tailieunhanh - STATE OF CALIFORNIA SCHEDULE OF MEDI-CAL ANCILLARY COSTS_part1

TIỂU BANG CALIFORNIA LỊCH MEDI-CAL phụ trợ CHI PHÍ Tên nhà cung cấp: ST. Dễ chịu BỆNH VIỆN John VALLEY Nhà cung cấp Không: HSC 30616I TỔNG phụ trợ CHI PHÍ * TRUNG TÂM CHI PHÍ phụ trợ 37,00 điều hành Phòng 38,00 phục hồi Phòng 39,00 Giao hàng tận nơi trong phòng và Phòng Lao động - 40,00 Gây Mê 41,00 X Quang - Chẩn đoán 42,00 X Quang - điều trị 42,01 siêu âm 42,02 CAT Scan 43,00 đồng vị phóng xạ 44,00 | STATE OF CALIFORNIA CONTRACTSCH 5 SCHEDULE OF MEDI-CAL ANCILLARY COSTS Provider Name ST. JOHN S PLEASANT VALLEY HOSPITAL Fiscal Period Ended JUNE 30 2008 Provider No HSC 30616I TOTAL ANCILLARY COST TOTAL ANCILLARY CHARGES Adj RATIO COST TO CHARGES MEDI-CAL CHARGES Contract Sch 6 MEDI-CAL COST ANCILLARY COST CENTERS Operating Room 5 113 492 54 808 109 828 670 77 313 Recovery Room 0 0 0 0 Delivery Room and Labor Room 137 285 1 479 613 208 082 19 307 Anesthesiology 0 0 0 0 Radiology - Diagnostic 3 592 122 14 713 725 134 282 32 783 Radiology - Therapeutic 0 0 0 0 Ultrasound 435 198 2 322 099 27 387 5 133 CAT Scan 829 868 14 621 127 167 503 9 507 Radioisotope 345 042 1 571 726 17 763 3 900 Laboratory 4 380 098 35 372 413 854 289 105 785 Pathological Lab 0 0 0 0 Whole Blood 0 0 0 0 Blood Storing and Processing 0 0 0 0 Intravenous Therapy 0 0 0 0 Respiratory Therapy 2 668 925 44 775 936 455 419 27 146 Hyperbaric Chamber 1 399 828 10 624 124 0 0 Physical Therapy 1 612 854 3 947 415 57 121 23 339 Occupational Therapy 305 168 1 291 834 6 303 1 489 Speech Pathology 129 738 569 919 12 528 2 852 Electrocardiology 870 858 5 487 247 155 700 24 711 Electroencephalography 0 0 0 0 Medical Supplies Charged to Patients 3 462 472 15 268 493 255 778 58 003 Implants Charged to Patients 3 287 181 3 246 746 19 982 20 231 Drugs Charged to Patients 4 525 666 34 060 494 1 174 697 156 084 Renal Dialysis 590 817 1 556 728 82 556 31 332 ASC Non-Distinct Part 0 0 0 0 0 0 0 0 0 0 0 0 Clinic 0 0 0 0 Other Clinic Services 0 0 0 0 Emergency 4 660 533 14