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.

Montclair Hospital LLC (NPI 1982720249)

Montclair Hospital LLC is a general acute care hospital provider located in Montclair, New Jersey. This profile covers 0 Medicare and 296 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Montclair Hospital LLC
Address	1 Bay Avenue
City	Montclair
State	NJ
ZIP	07042
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$48.6M
Medicare	$0

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

296 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	26,940	$530	$14.2M
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.	27,490	$390	$10.8M
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.	18,400	$250	$4.6M
G0378	Hospital observation service, per hour	5,160	$560	$2.9M
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.	2,150	$570	$1.2M
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.	5,980	$200	$1.2M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	7,360	$110	$772.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	11,810	$50	$566.9K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	8,190	$70	$557.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	14,630	$40	$556.1K

Showing 1–10 of 296

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

Montclair Hospital LLC — 0 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

296 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	44	80	6,290	$690	$6.6M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	161	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…	84	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.	79	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.	61	320	580	$230	$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.	37	280	920	$200	$2.6M
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.	67	150	3,680	$30	$1.5M
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.	69	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…	63	70	4,800	$50	$1M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	48	120	900	$20	$971.9K

Showing 1–10 of 296

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward Kosoy	NJ	Family Medicine Physician	$1.8M	$500
Shereen Dahab	NJ	Internal Medicine Physician	$446.8K	$0
Merieme Klobocista	NJ	Gynecologic Oncology Physician	$53.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Freehold Montclair Healthcare, LLC	NJ	Adult Day Care Clinic/Center	$0	$31.2M
Mental Health Association Of Essex And Morris, Inc.	NJ	Mental Health Counselor	$0	$13.7M
Fadi El Atat	NJ	Cardiovascular Disease Physician	$288K	$1.1M
Montclair Ambulance Unit	NJ	Land Ambulance	$320.2K	$321.3K
Naveen Allam	NJ	Internal Medicine Physician	$558.1K	$0
Rowen Diano	NJ	Geriatric Medicine (Internal Medicine) Physician	$449.3K	$0
Joo Young Lee	NJ	Diagnostic Radiology Physician	$335.6K	$0
Nabila Hai	NJ	Diagnostic Radiology Physician	$278.8K	$0
Nirman Tulsyan	NJ	Vascular Surgery Physician	$268.8K	$0
Joseph Bellapianta	NJ	Orthopaedic Surgery Physician	$245.5K	$0

Montclair Hospital LLC — Billing Profile & Reimbursement Data

Sign up for Montclair Hospital LLC — Billing Profile & Reimbursement Data policy alerts

Montclair Hospital LLC — Billing Profile & Reimbursement Data

Sign up for Montclair Hospital LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References