STATE OF CALIFORNIASCHEDULE 5 PROGRAM: NONCONTRACT SCHEDULE OF MEDI-CAL ANCILLARY COSTSProvider

LỊCH 5 CHƯƠNG TRÌNH: NONCONTRACT LỊCH CỦA CHI PHÍ phụ trợ MEDI-CAL Nhà cung cấp: Nhà cung cấp trung tâm y tế Cedars-Sinai số: ZZT 30625F CHI PHÍ phụ trợ TỔNG CHI PHÍ phụ trợ TRUNG TÂM 37,00 điều hành Phòng 39,00 Phòng Giao hàng tận nơi và Phòng Lao động - 40,00 Gây Mê 41,00 X Quang-Chẩn đoán 43,01 siêu âm 43,02 CAT Scan 44,00 | STATE OF CALIFORNIA SCHEDULE 5 PROGRAM NONCONTRACT SCHEDULE OF MEDI-CAL ANCILLARY COSTS Provider Name CEDARS-SINAI MEDICAL CENTER Fiscal Period Ended JUNE 30 2008 Provider No ZZT 30625F TOTAL ANCILLARY COST TOTAL ANCILLARY CHARGES Adj RATIO COST TO CHARGES MEDI-CAL CHARGES From Schedule 6 MEDI-CAL COST ANCILLARY COST CENTERS Operating Room 95 710 199 585 456 449 0 0 Delivery Room and Labor Room 29 518 483 75 488 257 0 0 Anesthesiology 55 602 856 446 285 096 0 0 Radiology-Diagnostic 49 746 582 193 969 630 9 574 2 455 Ultrasound 4 215 379 29 801 839 14 563 2 060 CAT Scan 12 997 062 201 731 626 0 0 Laboratory 81 858 827 694 170 211 643 608 75 896 Laboratory-Pathological 25 512 941 62 236 846 0 0 HLA Lab 4 969 551 11 666 069 0 0 Blood Storing Processing Trans 25 970 759 39 817 972 0 0 Respiratory Therapy 29 840 758 292 629 267 0 0 Physical Therapy 11 777 981 41 779 821 21 403 6 034 Occupational Therapy 4 439 833 22 511 543 7 380 1 456 Speech Pathology 1 689 666 8 339 831 2 806 569 Electrocardiology 13 588 420 98 869 613 0 0 Electroencephalography 4 408 169 21 049 131 0 0 Electromyography 166 799 1 342 237 0 0 Medical Supplies Charged to Patients 125 543 810 522 478 410 0 0 Drugs Charged to Patients 93 304 736 462 202 429 48 946 9 881 Renal Dialysis 8 102 366 31 845 109 0 0 Gastro Intestinal Services 17 677 073 51 780 517 0 0 Eye Laboratory 116 474 643 684 0 0 Cardiac Catheterization Laboratory 10 383 847 81 800 167 0 0 Vascular Laboratory 4 491 186 49 819 261 0 0 Psychiatric Psychological Services 948 688 4 444 067 0 0 Nuclear Medicine - Therapeutic 14 418 226 116 313 021 8 965 1 111 .