Month ed ed Partial Full or Partial No Withdrawn Withdrawn MAR18 16 45 11 24.4 10 2 26.7 10 22.2 12 26.7
Payer Cased / by Payer Partial Full or Partial No AETNA 0 3 2 66.7 0 1 33.3 0 0.0 0 0.0 AMERICHOICE NJ AMERIGROUP NJ 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 AMERIHEALTH HMO, INC. AMERIHEALTH INSURANCE CO. OF NJ CIGNA 1 7 0 0.0 4 0 57.1 3 42.9 0 0.0 HORIZON BCBS 1 14 2 14.3 2 0 14.3 0 0.0 10 71.4 HORIZON NJ HEALTH 0 1 0 0.0 0 0 0.0 0 0.0 1 100.0 HORIZON NJ HEALTH NJ 1 2 2 100.0 0 0 0.0 0 0.0 0 0.0 OXFORD HEALTH PLANS 2 10 0 0.0 4 0 40.0 6 60.0 0 0.0 UNITED HEALTHCARE 1 3 3 100.0 0 0 0.0 0 0.0 0 0.0 UNITED HEALTHCARE COMMUNITY PLAN UNITED HEALTHCARE COMMUNITY PLAN NJ - AMERICHOICE 0 1 0 0.0 0 0 0.0 1 100.0 0 0.0 8 3 1 33.3 0 1 33.3 0 0.0 1 33.3 Mar2018 Total 16 45 11 24.4 10 2 26.7 10 22.2 12 26.7
Provider ALLIANCE SPINE ASSOCIATES ATLANTIC ORTHOPAEDIC ASSOCIATES Cased / by Provider Partial Full or Partial No Withdr, 0 2 0 0.0 2 0 100.0 0 0.0 0 0.0 0 3 0 0.0 3 0 100.0 0 0.0 0 0.0 CHRIST HOSPITAL 0 14 0 0.0 5 0 35.7 9 64.3 0 0.0 GRAND VIEW HEALTH 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 HACKENSACK UMC MOUNTAINSIDE HACKENSACK UNIVERSITY HOBOKEN UNIVERSITY 0 1 0 0.0 0 0 0.0 0 0.0 1 100.0 0 1 0 0.0 0 0 0.0 1 100.0 0 0.0 LHS 1 6 5 83.3 0 1 16.7 0 0.0 0 0.0 M SAHOTA MD PC 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 MITCHELL F REITER MD PC 0 6 1 16.7 0 0 0.0 0 0.0 5 83.3 OUR LADY OF LOURDES 0 1 0 0.0 0 1 100.0 0 0.0 0 0.0 RICHARD M. VITALI, PA-C RODOLFO COLACO MD 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 SACRAMENTO MIDTOWN ENDOSCOPY CENTER SAINT FRANCIS MEDICAL CENTER SPINE EXPOSURE SPECIALISTS LLC 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 4 6 1 16.7 0 0 0.0 0 0.0 5 83.3 THE VALLEY HOSPITAL 1 1 0 0.0 0 0 0.0 0 0.0 1 100.0
Provider Cased / by Provider Partial Full or Partial No Withdr, UNIVERSITY HOSPITAL 7 0 0 0 0 0 0 0 0 0 0 Mar2018 Total 16 45 11 24.4 10 2 26.7 10 22.2 12 26.7
Requestor ALLIANCE SPINE ASSOCIATES ENSEMBLE HEALTH PARTNERS Cased / by Requestor Partial Full or Partial No 0 2 0 0.0 2 0 100.0 0 0.0 0 0.0 1 15 0 0.0 5 0 33.3 9 60.0 1 6.7 GRAND VIEW HEALTH 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 HACKENSACK UNIVERSITY 0 1 0 0.0 0 0 0.0 1 100.0 0 0.0 LHS 1 6 5 83.3 0 1 16.7 0 0.0 0 0.0 M SAHOTA MD PC 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 MITCHELL F REITER MD PC 0 6 1 16.7 0 0 0.0 0 0.0 5 83.3 OUR LADY OF LOURDES PRECISE REVENUE SOLUTIONS, LLC 0 1 0 0.0 0 1 100.0 0 0.0 0 0.0 RODOLFO COLACO MD 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 SACRAMENTO MIDTOWN ENDOSCOPY CENTER SAINT FRANCIS MEDICAL CENTER SCHNEIDER-ZENNA & GAFFNEY SPINE EXPOSURE SPECIALISTS LLC 0 1 1 100.0 0 0 0.0 0 0.0 0 0.0 0 3 0 0.0 3 0 100.0 0 0.0 0 0.0 4 6 1 16.7 0 0 0.0 0 0.0 5 83.3 THE VALLEY HOSPITAL 1 1 0 0.0 0 0 0.0 0 0.0 1 100.0 UNIVERSITY HOSPITAL 7 0 0 0 0 0 0 0 0 0 0 Mar2018 Total 16 45 11 24.4 10 2 26.7 10 22.2 12 26.7 04/19/18 Requestor is Same Value as Provider, if Provider Filed Their Own Claim NJPICPA
Total Amount ed by Payer Sum TotalAmt cases Payer AETNA $4,952.00 3 AMERIGROUP NJ $0.00 1 CIGNA $20,567.27 7 HORIZON BCBS $99,452.38 14 HORIZON NJ HEALTH $0.00 1 HORIZON NJ HEALTH NJ $0.00 2 OXFORD HEALTH PLANS $31,759.58 10 UNITED HEALTHCARE $0.00 3 UNITED HEALTHCARE COMMUNITY PLAN $0.00 1 UNITED HEALTHCARE COMMUNITY PLAN NJ - AMERICHOICE $21,535.78 3 All $178,267.01 45