| 1623001 |
ADIRONDACK MEDICAL CENTER |
$792.34 |
$60.03 |
$231.32 |
$189.97 |
| 0101000 |
ALBANY MEDICAL CTR HOSP |
$679.44 |
$210.16 |
$244.16 |
$189.97 |
| 0501000 |
AUBURN COMMUNITY HOSPITAL |
$829.88 |
$41.05 |
$242.28 |
$189.97 |
| 7002001 |
BELLEVUE HOSPITAL CENTER |
$727.43 |
$190.82 |
$287.55 |
$288.92 |
| 7002002 |
BETH ISRAEL MEDICAL CENTER |
$803.57 |
$314.59 |
$317.64 |
$288.92 |
| 3535001 |
BON SECOURS COMMUNITY HOSP |
$652.22 |
$31.23 |
$257.82 |
$189.97 |
| 7000001 |
BRONX-LEBANON HOSPITAL CTR |
$756.93 |
$275.40 |
$299.21 |
$288.92 |
| 7001002 |
BROOKDALE HOSPITAL MED CTR |
$744.71 |
$129.44 |
$294.38 |
$288.92 |
| 5123000 |
BROOKHAVEN MEMORIAL HOSP |
$723.88 |
$39.38 |
$286.14 |
$288.92 |
| 5263000 |
CATSKILL REGIONAL MED CTR |
$880.60 |
$31.12 |
$257.09 |
$189.97 |
| 5401001 |
CAYUGA MEDICAL CENTER |
$848.16 |
$43.59 |
$247.62 |
$189.97 |
| 0901001 |
CHAMPLAIN VALLEY PHYS |
$808.80 |
$58.01 |
$236.12 |
$189.97 |
| 4401000 |
CLAXTON-HEPBURN MED CTR |
$740.36 |
$36.57 |
$216.15 |
$189.97 |
| 3421000 |
CLIFTON SPRINGS HOSPITAL |
$668.75 |
$26.25 |
$195.24 |
$189.97 |
| 1001000 |
COLUMBIA MEMORIAL HOSPITAL |
$789.74 |
$30.03 |
$230.56 |
$189.97 |
| 7001009 |
CONEY ISLAND HOSPITAL |
$718.69 |
$188.23 |
$284.09 |
$288.92 |
| 1101000 |
CORTLAND REGIONAL MED CTR |
$772.90 |
$78.20 |
$225.64 |
$189.97 |
| 5127000 |
EASTERN LONG ISLAND HOSPITAL |
$704.05 |
$63.69 |
$278.30 |
$288.92 |
| 3101000 |
EASTERN NIAGARA HOSPITAL |
$632.06 |
$15.04 |
$227.13 |
$189.97 |
| 4601001 |
ELLIS HOSPITAL |
$656.92 |
$34.62 |
$236.07 |
$189.97 |
| 7003000 |
ELMHURST HOSPITAL CTR |
$765.11 |
$349.99 |
$302.44 |
$288.92 |
| 1401005 |
ERIE COUNTY MEDICAL CENTER |
$720.81 |
$63.79 |
$259.03 |
$189.97 |
| 3202003 |
FAXTON-ST LUKES HEALTHCARE |
$799.65 |
$63.14 |
$233.45 |
$189.97 |
| 7003001 |
FLUSHING HOSPITAL |
$734.47 |
$164.26 |
$290.33 |
$288.92 |
| 2910000 |
FRANKLIN HOSPITAL |
$698.71 |
$37.90 |
$276.19 |
$288.92 |
| 2901000 |
GLEN COVE HOSPITAL |
$802.43 |
$40.78 |
$317.19 |
$288.92 |
| 5601000 |
GLENS FALLS HOSPITAL |
$784.25 |
$54.46 |
$228.96 |
$189.97 |
| 7002009 |
HARLEM HOSPITAL CENTER |
$747.05 |
$291.15 |
$295.30 |
$288.92 |
| 5501000 |
HEALTHALLIANCE HOSP MARYS AVE CAMPUS |
$839.89 |
$22.48 |
$245.20 |
$189.97 |
| 5153000 |
HUNTINGTON HOSPITAL |
$752.10 |
$42.19 |
$297.30 |
$288.92 |
| 7001046 |
INTERFAITH MEDICAL CENTER |
$749.11 |
$38.07 |
$296.12 |
$288.92 |
| 7000002 |
JACOBI MEDICAL CENTER |
$788.57 |
$260.05 |
$311.71 |
$288.92 |
| 7003003 |
JAMAICA HOSPITAL |
$799.09 |
$258.50 |
$315.87 |
$288.92 |
| 5149000 |
JOHN T MATHER MEMORIAL HOSP |
$731.20 |
$68.87 |
$289.04 |
$288.92 |
| 7001016 |
KINGS COUNTY HOSPITAL CENTER |
$721.18 |
$343.53 |
$285.07 |
$288.92 |
| 7001033 |
KINGSBROOK JEWISH MED CTR |
$816.22 |
$53.33 |
$322.64 |
$288.92 |
| 7002017 |
LENOX HILL HOSPITAL |
$739.80 |
$199.65 |
$292.44 |
$288.92 |
| 7000008 |
LINCOLN MEDICAL |
$733.69 |
$318.32 |
$290.02 |
$288.92 |
| 7003004 |
LONG ISLAND JEWISH |
$773.57 |
$151.58 |
$305.78 |
$288.92 |
| 7001019 |
LUTHERAN MEDICAL CENTER |
$723.10 |
$107.59 |
$285.83 |
$288.92 |
| 7001020 |
MAIMONIDES MEDICAL CENTER |
$846.22 |
$107.23 |
$334.50 |
$288.92 |
| 3824000 |
MARY IMOGENE BASSETT HOSP |
$725.54 |
$37.57 |
$211.82 |
$189.97 |
| 2909000 |
MERCY MEDICAL CENTER |
$722.74 |
$46.05 |
$285.69 |
$288.92 |
| 7002021 |
METROPOLITAN HOSPITAL CENTER |
$725.87 |
$319.92 |
$286.93 |
$288.92 |
| 7000006 |
MONTEFIORE MEDICAL CENTER |
$798.24 |
$650.88 |
$315.53 |
$288.92 |
| 5903001 |
MONTEFIORE MOUNT VERNON HOSP |
$749.97 |
$18.38 |
$296.46 |
$288.92 |
| 7002024 |
MOUNT SINAI HOSPITAL |
$796.60 |
$166.14 |
$314.89 |
$288.92 |
| 2950002 |
NASSAU UNIV MED CTR |
$804.99 |
$57.98 |
$318.20 |
$288.92 |
| 3102000 |
NIAGARA FALLS MEMORIAL |
$607.42 |
$28.15 |
$218.28 |
$189.97 |
| 7000024 |
NORTH CENTRAL BRONX HOSPITAL |
$810.96 |
$155.33 |
$320.56 |
$288.92 |
| 2951001 |
NORTH SHORE UNIVERSITY HOSP |
$825.82 |
$569.61 |
$326.44 |
$288.92 |
| 5920000 |
NORTHERN WESTCHESTER HOSP |
$719.12 |
$110.92 |
$284.26 |
$288.92 |
| 4324000 |
NYACK HOSPITAL |
$693.10 |
$21.36 |
$273.98 |
$288.92 |
| 7001021 |
NY METHODIST HOSP / BROOKLYN |
$759.42 |
$156.95 |
$300.19 |
$288.92 |
| 7002054 |
NY PRESBYTERIAN HOSPITAL |
$795.04 |
$163.62 |
$314.27 |
$288.92 |
| 7002053 |
NYU HOSPITALS CENTER |
$760.70 |
$668.18 |
$300.70 |
$288.92 |
| 0401001 |
OLEAN GENERAL HOSPITAL |
$739.30 |
$54.48 |
$215.84 |
$189.97 |
| 3523000 |
ORANGE REGIONAL MED CTR |
$707.88 |
$127.94 |
$279.82 |
$189.97 |
| 3702000 |
OSWEGO HOSPITAL |
$792.05 |
$56.12 |
$231.23 |
$189.97 |
| 5932000 |
PHELPS MEMORIAL HOSP |
$710.87 |
$72.40 |
$281.00 |
$288.92 |
| 3950000 |
PUTNAM COMMUNITY HOSPITAL |
$729.14 |
$32.44 |
$288.22 |
$189.97 |
| 7003007 |
QUEENS HOSPITAL CENTER |
$810.25 |
$314.31 |
$320.28 |
$288.92 |
| 7004010 |
RICHMOND UNIV MED CTR |
$710.73 |
$41.35 |
$280.94 |
$288.92 |
| 2701003 |
ROCHESTER GENERAL HOSPITAL |
$663.96 |
$70.83 |
$238.60 |
$189.97 |
| 3201002 |
ROME MEMORIAL HOSPITAL |
$741.81 |
$23.95 |
$216.57 |
$189.97 |
| 4102002 |
SAMARITAN HOSPITAL OF TROY |
$621.73 |
$22.28 |
$223.42 |
$189.97 |
| 2201000 |
SAMARITAN MEDICAL CENTER |
$812.74 |
$43.96 |
$237.28 |
$189.97 |
| 4501000 |
SARATOGA HOSPITAL |
$650.74 |
$38.64 |
$233.85 |
$189.97 |
| 6120700 |
SOLDIERS AND SAILORS MEM HOSP |
$645.27 |
$61.39 |
$188.38 |
$189.97 |
| 2950001 |
SOUTH NASSAU COMMUNITIES |
$684.71 |
$86.50 |
$270.66 |
$288.92 |
| 5154000 |
SOUTHSIDE HOSPITAL |
$744.14 |
$61.02 |
$294.15 |
$288.92 |
| 7000014 |
ST BARNABAS HOSPITAL |
$729.85 |
$111.72 |
$288.50 |
$288.92 |
| 5157003 |
ST CATHERINE OF SIENA |
$752.03 |
$60.29 |
$297.27 |
$288.92 |
| 3202002 |
ST ELIZABETH MEDICAL CENTER |
$807.64 |
$27.14 |
$235.79 |
$189.97 |
| 1302000 |
ST FRANCIS HOSP / POUGH |
$614.19 |
$70.16 |
$242.78 |
$189.97 |
| 7001024 |
ST JOHNS EPISCOPAL SO SHORE |
$848.57 |
$132.97 |
$335.43 |
$288.92 |
| 0701001 |
ST JOSEPHS HOSP / ELMIRA |
$715.05 |
$14.69 |
$208.75 |
$189.97 |
| 3301003 |
ST JOSEPHS HOSP HLTH CTR |
$690.94 |
$52.72 |
$248.29 |
$189.97 |
| 5907002 |
ST JOSEPHS MEDICAL CENTER |
$728.29 |
$48.12 |
$287.88 |
$288.92 |
| 7002032 |
ST LUKES / ROOSEVELT HOSP |
$865.91 |
$137.82 |
$342.29 |
$288.92 |
| 2801001 |
ST MARYS HOSP / AMSTERDAM |
$727.27 |
$22.66 |
$212.32 |
$189.97 |
| 7001037 |
STATE UNIV HOSP / DOWNSTATE |
$775.49 |
$236.47 |
$306.54 |
$288.92 |
| 7004003 |
STATEN ISLAND UNIV HOSP |
$723.52 |
$114.17 |
$286.00 |
$288.92 |
| 2701005 |
STRONG MEMORIAL HOSPITAL |
$703.45 |
$109.06 |
$252.79 |
$189.97 |
| 2754001 |
THE UNITY HOSP OF ROCHESTER |
$606.17 |
$49.92 |
$217.83 |
$189.97 |
| 0427000 |
TLC HEALTH NETWORK |
$656.82 |
$35.63 |
$191.75 |
$189.97 |
| 0303001 |
UNITED HEALTH SERVICES INC |
$663.41 |
$38.78 |
$238.40 |
$189.97 |
| 5151001 |
UNIV HOSP AT STONY BROOK |
$729.14 |
$199.43 |
$288.22 |
$288.92 |
| 3301007 |
UNIV HOSP SUNY HLTH SCI CTR |
$718.15 |
$168.69 |
$258.07 |
$189.97 |
| 3301003 |
UPSTATE UNIV HOSP/COMM GEN |
$724.40 |
$33.99 |
$260.32 |
$189.97 |
| 5820000 |
WAYNE HEALTH CARE |
$744.41 |
$48.62 |
$217.33 |
$189.97 |
| 5957001 |
WESTCHESTER MEDICAL CENTER |
$809.89 |
$173.95 |
$320.14 |
$288.92 |
| 0602001 |
WOMANS CHRISTIAN ASSOC |
$713.80 |
$32.27 |
$208.39 |
$189.97 |
| 7001045 |
WOODHULL MEDICAL |
$723.31 |
$117.75 |
$285.92 |
$288.92 |
| 6027000 |
WYOMING CO COMMUNITY HOSP |
$746.81 |
$52.43 |
$218.03 |
$189.97 |
