Carbon Monroe Pike MH DS

Carbon Monroe Pike MH DS was paid $13.17M by Medicaid between Jan 2018 and Dec 2024, across 4 billing codes. Its largest line is W7210, State-specific procedure code — 50% of everything it billed.

33Billing provider infoCARBON MONROE PIKE MH DS
STROUDSBURG, PA 18360

33aNPI1437377553assigned 04/23/2007

33bProvider typeCase Management Agency

28Total paid$13.17M

24GClaims172,534

24DCodes billed4

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Case Management Agency providers in Pennsylvania

Rank by total paid#37 of 206

Median peer was paid$2.13M

This provider vs. median6.2×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	28,471	$1.97M
2019	28,352	$1.97M
2020	34,349	$2.23M
2021	35,214	$2.59M
2022	25,180	$2.12M
2023	12,093	$1.32M
2024incomplete	8,875	$972K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
W7210	State-specific procedure code	50%	91,624	30,897	$6.53M
T1017	Case management, billed per 15 minutesTargeted case management, each 15 minutes	38%	55,438	23,369	$5.06M
T1016	Case management, each 15 minutes	10%	21,386	11,384	$1.35M
W0016		1.7%	4,086	2,641	$225K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialTHEODOROU, SHEILA (ADMINISTRATOR)