| A | B | C | D | E | F | G | H | |||
| Estimated | Estimated | Estimated | ||||||||
| Estimated | Payable | Recoverable | Amount Eligible | Estimated | First Interim | |||||
| Submitted | Percent | Amount | Two-Thirds | Amount | for Distribution | Distribution | Distribution | |||
| Type | POC # | Provider Name | POC Amount | Allowable | (Col A x B) | of Col C | To Date | (Col D - E) | at 35% | w/ De Minimus |
| Hospital | 3777 | ABLINGTON MEMORIAL HOSPITAL | $4,069.50 | 27.08% | $1,102.02 | $734.68 | $734.68 | $257.14 | ||
| Hospital | 3508 | ALBERT EINSTEIN MEDICAL CENTER | $342,773.31 | 27.08% | $92,823.01 | $61,882.01 | $61,882.01 | $21,658.70 | $21,658.70 | |
| Hospital | 6014 | ALLEGHENY UNIVERSITY HOSPITAL RANCOCAS | $1,093,700.64 | 27.98% | $306,017.44 | $204,011.63 | $204,011.63 | $71,404.07 | $71,404.07 | |
| Hospital | 2887 | AMERICAN ONCOLOGIC HOSPITAL | $62,212.55 | 27.08% | $16,847.16 | $11,231.44 | $11,231.44 | $3,931.00 | $3,931.00 | |
| Hospital | 3847 | ARDEN HILL HOSPITAL | $611.00 | 27.08% | $165.46 | $110.31 | $110.31 | $38.61 | ||
| Hospital | 4863 | ATLANTIC CITY MEDICAL CENTER | $865,008.95 | 47.90% | $414,336.49 | $276,224.33 | $276,224.33 | $96,678.52 | $96,678.52 | |
| Hospital | 3066 | ATLANTIC GENERAL HOSPITAL | $282.09 | 27.08% | $76.39 | $50.93 | $50.93 | $17.82 | ||
| Hospital | 3344 | ATLANTIC HEALTH SYSTEM | $4,156,649.67 | 50.71% | $2,108,024.40 | $1,405,349.60 | $539,000.00 | $866,349.60 | $303,222.36 | $303,222.36 |
| Hospital | 5113 | BARNERT HOSPITAL | $196,169.59 | 27.08% | $53,122.72 | $35,415.15 | $35,415.15 | $12,395.30 | $12,395.30 | |
| Hospital | 4235 | BARTLETT REGIIONAL HOSPITAL | $6,223.25 | 27.08% | $1,685.26 | $1,123.50 | $1,123.50 | $393.23 | ||
| Hospital | 5762 | BAYFRONT MEDICAL CENTER | $10,648.75 | 27.08% | $2,883.68 | $1,922.45 | $1,922.45 | $672.86 | ||
| Hospital | 5927 | BAYONNE HOSPITAL | $423,875.61 | 27.08% | $114,785.52 | $76,523.68 | $76,523.68 | $26,783.29 | $26,783.29 | |
| Hospital | 4158 | BAYSHORE COMMUNITY HOSPITAL | $840,632.00 | 27.08% | $227,643.15 | $151,762.10 | $151,762.10 | $53,116.73 | $53,116.73 | |
| Hospital | 3323 | BERGEN REGIONAL MEDICAL CENTER | $74,953.47 | 27.08% | $20,297.40 | $13,531.60 | $13,531.60 | $4,736.06 | $4,736.06 | |
| Hospital | 5006 | BETH ISRAEL HOSPITAL EKG GROUP | $901.00 | 27.08% | $243.99 | $162.66 | $162.66 | $56.93 | ||
| Hospital | 2238 | BLOOMSBURG HOSPITAL | $184.00 | 27.08% | $49.83 | $33.22 | $33.22 | $11.63 | ||
| Hospital | 3905 | BULLOCH MEMORIAL HOSPITAL | $636.48 | 27.08% | $172.36 | $114.91 | $114.91 | $40.22 | ||
| Hospital | 3358 | CAPE CORAL HOSPITAL | $119.31 | 27.08% | $32.31 | $21.54 | $21.54 | $7.54 | ||
| Hospital | 4801 | CAPTIAL HEALTH SYSTEMS | $2,436,217.11 | 26.19% | $638,096.32 | $425,397.55 | $649,000.00 | ($223,602.45) | ||
| Hospital | 5551 | CATHEDRAL HEATHCARE SERVICE | $318,377.65 | 27.08% | $86,216.67 | $57,477.78 | $57,477.78 | $20,117.22 | $20,117.22 | |
| Hospital | 5838 | CENTER FOR SPECIAL SURGERY | $22,043.61 | 27.08% | $5,969.41 | $3,979.61 | $3,979.61 | $1,392.86 | ||
| Hospital | 5884 | CENTRA STAE MEDICAL CENTER | $16,073.00 | 27.08% | $4,352.57 | $2,901.71 | $2,901.71 | $1,015.60 | ||
| Hospital | 2041 | CHILDRENS HOSPITAL | $19,824.09 | 27.08% | $5,368.36 | $3,578.91 | $3,578.91 | $1,252.62 | ||
| Hospital | 1802 | CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS | $3,537.90 | 27.08% | $958.06 | $638.71 | $638.71 | $223.55 | ||
| Hospital | 5256 | CHILDRENS SPECIALIZED HOSPITAL | $650,754.86 | 27.08% | $176,224.42 | $117,482.94 | $117,482.94 | $41,119.03 | $41,119.03 | |
| Hospital | 5290 | CHILTON MEMORIAL HOSPITAL | $3,350.00 | 27.08% | $907.18 | $604.79 | $604.79 | $211.68 | ||
| Hospital | 5691 | CHILTON MEMORIAL HOSPITAL | $73,360.00 | 27.08% | $19,865.89 | $13,243.93 | $13,243.93 | $4,635.37 | $4,635.37 | |
| Hospital | 5215 | CHRIST HOSPITAL | $395,956.00 | 27.08% | $107,224.88 | $71,483.26 | $71,483.26 | $25,019.14 | $25,019.14 | |
| Hospital | 4562 | CHRISTIANA CARE HEALTH SERVICES | $564.80 | 27.08% | $152.95 | $101.97 | $101.97 | $35.69 | ||
| Hospital | 5909 | CLARA MAASS MEDICAL CENTER | $356,766.66 | 27.08% | $96,612.41 | $64,408.27 | $64,408.27 | $22,542.90 | $22,542.90 | |
| Hospital | 3046 | CLARK NURSING AND REHABILITATION CENTER | $89,766.28 | 27.08% | $24,308.71 | $16,205.81 | $16,205.81 | $5,672.03 | $5,672.03 | |
| Hospital | 3668 | CLEVELAND CLINIC FOUNDATION | $3,865.00 | 27.08% | $1,046.64 | $697.76 | $697.76 | $244.22 | ||
| Hospital | 1908 | COLUMBIA CLEAR LADE REGIONAL MEDICAL CENTER | $24,798.57 | 27.08% | $6,715.45 | $4,476.97 | $4,476.97 | $1,566.94 | ||
| Hospital | 3538 | COLUMBIA MEMORIAL HOSPITAL | $308.50 | 27.08% | $83.54 | $55.69 | $55.69 | $19.49 | ||
| Hospital | 1809 | COLUMBUS HOSPTAL | $98,247.00 | 27.08% | $26,605.29 | $17,736.86 | $17,736.86 | $6,207.90 | $6,207.90 | |
| Hospital | 2610 | COMMUNITY MEDICAL CENTER | $1,786,012.72 | 27.08% | $483,652.24 | $322,434.83 | $322,434.83 | $112,852.19 | $112,852.19 | |
| Hospital | 5576 | COOPER HOSPITAL INC | $9,137,062.00 | 30.01% | $2,741,906.91 | $1,827,937.94 | $1,305,000.00 | $522,937.94 | $183,028.28 | $183,028.28 |
| Hospital | 3512 | CROZER TAYLOR SPRINGFIELD | $1,442.00 | 27.08% | $390.49 | $260.33 | $260.33 | $91.12 | ||
| Hospital | 1446 | CVPH MEDIAL CENTER | $492.75 | 27.08% | $133.44 | $88.96 | $88.96 | $31.14 | ||
| Hospital | 2259 | DEBORAH HEART AND LUNG CENTER | $1,225,035.34 | 59.73% | $731,656.39 | $487,770.93 | $487,770.93 | $170,719.82 | $170,719.82 | |
| Hospital | 4394 | EAST ORANGE GENERAL HOSPITAL | $201,175.34 | 27.08% | $54,478.28 | $36,318.85 | $36,318.85 | $12,711.60 | $12,711.60 | |
| Hospital | 3332 | EASTERN NEW MEXICO MEDICAL CENTER | $15,463.00 | 27.08% | $4,187.38 | $2,791.59 | $2,791.59 | $977.06 | ||
| Hospital | 4913 | ELIZABETHTOWN COMMUNITY HOSPITAL | $487.00 | 27.08% | $131.88 | $87.92 | $87.92 | $30.77 | ||
| Hospital | 2585 | ELWOOD CITY HOSPITAL | $12,340.96 | 27.08% | $3,341.93 | $2,227.95 | $2,227.95 | $779.78 | ||
| Hospital | 2903 | ENGLEWOOD HOSPITAL AND MED CTR | $10,948.00 | 27.08% | $2,964.72 | $1,976.48 | $1,976.48 | $691.77 | ||
| Hospital | 4602 | ENGLEWOOD HOSPITAL EKG ASSOC | $38.00 | 27.08% | $10.29 | $6.86 | $6.86 | $2.40 | ||
| Hospital | 4928 | EPHRATA COMMUNITY HOSPITAL | $629.93 | 27.08% | $170.59 | $113.72 | $113.72 | $39.80 | ||
| Hospital | 5084 | FLORIDA HOSPITAL | $29,717.05 | 27.08% | $8,047.38 | $5,364.92 | $5,364.92 | $1,877.72 | ||
| Hospital | 1535 | FOX SUBACUTE CENTER | $89,100.00 | 27.08% | $24,128.28 | $16,085.52 | $16,085.52 | $5,629.93 | $5,629.93 | |
| Hospital | 4016 | FRANKLIN CARE CENTER | $379,040.00 | 27.08% | $102,644.03 | $68,429.35 | $68,429.35 | $23,950.27 | $23,950.27 | |
| Hospital | 3956 | FRIENDS HOSPITAL | $6,706.10 | 27.08% | $1,816.01 | $1,210.67 | $1,210.67 | $423.74 | ||
| Hospital | 4926 | GENERAL HOSPITAL CENTER AT PASSAIC | $2,264.00 | 27.08% | $613.09 | $408.73 | $408.73 | $143.05 | ||
| Hospital | 1860 | GEORGETOWN MEMORIAL HOSPITAL | $3,037.35 | 27.08% | $822.51 | $548.34 | $548.34 | $191.92 | ||
| Hospital | 4259 | GEORGETOWN UNIVERSITY MEDICAL CENTER | $150.75 | 27.08% | $40.82 | $27.22 | $27.22 | $9.53 | ||
| Hospital | 3509 | GERMANTOWN HOSPITAL | $474.00 | 27.08% | $128.36 | $85.57 | $85.57 | $29.95 | ||
| Hospital | 2089 | GOOD SAMARITAN HOSPITAL | $2,489.25 | 27.08% | $674.09 | $449.39 | $449.39 | $157.29 | ||
| Hospital | 1971 | GREENVILLE HOSPITAL | $195,425.60 | 27.08% | $52,921.25 | $35,280.83 | $35,280.83 | $12,348.29 | $12,348.29 | |
| Hospital | 5389 | HACKENSACK UNIVERSITY MEDICAL CENTER | $2,311,466.00 | 52.85% | $1,221,637.65 | $814,425.10 | $746,000.00 | $68,425.10 | $23,948.79 | $23,948.79 |
| Hospital | 4489 | HAMILTON PARK HEALTH CARE CENTER | $54,037.84 | 27.08% | $14,633.45 | $9,755.63 | $9,755.63 | $3,414.47 | $3,414.47 | |
| Hospital | 1980 | HAMPTON HOSPITAL | $145,500.00 | 27.08% | $39,401.40 | $26,267.60 | $26,267.60 | $9,193.66 | $9,193.66 | |
| Hospital | 1894 | HEALTHSOUTH READIN REHAB HOSPITAL | $2,120.20 | 27.08% | $574.15 | $382.77 | $382.77 | $133.97 | ||
| Hospital | 1663 | HELEN HAYES HOSPITAL | $60,128.32 | 27.08% | $16,282.75 | $10,855.17 | $10,855.17 | $3,799.31 | $3,799.31 | |
| Hospital | 4582 | HOLY NAME HOSPITAL | $802,360.60 | 43.85% | $351,835.12 | $234,556.75 | $234,556.75 | $82,094.86 | $82,094.86 | |
| Hospital | 5734 | HOSPITAL CENTER AT ORANGE | $251,466.66 | 27.08% | $68,097.17 | $45,398.11 | $45,398.11 | $15,889.34 | $15,889.34 | |
| Hospital | 1884 | HOSPITAL FOR SPECIAL SURGERY | $45.00 | 27.08% | $12.19 | $8.12 | $8.12 | $2.84 | ||
| Hospital | 3051 | HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA | $581,701.65 | 27.08% | $157,524.81 | $105,016.54 | $105,016.54 | $36,755.79 | $36,755.79 | |
| Hospital | 1916 | HUNTERDON CARE CENTER | $3,800.00 | 27.08% | $1,029.04 | $686.03 | $686.03 | $240.11 | ||
| Hospital | 1775 | HUNTERDON MEDICAL CENTER | $58,929.04 | 31.58% | $18,608.62 | $12,405.74 | $12,405.74 | $4,342.01 | $4,342.01 | |
| Hospital | 5885 | IHS OF NJ AT SOMERSET VALLEY | $119,246.88 | 27.08% | $32,292.06 | $21,528.04 | $21,528.04 | $7,534.81 | $7,534.81 | |
| Hospital | 2445 | INOVA ALEXANDRIA HOSPITAL | $387.00 | 27.08% | $104.80 | $69.87 | $69.87 | $24.45 | ||
| Hospital | 2690 | IRVINGTON GENERAL HOSPITAL | $105,712.20 | 27.08% | $28,626.86 | $19,084.58 | $19,084.58 | $6,679.60 | $6,679.60 | |
| Hospital | 1897 | ISLAND HOSPITAL | $1,132.34 | 27.08% | $306.64 | $204.43 | $204.43 | $71.55 | ||
| Hospital | 2748 | JERSEY CITY MEDICAL CENTER AND JCMC PHYS SERV | $2,523,203.00 | 19.80% | $499,478.37 | $332,985.58 | $332,985.58 | $116,544.95 | $116,544.95 | |
| Hospital | 5915 | JFK MEDICAL CENTER | $1,655,626.00 | 44.99% | $744,885.22 | $496,590.15 | $496,590.15 | $173,806.55 | $173,806.55 | |
| Hospital | 4896 | JOHNS HOPKINS BAYVIEW MEDICAL CENTER | $500.41 | 27.08% | $135.51 | $90.34 | $90.34 | $31.62 | ||
| Hospital | 6003 | JOHNS HOPKINS HOSPITAL | $52,005.65 | 27.08% | $14,083.13 | $9,388.75 | $9,388.75 | $3,286.06 | $3,286.06 | |
| Hospital | 3044 | KELLER ARMY COMMUNITY HOSPITAL | $211.00 | 27.08% | $57.14 | $38.09 | $38.09 | $13.33 | ||
| Hospital | 4892 | KENNEDY HEALTH SYSTEM | $331,296.94 | 27.08% | $89,715.21 | $59,810.14 | $59,810.14 | $20,933.55 | $20,933.55 | |
| Hospital | 5906 | KIMBALL MEDICAL CENTRE | $215,500.90 | 27.08% | $58,357.64 | $38,905.10 | $38,905.10 | $13,616.78 | $13,616.78 | |
| Hospital | 4337 | LILLIAN BOOTH DIALYSIS CENTER | $337,377.95 | 27.08% | $91,361.95 | $60,907.97 | $60,907.97 | $21,317.79 | $21,317.79 | |
| Hospital | 5578 | LONG ISLAND COLLEGE HOSPITAL | $13,050.00 | 27.08% | $3,533.94 | $2,355.96 | $2,355.96 | $824.59 | ||
| Hospital | 4335 | MAGEE REHABILITAION HOSPITAL | $134,171.99 | 27.08% | $36,333.77 | $24,222.52 | $24,222.52 | $8,477.88 | $8,477.88 | |
| Hospital | 891 | MARTHAS VINEYARD HOSPITAL | $5,523.46 | 27.08% | $1,495.75 | $997.17 | $997.17 | $349.01 | ||
| Hospital | 5512 | MEADOWLANDS MEDICAL CENTER | $393,677.90 | 27.08% | $106,607.98 | $71,071.98 | $71,071.98 | $24,875.19 | $24,875.19 | |
| Hospital | 911 | MEDIPLEX OF ORADELL | $26,140.00 | 27.08% | $7,078.71 | $4,719.14 | $4,719.14 | $1,651.70 | ||
| Hospital | 1373 | MEDIPLEX REHAB CAMDEN | $76,762.00 | 27.08% | $20,787.15 | $13,858.10 | $13,858.10 | $4,850.33 | $4,850.33 | |
| Hospital | 5917 | MEDIPLEX SURGERY CENTER | $1,257.00 | 27.08% | $340.40 | $226.93 | $226.93 | $79.43 | ||
| Hospital | 5015 | MEM HOSP OF BURLINGTON CTY VIRTUA HS | $2,398,555.44 | 27.08% | $649,528.81 | $433,019.21 | $433,019.21 | $151,556.72 | $151,556.72 | |
| Hospital | 3542 | MEMORIAL SLOAN KETTERING CANCER CENTER | $120,102.50 | 27.08% | $32,523.76 | $21,682.50 | $21,682.50 | $7,588.88 | $7,588.88 | |
| Hospital | 4203 | MERCY COMMUNITY HOSPITAL | $2,528.89 | 27.08% | $684.82 | $456.55 | $456.55 | $159.79 | ||
| Hospital | 4851 | MERIDIAN HOSPITALS CORPORATION | $1,571,114.00 | 27.08% | $425,457.67 | $283,638.45 | $283,638.45 | $99,273.46 | $99,273.46 | |
| Hospital | 3275 | METHODIST HOSPITAL AND THOMAS JEFFERSON UNIV HOSP | $232,523.45 | 27.08% | $62,967.35 | $41,978.23 | $41,978.23 | $14,692.38 | $14,692.38 | |
| Hospital | 4417 | MHHS MEMORIAL HOSPITAL | $243.75 | 27.08% | $66.01 | $44.01 | $44.01 | $15.40 | ||
| Hospital | 3221 | MIDDLESEX SAME DAY SURGICAL CENTER | $210,655.68 | 27.08% | $57,045.56 | $38,030.37 | $38,030.37 | $13,310.63 | $13,310.63 | |
| Hospital | 5900 | MONMOUTH MEDICAL CENTER | $792,873.21 | 27.08% | $214,710.07 | $143,140.04 | $143,140.04 | $50,099.02 | $50,099.02 | |
| Hospital | 3043 | MOSES TAYLOR HOSPITAL | $676.80 | 27.08% | $183.28 | $122.18 | $122.18 | $42.76 | ||
| Hospital | 5919 | MUHLENBERG REGIONAL MEDICAL CENTER | $685,373.7 |