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STATE OF CALIFORNIA SCHEDULE 4A PROGRAM: NONCONTRACT COMPUTATION OF MEDI-CAL INPATIENT ROUTINE SERVICE COST

Tham khảo tài liệu 'state of california schedule 4a program: noncontract computation of medi-cal inpatient routine service cost', tài chính - ngân hàng, kế toán - kiểm toán phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | STATE OF CALIFORNIA SCHEDULE 4A PROGRAM NONCONTRACT COMPUTATION OF MEDI-CAL INPATIENT ROUTINE SERVICE COST Provider Name SUTTER MEDICAL CENTER - SACRAMENTO Fiscal Period Ended DECEMBER 31 2007 Provider No. ZZR00108F 1811946734 SPECIAL CARE AND OR NURSERY UNITS NURSERY REPORTED 1 L AUDITED 1 4 821 401 4 581 333 1. Total Inpatient Routine Cost Sch 8 Line 33 Col 27 2. Total Inpatient Days Adj 26 10 436 10 826 3. Average Per Diem Cost 462.00 423.18 4. Medi-Cal Inpatient Days Adj 0 0 5. Cost Applicable to Medi-Cal 0 0 INTENSIVE CARE UNIT 6. Total Inpatient Routine Cost Sch 8 Line 26 Col 27 22 461 769 20 989 878 7. Total Inpatient Days Adj 26 9 184 9 539 8. Average Per Diem Cost 2 445.75 2 200.43 9. Medi-Cal Inpatient Days Adj 0 0 10. Cost Applicable to Medi-Cal 0 0 CORONARY CARE UNIT 11. Total Inpatient Routine Cost Sch 8 Line 27 Col 27 11 130 601 10 294 182 12. Total Inpatient Days Adj 26 5 729 6 104 13. Average Per Diem Cost 1 942.85 1 686.46 14. Medi-Cal Inpatient Days Adj 0 0 15. Cost Applicable to Medi-Cal 0 0 NEONATAL INTENSIVE CARE UNIT 16. Total Inpatient Routine Cost Sch 8 Line 28 Col 27 26 447 017 25 023 717 17. Total Inpatient Days Adj 26 20 075 20 464 18. Average Per Diem Cost 1 317.41 1 222.82 19. Medi-Cal Inpatient Days Adj 0 0 20. Cost Applicable to Medi-Cal 0 0 SURGICAL INTENSIVE CARE UNIT 21. Total Inpatient Routine Cost Sch 8 Line 29 Col 27 0 0 22. Total Inpatient Days Adj 0 0 23. Average Per Diem Cost 0.00 0.00 24. Medi-Cal Inpatient Days Adj 0 0 25. Cost Applicable to Medi-Cal 0 0 ADMINISTRATIVE DAYS JANUARY 1 2007 THROUGH JULY 31 2007 26. Per Diem Rate Adj 29 0.00 310.68 27. Medi-Cal Inpatient Days Adj 29 0 193 28. Cost Applicable to Medi-Cal 0 59 961 ADMINISTRATIVE DAYS AUGUST 1 2007 THROUGH DECEMBER 31 2007 29. Per Diem Rate Adj 29 0.00 317.95 30. Medi-Cal Inpatient Days Adj 29 0 158 31. Cost Applicable to Medi-Cal 0 50 236 32. Medi-Cal Routine Cost Sum of Lines 5 10 15 20 25 28 31 0 110 197 This is trial version To Schedule 4 www.adultpdf.com .