HIP Ancillary Provider Second Interim Distribution


Proof of Claim # Name (A) Submitted Proof of Claim Amount (B) Estimated Percent Allowable (C) Estimated Payable Amount (Col A x Col B) (D) Two-Thirds of Column C (E) Recovery Amount to Date (F) Estimated Amount Eligible for Distribution (Col D - Col E) (G) Estimated Distribution at 50% (H) 1st Interim Distribution Payment (J) Proposed Interim Distribution With Deminimus Ancillary - $1,000; Hospital - $3,000; Physician - $1,000
5385 A AND A DERMATOLOGY $1,027.00 80.82% $830.03 $553.35   $553.35 $276.68 $0.00  
801 A TEAM APPROACH $2,480.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
2190 ABC CHIROPRACTIC CENTER $605.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
3121 ACCUFIT BRACING $1,408.89 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1530 ACE AMBULANCE SERVICE INC $470.00 17.87% $84.00 $56.00   $56.00 $28.00 $0.00  
2824 ACTIVE FOOT AND ANKLE CARE CENTER $7,540.50 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1731 ACTIVIZE $717.17 34.31% $246.06 $164.04   $164.04 $82.02 $0.00  
5585 ADAMS LCSWBCD $125.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
6030 ADVANCED DIAG AND PSYCH THERAPY $300.00 34.31% $102.93 $68.62   $68.62 $34.31 $0.00  
5010 ADVANCED IMAGING AND RADIOLOGY ASSOCIATES PA $1,976.29 18.04% $356.54 $237.69   $237.69 $118.85 $0.00  
3313 ADVANTAGE FOOT AND ANKLE CENTERS $31,794.55 0.00% $0.00 $0.00   $0.00 $0.00 $2,937.07  
2981 AERO AMBULANCE SERVICE $4,867.25 34.31% $1,669.95 $1,113.30   $1,113.30 $556.65 $0.00  
3543 AFFILIATED FOOT AND ANKLE CENTER LLP $28,107.77 0.00% $0.00 $0.00   $0.00 $0.00 $2,596.50  
2553 AFFILIATES IN PSYCHOTHERAPY $1,575.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4779 ALIGINIS INC $361,190.94 2.28% $8,235.15 $5,490.10   $5,490.10 $2,745.05 $33,365.62  
2552 ALLCARE MEDICAL $87,301.03 23.82% $20,791.81 $13,861.21   $13,861.21 $6,930.60 $8,064.58  
5371 ALLIED VISION SERVICES $200.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
730 ALTAMURO DC $3,059.55 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5723 AMSERV HEALTHCARE OF NJ $53,480.00 0.00% $0.00 $0.00   $0.00 $0.00 $4,940.30  
1353 ANTHWAL EYE ASSOCIATES $520.00 69.04% $359.00 $239.33   $239.33 $119.67 $0.00  
5472 ARROYO MD $390.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1350 ARTHUR PHD $1,540.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1513 ASSOC IN PSYCHIATRY $9,582.07 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
3635 ASSOCIATED EYE PHYSICIANS AND SURGEONS OF NJ PA $20,455.00 0.00% $0.00 $0.00   $0.00 $0.00 $1,889.56  
1589 ASSOCIATED OPTHAMOLOGISTS PA $1,530.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4428 ASSOCIATED RADIOLOGISTS PA $170,864.13 43.33% $74,027.45 $49,351.63   $49,351.63 $24,675.82 $18,560.41 $6,115.41
1525 ATLANTIC EYE PHYSICIANS PA $531.47 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
6024 ATLANTIC MEDICAL IMAGING $13,693.00 75.61% $10,352.63 $6,901.75   $6,901.75 $3,450.88 $1,264.91 $2,185.96
5684 ATLANTIC RADIOLOGISTS $7,140.53 55.76% $3,981.67 $2,654.44   $2,654.44 $1,327.22 $0.00 $1,327.22
884 BACK AND NECK CARE CENTER $3,471.40 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1598 BARBIERI DMD $12,365.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
952 BARRY CHIROPRACTIC CENTER $1,011.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
2665 BAYSHORE MAMMOGRAPHY $288.00 32.50% $93.60 $62.40   $62.40 $31.20 $0.00  
5022 BELL OD $13,927.10 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5177 BELLEVILLE AMBULANCE $9,950.00 33.29% $3,312.50 $2,208.33   $2,208.33 $1,104.17 $0.00 $1,104.17
878 BENNETT DC $1,217.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
836 BERG MD $605.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
6523 BERGEN CLINICAL LABS $251.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4504 BERGEN COMMUNITY HEALTH CARE $9,794.75 39.34% $3,853.24 $2,568.83   $2,568.83 $1,284.41 $0.00 $1,284.41
3620 BERGEN PASSAIC CATARACT SURGERY AND LASER CENTER $2,447.95 91.46% $2,238.94 $1,492.63   $1,492.63 $746.31 $0.00  
4084 BERGER HIRSCH AND OW $4,382.00 41.74% $1,829.00 $1,219.33   $1,219.33 $609.67 $0.00  
3675 BERKOWITZ MD $7,258.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4872 BEY LEA VILLAGE NURSING HOME $24,508.00 34.31% $8,408.69 $5,605.80   $5,605.80 $2,802.90 $2,263.97  
5266 BIEBEL DPM $4,537.31 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1873 BIO LABS USA INC $40,114.93 29.09% $11,670.93 $7,780.62   $7,780.62 $3,890.31 $2,665.41 $1,224.90
6035 BIO MEDICAL APPLICATIONS OF EAST ORANGE INC $1,799.67 34.31% $617.47 $411.64   $411.64 $205.82 $0.00  
6036 BIO MEDICAL APPLICATIONS OF IRVINGTON INC $4,298.19 34.31% $1,474.71 $983.14   $983.14 $491.57 $0.00  
5150 BIO MEDICAL APPLICATIONS OF NJ INC $109,055.61 0.44% $480.82 $320.55   $320.55 $160.27 $1,116.27  
6034 BIO MEDICAL APPLICATIONS OF TRENTON INC $14,610.20 34.31% $5,012.76 $3,341.84   $3,341.84 $1,670.92 $1,349.64  
3125 BIO TRAX INTERNATIONAL INC $88,340.00 44.83% $39,607.02 $26,404.68   $26,404.68 $13,202.34 $8,160.55 $5,041.78
808 BLOOMFIELD MEDICAL PC $230.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5299 BOOTH RADIOLOGY ASSOCIATION $22,564.09 27.84% $6,281.70 $4,187.80   $4,187.80 $2,093.90 $1,509.46  
2113 BOPF DPM $931.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4568 BRAHIN PA $48,695.00 42.86% $20,871.96 $13,914.64   $13,914.64 $6,957.32 $4,498.28 $2,459.04
1294 BRANCHBURG EYE PHYSICIANS $995.68 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
6492 BREYUT CONVALESCENT CENTER INC $2,850.00 34.31% $977.84 $651.89   $651.89 $325.95 $0.00  
5126 BRICK PSYCHOTHERAPY CENTER $840.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1528 BRITTNER DPM $148.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
716 BROWN DC $2,935.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1973 BROWN DPM $17,845.44 0.00% $0.00 $0.00   $0.00 $0.00 $1,648.50  
1399 BRUNO DC $1,730.45 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5592 BUCKLEY $6,515.00 58.83% $3,832.77 $2,555.18   $2,555.18 $1,277.59 $0.00 $1,277.59
5225 BURKE $66,238.16 0.00% $0.00 $0.00   $0.00 $0.00 $6,118.86  
6531 BURLINGTON WOODS CONVALESCENT CTR $46,455.86 12.17% $5,655.00 $3,770.00   $3,770.00 $1,885.00 $4,291.44  
804 CALDERONE JR $3,825.00 89.02% $3,405.00 $2,270.00   $2,270.00 $1,135.00 $0.00 $1,135.00
2146 CALZARETTO MD $1,342.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
2907 CAMARA MD $2,071.34 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4047 CAMPELL OD $1,744.12 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
798 CANCELL $1,461.67 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4806 CAPITAL IMAGING ASSOCIATION $6,426.00 20.20% $1,298.00 $865.33   $865.33 $432.67 $0.00  
5687 CARABIN MD $7,800.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1581 CARLASCIO ORTHOPEDIC $13,883.75 21.85% $3,033.46 $2,022.31   $2,022.31 $1,011.15 $1,282.53  
4719 CATANI DC $3,135.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
2834 CATHOLIC CHARITIES $1,710.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5945 CBC (Capitated) $1,208,456.63 81.93% $990,076.02 $660,050.68   $660,050.68 $330,025.34 $0.00 $330,025.34
2636 CENTER FOR SPEECH AND HEARING SCIENCES INC $20,644.29 2.63% $543.51 $362.34   $362.34 $181.17 $1,907.05  
3050 CENTERS FOR HEALTHCARE $21,077.08 0.00% $0.00 $0.00   $0.00 $0.00 $1,492.61  
2508 CENTORE CHIROPRACTIC $3,245.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5116 CENTRA PC $1,073.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
6046 CENTRAL JERSEY PATHOLOGY PA $22,685.45 34.31% $7,783.38 $5,188.92   $5,188.92 $2,594.46 $2,095.61  
1789 CENTRAL JERSEY RADIOLOGISTS $55,905.00 1.10% $617.00 $411.33   $411.33 $205.67 $0.00  
4056 CENTRAL MEDICAL IMAGING $3,000.00 34.31% $1,029.30 $686.20   $686.20 $343.10 $0.00  
2177 CENTURY AMBULANCE ROCKLAND DIVISION $1,325.33 100.00% $1,325.33 $883.55   $883.55 $441.78 $0.00  
3909 CERCONE OD $480.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
4212 CHARTER BEHAVIORAL HEALTH SYSTEMS OF SUMMIT $49,680.00 0.00% $0.00 $0.00   $0.00 $0.00 $4,589.27  
1929 CIMATO CHIROPRACTIC CENTER $9,924.36 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
974 CLARK PSYCHOLOGY CENTER $1,175.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
3279 CLAUSS $30.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
3144 CLIFTON MEDICAL IMAGING $109,652.00 29.99% $32,883.00 $21,922.00   $21,922.00 $10,961.00 $7,070.72 $3,890.28
3442 CLMLD $1,887.66 33.06% $623.97 $415.98   $415.98 $207.99 $0.00  
4301 COASTAL CHIROPRACTIC CENTER $90.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
5924 COLUMBIA PRESBYTERIAN RADIOLOGISTS $2,378.00 41.75% $992.72 $661.81   $661.81 $330.91 $0.00  
3569 CONIGLIO SPORTS AND FAMILY CHIRO $3,534.00 0.00% $0.00 $0.00   $0.00 $0.00 $0.00  
1670 CONTEMPORARY AND COSMETIC DERMATOLOGY PC $4,352.00 42.28% $1,840.00 $1,226.67   $1,226.67 $613.33 $0.00  
5458 COOPER PATHOLOGY $5,755.58 80.94% $4,658.73 $3,105.82   $3,105.82 $1,552.91 $0.00 $1,552.91
2057 COOPER REHABILITATION AND SPORTS THERAPY $2,150.00 0.00%