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STATE OF CALIFORNIA COMPUTATION OF MEDICAL INPATIENT ROUTINE SERVICE COST_PART2

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Tham khảo tài liệu 'state of california computation of medical inpatient routine service cost_part2', tài chính - ngân hàng, kế toán - kiểm toán phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | STATE OF CALIFORNIA CONTRACT SCH 4B COMPUTATION OF MEDI-CAL INPATIENT ROUTINE SERVICE COST Provider Name USC KENNETH NORRIS JR. CANCER HOSPITAL Provider No HSC 30660G Fiscal Period Ended MAY 31 2008 SPECIAL CARE UNITS 1. Total Inpatient Routine Cost Sch 8 Line_ Col 27 2. Total Inpatient Days Adj 3. Average Per Diem Cost 4. Medi-Cal Inpatient Days Adj 5. Cost Applicable to Medi-Cal 6. Total Inpatient Routine Cost Sch 8 Line_ Col 27 7. Total Inpatient Days Adj 8. Average Per Diem Cost 9. Medi-Cal Inpatient Days Adj 10. Cost Applicable to Medi-Cal 11. Total Inpatient Routine Cost Sch 8 Line_ Col 27 12. Total Inpatient Days Adj 13. Average Per Diem Cost 14. Medi-Cal Inpatient Days Adj 15. Cost Applicable to Medi-Cal 16. Total Inpatient Routine Cost Sch 8 Line Col 27 17. Total Inpatient Days Adj 18. Average Per Diem Cost 19. Medi-Cal Inpatient Days Adj 20. Cost Applicable to Medi-Cal 21. Total Inpatient Routine Cost Sch 8 Line Col 27 22. Total Inpatient Days Adj 23. Average Per Diem Cost 24. Medi-Cal Inpatient Days Adj 25. Cost Applicable to Medi-Cal 26. Total Inpatient Routine Cost Sch 8 Line Col 27 27. Total Inpatient Days Adj 28. Average Per Diem Cost 29. Medi-Cal Inpatient Days Adj 30. Cost Applicable to Medi-Cal 31. Medi-Cal Routine Cost Sum of Lines 5 10 15 20 25 30 L REPORTED 1 L AUDITED 0 0 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0.00 0.00 0 0 0 0 0 0 0 0 0.00 0.00 0 0 0 0 0 0 To Contract Sch 4 This is trial version www.adultpdf.com STATE OF CALIFORNIA CONTRACTSCH 5 SCHEDULE OF MEDI-CAL ANCILLARY COSTS Provider Name USC KENNETH NORRIS JR. CANCER HOSPITAL Fiscal Period Ended MAY 31 2008 Provider No HSC 30660G TOTAL ANCILLARY COST TOTAL ANCILLARY CHARGES Adj RATIO COST TO CHARGES MEDI-CAL CHARGES Contract Sch 6 MEDI-CAL COST ANCILLARY COST CENTERS 37.00 Operating Room 5 222 093 17 127 243 0.304900 178 331 54 373 38.00 Recovery Room 1 014 352 1 343 948 0.754756 6 458 4 874 39.00 .