychotherapy and partial/IOP services integrated alongside the hospital’s dominant ED activity, with some elements (short psychotherapy visits) being unusually large relative to peers.

High-volume, basic inpatient/ED support services are prominent: 93005 (109.4K claims, $2.5M, rank #1 100th percentile) and therapy/administration codes such as 97110 (85.8K claims, $3.2M, 99th percentile) and 96374/96375 (58.9K and 37.9K claims with 99th/97th percentile standing) indicate extensive use of EKGs, therapeutic exercise, and IV medication administration. These code-level volumes reinforce a picture of high patient turnover and substantial procedural throughput supporting the ED and inpatient services.

The provider’s NPI enumeration date is 2005-10-24 (~21 years ago), indicating long tenure in the market. Combined with the heavy Medicaid revenue base and repeated extreme‑percentile rankings across ED, imaging, and selected ancillary codes, the facility appears to function as an established regional safety‑net/acute care center with concentrated reliance on emergency and procedural service lines.

Medicaid: Complete Services Breakdown

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

746 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	168,030	$350	$59.3M
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.	182,230	$300	$53.8M
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.	67,020	$500	$33.4M
G0378	Hospital observation service, per hour	11,470	$700	$8M
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.	34,750	$200	$7M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	51,440	$110	$5.6M
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.	8,990	$570	$5.1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	20,080	$240	$4.8M
S9480	Intensive outpatient psychiatric services, per diem	5,580	$820	$4.6M
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…	10,640	$370	$3.9M

Showing 1–10 of 746

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

St Josephs University Medical Center Inc. — 19 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

746 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	20	80	6,290	$690	$6.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	7	10	680	$1,920	$5.1M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	88	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…	20	130	3,180	$60	$4.2M
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,…	5	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.	1	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.	4	320	580	$230	$4M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	13	30	9,660	$310	$3.4M
S9480	Intensive outpatient psychiatric services, per diem	7	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.	11	280	920	$200	$2.6M

Showing 1–10 of 746

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matthew Shahbandi	NJ	Urology Physician	$196.8K	$0
Donna Konlian	NJ	Cardiovascular Disease Physician	$171.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Joseph's Healthcare, Inc.	NJ	Internal Medicine Physician	$0	$31.7M
St. Joseph's Emergency Physicians Inc	NJ	Emergency Medical Services (Emergency Medicine) Physician	$0	$24.2M
Fayrouz Pediatric LLC	NJ	Pediatrics Physician	$0	$13.3M
St. Josephs Hospital And Medical Center	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$13.2M
Simeon Dialysis LLC	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.9M
St Josephs Medical Group PC	NJ	Internal Medicine Physician	$0	$10.1M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Ellsworth Wright	NJ	Emergency Medicine Physician	$247.3K	$0
Orestes Sanchez	NJ	Diagnostic Radiology Physician	$225.5K	$0
Edward Milman	NJ	Diagnostic Radiology Physician	$221.9K	$0

St Josephs University Medical Center Inc. — Billing Profile & Reimbursement Data

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St Josephs University 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