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.

Clara Maass Medical Center (NPI 1902901333)

Field	Value
Entity Type	Organization
Organization	Clara Maass Medical Center
Address	1 Clara Maass Dr
City	Belleville
State	NJ
ZIP	07109
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$156.9M
Medicare	$0

Key Findings

CLARA MAASS MEDICAL CENTER shows an effectively single‑payer footprint in this dataset: there is no Medicare billing on file while Medicaid revenue totals $156.9M, indicating Medicaid is the dominant — and in this data extract, the only — public payer driving recorded revenue. The facility’s NPI was enumerated 2006-09-13 (~20 years ago), so this profile reflects an established provider with a long Medicaid billing history.

Revenue is highly concentrated: the top three Medicaid codes (G0378, 99283, 99284) together account for 59.6% of the provider’s total Medicaid revenue. Individually those codes each produce roughly $25–$27M in revenue (G0378 $27.2M, 99283 $27.2M, 99284 $25.7M), so a small number of services disproportionately determine the hospital’s Medicaid cash flow.

The code mix strongly indicates a high‑throughput emergency and observation operation: G0378 (Hospital observation service, per hour) has 39.6K claims and $27.2M revenue (20.2%), 99283 has 80.1K claims and $27.2M revenue (20.2%), and 99284 has 64.1K claims and $25.7M revenue (19.1%). These volumes and dollar shares point to sustained ED patient flow plus prolonged observation stays rather than revenue driven by elective inpatient surgery or high‑margin specialty procedures.

On statewide competitive standing, CLARA MAASS ranks at or near the top for several high‑volume Medicaid codes: G0378 ranks #4 of 78 (96th percentile; notably above typical state volume), 99283 ranks #14 of 262 (95th percentile; notably above typical state volume), and several other ED codes (e.g., 99285) sit in the mid‑90s percentiles. This pattern suggests the hospital is a major regional provider for emergency and observation services under New Jersey Medicaid, outperforming many in‑state peers on volume.

There are notable statistical outliers in procedural and specialty codes that signal concentrated service lines beyond ED/observation. 58558 (hysteroscopic endometrial biopsy/polypectomy) is $3.4M and ranks #1 of 24 (100th percentile; extreme outlier), and 11042 (debridement to subcutaneous tissue) is $1.6M and ranks #2 of 103 (99th percentile; notably above typical state volume), indicating unusually high volumes in specific gynecologic and wound care procedures relative to peers.

Ancillary and diagnostic services also contribute meaningfully and show above‑typical volumes: 80053 (CMP) has 92K claims and $1.7M revenue (1.2%) and ranks #14 of 185 (93th percentile), OP250 and OP710 procedure buckets appear high in volume (OP250 169.6K claims $4.7M, rank #11 of 170, 94th percentile; OP710 21K claims $1.1M, rank #8 of 76, 91th percentile). The presence of high counts for basic labs and OP buckets alongside advanced testing (0202U PLA with 13K claims and $986.8K revenue, rank #6 of 47, 89th percentile) indicates broad service capacity supporting both ED/obs and outpatient workflows.

High claim counts on core ED codes — 99283 at 80.1K claims, 99284 at 64.1K, and 99285 at 55.8K — reinforce that throughput (volume) rather than high per‑claim reimbursement is the primary driver of emergency department revenue. Average paid/claim figures ($340 for 99283, $401 for 99284, $332 for 99285) are moderate, so total Medicaid dollars tied to ED care are being driven by large visit volumes rather than unusually high unit prices.

Because 59.6% of Medicaid revenue is concentrated in a small set of observation and ED codes, the provider’s Medicaid financial performance is sensitive to policy or payment changes affecting those specific codes. Any state Medicaid rate adjustments, observation‑to‑inpatient reclassifications, or utilization management initiatives targeting G0378/ED E/M codes would likely have an outsized impact on the hospital’s overall Medicaid revenue profile.

Medicaid: Complete Services Breakdown

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

401 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0378	Hospital observation service, per hour	39,630	$690	$27.2M
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.	80,070	$340	$27.2M
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.	64,130	$400	$25.7M
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.	55,770	$330	$18.5M
OP250	N/A	169,630	$30	$4.7M
S9480	Intensive outpatient psychiatric services, per diem	5,530	$760	$4.2M
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	1,980	$1,700	$3.4M
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.	14,990	$220	$3.3M
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.	2,590	$1,120	$2.9M
T2034	Crisis intervention, waiver; per diem	2,220	$860	$1.9M

Showing 1–10 of 401

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

Clara Maass Medical Center — 5 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

401 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	4	80	6,290	$690	$6.6M
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.	14	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.	24	320	580	$230	$4M
S9480	Intensive outpatient psychiatric services, per diem	8	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.	16	280	920	$200	$2.6M
T2034	Crisis intervention, waiver; per diem	11	20	2,220	$860	$2.3M
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.	107	150	3,680	$30	$1.5M
86480	The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.	27	40	810	$30	$1.4M
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.	23	140	1,410	$180	$1.3M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	35	70	4,800	$50	$1M

Showing 1–10 of 401

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Manooj Prasad	NJ	Foot & Ankle Surgery Podiatrist	$139K	$0
Robert Greenberg	NJ	Geriatric Psychiatry Physician	$52.2K	$230

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Essex Community Healthcare	NJ	Community/Behavioral Health Agency	$0	$23.5M
Belleville Senior Services, LLC	NJ	Adult Day Care Clinic/Center	$0	$19.9M
Elder Care Of Belleville LLC	NJ	Adult Day Care Clinic/Center	$0	$11.1M
123 Medical Transport LLC	NJ	Ambulance	$2.6M	$95.5K
Joel Eichler	NJ	Ophthalmology Physician	$2M	$5.6K
Susan Morrison	NJ	Allergy & Immunology Physician	$71.3K	$593.8K
Said Saleh	NJ	Hematology & Oncology Physician	$531.4K	$0
James Orsini	NJ	Hematology & Oncology Physician	$413.3K	$0
Shailendra Hajela	NJ	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$406.6K	$0
Amit Seth	NJ	Endocrinology, Diabetes & Metabolism Physician	$364.6K	$0

Clara Maass Medical Center — 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