INPATIENT CASE PAYMENT RATES EFFECTIVE 4/1/2014 - 6/30/2014 (MA HMO ONLY)

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)
DISCHARGE RATE STATEWIDE PRICE
-MA HMO
ISAF HIGH COST CC´s IME %´s DME RATE CAPITAL RATE
- PER DISCH
NON-COMPARABLE ADD-ONS CAPITAL RATE
- PER DIEM
STERILIZATION ALC HCRA SURCHARGES
"DEFAULT & CONTRACT"
DISCHARGE CASE
PAYMENT RATE
(INCLUDING PHL
§ 2807-c(33)
- Excluding IME)
"DEFAULT & CONTRACT"
STATEWIDE BASE
PRICE (INCLUDING PHL
§ 2807-c(33)
INSTITUTION SPECIFIC
ADJUSTMENT FACTOR (ISAF)
HIGH COST CHARGE
CONVERTOR (2011)
*Informational Only*
INDIRECT MEDICAL
EDUCATION (IME) %
*Informational Only*
DIRECT MEDICAL
EDUCATION (DME) ADD-ON
CAPITAL PER
DISCHARGE (EXCLUDING
NON-COMPARABLE
ADD-ONS)
AMBULANCE ADD-ON TEACHING ELECTION
AMENDMENT PHYSICIANS
ADD-ON
SCHOOL OF
NURSING ADD-ON
CAPITAL PER DIEM STERILIZATION DURING
DELIVERY (MANAGED
CARE ENROLLEES
OF FIDELIS CARE
ONLY)
ALC PRICE
PER DAY
INDIGENT CARE
AND HEALTH
CARE INITIATIVE
SURCHARGE
OPCERT HOSPITAL NAME **(PER DISCH)** **(PER DAY**) (2290)
1623001 ADIRONDACK MEDICAL CENTER $5,572.95 $6,829.27 0.8232 0.550690 0.00% $0.00 $443.18 $0.00 $0.00 $0.00 $108.24 $769.37 $171.74 7.04%
0101000 ALBANY MEDICAL CTR HOSP $5,870.82 $6,829.27 0.8689 0.329874 19.41% $591.51 $1,453.45 $0.00 $0.00 $0.00 $248.40 $810.50 $171.74 7.04%
0101000 ALBANY MEDICAL CTR SO CLINICAL $5,870.82 $6,829.27 0.8689 0.329874 19.41% $591.51 $1,453.45 $0.00 $0.00 $0.00 $248.40 $810.50 $171.74 7.04%
1624000 ALICE HYDE MEDICAL CENTER $5,455.16 $6,829.27 0.8048 0.595070 0.00% $0.00 $138.50 $0.00 $0.00 $0.00 $41.80 $753.11 $171.74 7.04%
0701000 ARNOT OGDEN MEDICAL CTR $5,475.10 $6,829.27 0.8033 0.441410 0.00% $0.00 $316.45 $0.00 $0.00 $40.00 $80.14 $755.86 $171.74 7.04%
0501000 AUBURN COMMUNITY HOSPITAL $5,858.71 $6,829.27 0.8622 0.445645 0.00% $0.00 $527.41 $0.00 $0.00 $0.00 $124.54 $808.82 $171.74 7.04%
3801000 AURELIA OSBORN FOX MEM HOSP $5,391.06 $6,829.27 0.7930 0.645624 0.00% $0.00 $411.08 $11.35 $0.00 $0.00 $88.92 $744.26 $171.74 7.04%
7002001 BELLEVUE HOSPITAL CENTER $6,927.93 $6,829.27 1.0233 0.773995 26.17% $2,425.49 $744.69 $0.00 $456.66 $0.00 $126.93 $956.43 $261.20 7.04%
1427000 BERTRAND CHAFFEE HOSPITAL $4,715.97 $6,829.27 0.6991 0.597355 0.00% $0.00 $218.27 $0.00 $0.00 $0.00 $48.05 $651.06 $171.74 7.04%
7001041 BETH ISRAEL / KINGS HIGHWAY $7,951.26 $6,829.27 1.1652 0.183347 0.20% $608.61 $192.97 $0.00 $0.00 $0.00 $31.03 $1,097.71 $261.20 7.04%
7002002 BETH ISRAEL MEDICAL CENTER $7,653.50 $6,829.27 1.1304 0.308539 24.35% $1,139.90 $788.55 $0.00 $0.00 $78.91 $175.26 $1,056.60 $261.20 7.04%
3535001 BON SECOURS COMMUNITY HOSP $6,078.73 $6,829.27 0.9175 0.272206 0.00% $0.00 $498.01 $0.00 $0.00 $0.00 $112.50 $839.20 $171.74 7.04%
7000001 BRONX-LEBANON HOSPITAL CTR $7,164.51 $6,829.27 1.0648 0.862280 27.13% $2,011.28 $523.27 $56.84 $0.00 $0.00 $121.06 $989.10 $261.20 7.04%
7001002 BROOKDALE HOSPITAL MED CTR $7,117.13 $6,829.27 1.0476 0.490403 20.83% $1,318.01 $435.37 $0.00 $0.00 $0.00 $80.00 $982.55 $261.20 7.04%
5123000 BROOKHAVEN MEMORIAL HOSP $6,774.84 $6,829.27 1.0183 0.193638 1.87% $0.00 $431.25 $0.00 $0.00 $0.00 $72.95 $935.30 $261.20 7.04%
7001003 BROOKLYN HOSPITAL $6,965.32 $6,829.27 1.0296 0.455530 20.55% $611.53 $435.05 $0.00 $0.00 $0.00 $84.42 $961.60 $261.20 7.04%
0601000 BROOKS MEMORIAL HOSPITAL $4,959.41 $6,829.27 0.7324 0.678877 0.00% $0.00 $208.35 $0.00 $0.00 $0.00 $51.59 $684.67 $171.74 7.04%
4102004 BURDETT CARE CENTER $5,429.95 $6,829.27 0.7951 0.707292 0.00% $0.00 $146.09 $0.00 $0.00 $0.00 $63.81 $749.63 $171.74 7.04%
4429000 CANTON-POTSDAM HOSPITAL $5,360.38 $6,829.27 0.7934 0.571952 0.00% $0.00 $314.35 $0.00 $0.00 $0.00 $103.59 $740.03 $171.74 7.04%
2238001 CARTHAGE AREA HOSPITAL INC $4,902.14 $6,829.27 0.7348 0.581448 0.00% $0.00 $280.45 $0.00 $0.00 $0.00 $78.67 $676.76 $171.74 7.04%
5263000 CATSKILL REGIONAL MED CTR $6,234.19 $6,829.27 0.9149 0.385795 0.00% $0.00 $600.16 $0.00 $0.00 $0.00 $126.53 $860.66 $171.74 7.04%
5401001 CAYUGA MEDICAL CENTER $5,992.05 $6,829.27 0.8812 0.748430 0.00% $0.00 $433.78 $0.00 $0.00 $0.00 $114.49 $827.23 $171.74 7.04%
0901001 CHAMPLAIN VALLEY PHYS $5,714.23 $6,829.27 0.8403 0.410036 0.00% $0.00 $1,009.16 $0.00 $0.00 $0.00 $179.33 $788.88 $171.74 7.04%
0824000 CHENANGO MEMORIAL HOSP $5,171.09 $6,829.27 0.7620 0.470507 0.00% $0.00 $248.49 $0.00 $0.00 $0.00 $77.68 $713.89 $171.74 7.04%
4401000 CLAXTON-HEPBURN MED CTR $5,091.67 $6,829.27 0.7692 0.611839 0.00% $0.00 $485.05 $0.00 $0.00 $0.00 $100.07 $702.93 $171.74 7.04%
3421000 CLIFTON SPRINGS HOSPITAL $4,444.27 $6,829.27 0.6948 0.542357 0.00% $0.00 $318.70 $0.00 $0.00 $0.00 $78.22 $613.55 $171.74 7.04%
4720001 COBLESKILL REGIONAL HOSP $5,192.98 $6,829.27 0.7604 1.064008 0.00% $0.00 $317.35 $0.00 $0.00 $0.00 $30.36 $716.92 $171.74 7.04%
1001000 COLUMBIA MEMORIAL HOSPITAL $5,453.86 $6,829.27 0.8205 0.428438 0.00% $0.00 $419.87 $0.00 $0.00 $0.00 $97.60 $752.93 $171.74 7.04%
2625000 COMMUNITY MEMORIAL HOSPITAL $5,458.92 $6,829.27 0.8044 0.577756 0.00% $0.00 $257.84 $0.00 $0.00 $0.00 $86.24 $753.63 $171.74 7.04%
7001009 CONEY ISLAND HOSPITAL $6,858.28 $6,829.27 1.0110 0.749279 16.91% $1,175.65 $908.38 $0.00 $0.00 $0.00 $151.79 $946.82 $261.20 7.04%
5001000 CORNING HOSPITAL $5,978.54 $6,829.27 0.8778 0.433032 0.00% $0.00 $383.83 $0.00 $0.00 $0.00 $109.67 $825.37 $171.74 7.04%
1101000 CORTLAND REGIONAL MED CTR $5,413.12 $6,829.27 0.8030 0.650282 0.00% $0.00 $493.09 $0.00 $0.00 $0.00 $74.58 $747.31 $171.74 7.04%
3301008 CROUSE HOSPITAL $6,408.04 $6,829.27 0.9458 0.488251 5.23% $128.81 $456.67 $0.00 $0.00 $86.18 $96.26 $884.66 $171.74 7.04%
5127000 EASTERN LONG ISLAND HOSPITAL $6,758.78 $6,829.27 0.9904 0.227798 0.00% $0.00 $654.82 $0.00 $0.00 $0.00 $156.18 $933.08 $261.20 7.04%
3101000 EASTERN NIAGARA HOSPITAL $5,441.97 $6,829.27 0.8083 0.548871 0.00% $0.00 $173.84 $0.00 $0.00 $0.00 $37.06 $751.29 $171.74 7.04%
4601001 ELLIS HOSPITAL $5,737.27 $6,829.27 0.8401 0.280787 5.19% $154.39 $311.13 $0.00 $0.00 $28.92 $68.49 $792.06 $171.74 7.04%
7003000 ELMHURST HOSPITAL CTR $7,313.10 $6,829.27 1.0763 0.679995 22.43% $1,218.67 $565.01 $0.00 $0.00 $0.00 $128.52 $1,009.61 $261.20 7.04%
1401005 ERIE COUNTY MEDICAL CENTER $6,182.69 $6,829.27 0.9218 0.548935 21.68% $547.75 $795.96 $0.00 $0.00 $0.00 $128.62 $853.55 $171.74 7.04%
3429000 F F THOMPSON HOSPITAL $4,719.04 $6,829.27 0.7053 0.585654 0.00% $0.00 $515.20 $0.00 $0.00 $0.00 $135.06 $651.49 $171.74 7.04%
3202003 FAXTON-ST LUKES HEALTHCARE $5,611.88 $6,829.27 0.8308 0.401787 0.66% $0.13 $448.43 $0.00 $0.00 $0.00 $99.52 $774.75 $171.74 7.04%
7003001 FLUSHING HOSPITAL $7,014.71 $6,829.27 1.0332 0.500323 17.85% $658.46 $412.41 $308.06 $0.00 $0.00 $77.67 $968.42 $261.20 7.04%
7003013 FOREST HILLS HOSPITAL $7,688.43 $6,829.27 1.1309 0.314304 7.13% $124.15 $323.53 $0.00 $0.00 $0.00 $75.51 $1,061.43 $261.20 7.04%
2910000 FRANKLIN HOSPITAL $6,712.49 $6,829.27 0.9829 0.279524 1.40% $206.33 $383.69 $0.00 $0.00 $0.00 $69.63 $926.69 $261.20 7.04%
3402000 GENEVA GENERAL HOSPITAL $4,966.31 $6,829.27 0.7297 0.568222 0.00% $0.00 $373.13 $0.00 $0.00 $45.07 $93.03 $685.62 $171.74 7.04%
2901000 GLEN COVE HOSPITAL $7,703.20 $6,829.27 1.1288 0.303907 4.10% $130.56 $550.17 $0.00 $0.00 $0.00 $105.28 $1,063.46 $261.20 7.04%
5601000 GLENS FALLS HOSPITAL $5,539.65 $6,829.27 0.8148 0.456191 0.00% $0.00 $493.60 $0.00 $0.00 $0.00 $106.56 $764.78 $171.74 7.04%
4329000 GOOD SAMARITAN / SUFFERN $6,953.64 $6,829.27 1.0239 0.220855 0.00% $0.00 $501.06 $0.00 $0.00 $0.00 $126.25 $959.98 $261.20 7.04%
5154001 GOOD SAMARITAN / WEST ISLIP $6,840.74 $6,829.27 1.0148 0.225889 5.49% $212.39 $397.59 $0.00 $0.00 $0.00 $80.43 $944.40 $261.20 7.04%
7002009 HARLEM HOSPITAL CENTER $7,109.18 $6,829.27 1.0509 1.037858 31.20% $2,721.29 $1,185.63 $0.00 $0.00 $16.07 $236.77 $981.46 $261.20 7.04%
5501001 HEALTHALLIANCE HOSP BROADWAY CAMPUS $5,957.16 $6,829.27 0.8734 0.255361 5.30% $219.93 $290.84 $0.00 $0.00 $0.00 $62.80 $822.42 $171.74 7.04%
5501000 HEALTHALLIANCE HOSP MARYS AVE CAMPUS $5,845.26 $6,829.27 0.8726 0.343464 2.09% $81.52 $857.05 $0.00 $0.00 $0.00 $160.50 $806.97 $171.74 7.04%
2701001 HIGHLAND HOSP OF ROCHESTER $5,850.00 $6,829.27 0.8599 0.591136 10.42% $103.08 $410.25 $0.00 $0.00 $0.00 $108.26 $807.62 $171.74 7.04%
7002012 HOSPITAL FOR SPECIAL SURGERY $7,988.87 $6,829.27 1.1809 0.391481 20.75% $1,544.31 $1,655.82 $0.00 $0.00 $0.00 $435.16 $1,102.90 $261.20 7.04%
5901000 HUDSON VALLEY HOSPITAL CTR $6,496.49 $6,829.27 0.9564 0.282930 0.00% $0.00 $786.78 $0.00 $0.00 $0.00 $170.18 $896.87 $261.20 7.04%
5153000 HUNTINGTON HOSPITAL $7,089.83 $6,829.27 1.0624 0.320920 0.76% $12.07 $381.36 $0.00 $0.00 $0.00 $86.64 $978.79 $261.20 7.04%
7001046 INTERFAITH MEDICAL CENTER $7,137.71 $6,829.27 1.0538 0.292808 31.03% $873.56 $472.87 $0.00 $0.00 $0.00 $84.58 $985.40 $261.20 7.04%
5022000 IRA DAVENPORT MEMORIAL HOSP $5,068.22 $6,829.27 0.7532 0.522758 0.00% $0.00 $382.98 $0.00 $0.00 $0.00 $111.86 $699.69 $171.74 7.04%
7000002 JACOBI MEDICAL CENTER $7,538.87 $6,829.27 1.1093 0.859302 27.30% $1,983.37 $894.10 $0.00 $338.52 $0.00 $182.93 $1,040.78 $261.20 7.04%
7003003 JAMAICA HOSPITAL $7,635.40 $6,829.27 1.1241 0.454197 16.18% $693.84 $204.31 $329.15 $0.00 $0.00 $48.33 $1,054.10 $261.20 7.04%
5149000 JOHN T MATHER MEMORIAL HOSP $6,989.01 $6,829.27 1.0286 0.294673 0.00% $0.00 $582.61 $0.00 $0.00 $0.00 $104.81 $964.87 $261.20 7.04%
0228000 JONES MEMORIAL HOSPITAL $5,041.01 $6,829.27 0.7428 0.535979 0.00% $0.00 $342.08 $0.00 $0.00 $0.00 $106.53 $695.94 $171.74 7.04%
1401014 KALEIDA HEALTH $6,249.29 $6,829.27 0.9274 0.427742 12.35% $301.05 $853.84 $0.00 $0.00 $0.00 $154.10 $862.75 $171.74 7.04%
1401014 KALEIDA HEALTH (MILLARD) $6,249.29 $6,829.27 0.9274 0.427742 12.35% $301.05 $853.84 $0.00 $0.00 $0.00 $154.10 $862.75 $171.74 7.04%
1401002 KALEIDA HLTH/WOMAN&CHILDRENS $6,192.38 $6,829.27 0.9147 0.440617 26.52% $359.21 $294.65 $0.00 $0.00 $0.00 $64.98 $854.89 $171.74 7.04%
1404000 KENMORE MERCY HOSPITAL $5,588.74 $6,829.27 0.8193 0.451042 0.00% $0.00 $406.67 $90.35 $0.00 $0.00 $100.35 $771.55 $171.74 7.04%
7001016 KINGS COUNTY HOSPITAL CENTER $6,905.02 $6,829.27 1.0145 0.974490 33.45% $2,408.63 $919.23 $0.00 $460.72 $0.00 $172.48 $953.27 $261.20 7.04%
7001033 KINGSBROOK JEWISH MED CTR $7,745.75 $6,829.27 1.1482 0.293080 14.58% $1,083.10 $454.78 $0.00 $0.00 $0.00 $82.26 $1,069.34 $261.20 7.04%
5922000 LAWRENCE HOSPITAL $6,789.42 $6,829.27 0.9974 0.348137 0.00% $0.00 $486.61 $0.00 $0.00 $0.00 $100.53 $937.31 $261.20 7.04%
7002017 LENOX HILL HOSPITAL $6,987.73 $6,829.27 1.0407 0.247374 15.32% $1,063.05 $1,033.34 $209.96 $0.00 $0.00 $233.59 $964.69 $261.20 7.04%
2424000 LEWIS COUNTY GENERAL HOSP $5,526.23 $6,829.27 0.8163 0.779088 0.00% $0.00 $433.07 $0.00 $0.00 $0.00 $134.28 $762.92 $171.74 7.04%
7000008 LINCOLN MEDICAL $6,980.64 $6,829.27 1.0321 0.946222 24.42% $1,164.62 $464.97 $0.00 $0.00 $0.00 $122.65 $963.71 $261.20 7.04%
2902000 LONG BEACH MEDICAL CENTER $6,083.33 $6,829.27 0.9032 0.308383 11.04% $420.24 $525.41 $0.00 $0.00 $0.00 $83.74 $839.83 $261.20 7.04%
7003004 LONG ISLAND JEWISH $7,335.25 $6,829.27 1.0882 0.262745 29.02% $1,031.21 $794.22 $0.00 $0.00 $0.00 $169.60 $1,012.67 $261.20 7.04%
7001019 LUTHERAN MEDICAL CENTER $6,883.75 $6,829.27 1.0172 0.510266 24.00% $956.70 $269.29 $203.36 $0.00 $0.00 $62.17 $950.34 $261.20 7.04%
7001020 MAIMONIDES MEDICAL CENTER $8,129.56 $6,829.27 1.1904 0.286038 23.15% $1,010.91 $830.31 $116.44 $0.00 $0.00 $178.42 $1,122.33 $261.20 7.04%
3824000 MARY IMOGENE BASSETT HOSP $5,088.32 $6,829.27 0.7538 0.473270 12.95% $353.17 $515.45 $0.00 $0.00 $0.00 $106.49 $702.47 $171.74 7.04%
4402000 MASSENA MEMORIAL HOSPITAL $5,484.38 $6,829.27 0.8040 0.651479 0.00% $0.00 $405.67 $0.00 $0.00 $0.00 $102.81 $757.15 $171.74 7.04%
3622000 MEDINA MEMORIAL HOSPITAL $4,417.85 $6,829.27 0.6469 0.658814 0.00% $0.00 $104.25 $0.00 $0.00 $0.00 $21.37 $609.91 $171.74 7.04%
0101003 MEMORIAL HOSP OF ALBANY $5,367.72 $6,829.27 0.8062 0.444638 0.00% $0.00 $378.11 $0.00 $0.00 $144.18 $83.24 $741.04 $171.74 7.04%
1401008 MERCY HOSPITAL OF BUFFALO $5,848.07 $6,829.27 0.8840 0.464171 3.01% $44.23 $426.01 $21.60 $0.00 $0.00 $97.84 $807.35 $171.74 7.04%
2909000 MERCY MEDICAL CENTER $6,851.65 $6,829.27 1.0167 0.286411 0.30% $55.78 $497.33 $0.00 $0.00 $0.00 $92.96 $945.90 $261.20 7.04%
7002021 METROPOLITAN HOSPITAL CENTER $6,885.69 $6,829.27 1.0211 0.874182 27.91% $1,897.21 $248.61 $0.00 $0.00 $0.00 $73.29 $950.60 $261.20 7.04%
7000006 MONTEFIORE MEDICAL CENTER $7,589.13 $6,829.27 1.1229 0.272430 28.96% $2,362.58 $730.99 $0.00 $0.00 $0.00 $125.68 $1,047.72 $261.20 7.04%
5903001 MONTEFIORE MOUNT VERNON HOSP $7,123.95 $6,829.27 1.0550 0.539888 9.54% $978.81 $305.71 $0.00 $0.00 $342.60 $54.50 $983.50 $261.20 7.04%
5904001 MONTEFIORE NEW ROCHELLE HOSP $6,969.64 $6,829.27 1.0294 0.528855 10.85% $628.88 $476.72 $0.00 $0.00 $0.00 $109.01 $962.19 $261.20 7.04%
7003015 MOUNT SINAI HOSP OF QUEENS $7,547.00 $6,829.27 1.1206 0.417467 32.88% $1,243.60 $488.19 $0.00 $0.00 $0.00 $81.23 $1,041.90 $261.20 7.04%
7002024 MOUNT SINAI HOSPITAL $7,547.00 $6,829.27 1.1206 0.382416 32.88% $1,243.60 $717.34 $0.00 $0.00 $0.00 $145.79 $1,041.90 $261.20 7.04%
3121001 MOUNT ST MARYS HOSPITAL $5,795.27 $6,829.27 0.8495 0.587047 0.00% $0.00 $231.67 $0.00 $0.00 $0.00 $53.88 $800.07 $171.74 7.04%
2950002 NASSAU UNIV MED CTR $7,605.48 $6,829.27 1.1324 0.501971 21.68% $834.88 $392.05 $109.11 $0.00 $0.00 $87.78 $1,049.97 $261.20 7.04%
1701000 NATHAN LITTAUER HOSPITAL $5,269.89 $6,829.27 0.7774 0.439216 0.00% $0.00 $237.61 $0.00 $0.00 $0.00 $69.58 $727.53 $171.74 7.04%
7002000 NEW YORK DOWNTOWN HOSP $7,124.02 $6,829.27 1.0608 0.586127 18.06% $665.85 $1,184.64 $166.72 $0.00 $0.00 $215.72 $983.51 $261.20 7.04%
3102000 NIAGARA FALLS MEMORIAL $5,233.57 $6,829.27 0.7768 0.545618 4.15% $78.96 $464.64 $0.00 $0.00 $0.00 $128.07 $722.52 $171.74 7.04%
2527000 NICHOLAS H NOYES MEMORIAL $4,951.73 $6,829.27 0.7411 0.442823 0.00% $0.00 $412.98 $0.00 $0.00 $0.00 $120.79 $683.61 $171.74 7.04%
7000024 NORTH CENTRAL BRONX HOSPITAL $7,628.03 $6,829.27 1.1408 0.741199 12.87% $1,258.85 $531.27 $0.00 $267.66 $0.00 $125.36 $1,053.09 $261.20 7.04%
2951001 NORTH SHORE UNIVERSITY HOSP $7,866.85 $6,829.27 1.1617 0.254440 16.19% $1,202.02 $694.59 $411.20 $0.00 $0.00 $133.04 $1,086.06 $261.20 7.04%
1327000 NORTHERN DUTCHESS HOSPITAL $6,492.55 $6,829.27 0.9546 0.366251 0.00% $0.00 $369.20 $0.00 $0.00 $0.00 $104.84 $896.33 $171.74 7.04%
5920000 NORTHERN WESTCHESTER HOSP $6,874.11 $6,829.27 1.0116 0.509174 0.00% $0.00 $709.35 $0.00 $0.00 $0.00 $181.01 $949.00 $261.20 7.04%
7001008 NY COMMUNITY / BROOKLYN $7,599.61 $6,829.27 1.1128 0.517469 0.00% $0.00 $345.85 $0.00 $0.00 $0.00 $58.29 $1,049.16 $261.20 7.04%
7002026 NY EYE AND EAR INFIRMARY $6,933.83 $6,829.27 1.0217 0.444781 16.08% $2,244.99 $606.90 $0.00 $0.00 $0.00 $320.48 $957.25 $261.20 7.04%
7003010 NY MED CTR OF QUEENS $7,399.95 $6,829.27 1.0990 0.404466 16.54% $738.30 $813.36 $171.83 $0.00 $0.00 $151.64 $1,021.60 $261.20 7.04%
7001021 NY METHODIST HOSP / BROOKLYN $7,202.89 $6,829.27 1.0683 0.445267 16.78% $779.41 $306.78 $0.00 $0.00 $0.00 $63.73 $994.39 $261.20 7.04%
7002054 NY PRESBYTERIAN HOSPITAL $7,592.51 $6,829.27 1.1184 0.357925 27.06% $1,344.29 $1,184.64 $258.17 $0.00 $0.00 $215.72 $1,048.18 $261.20 7.04%
7002054 NY PRESBYTERIAN HOSPITAL (ALLEN) $7,592.51 $6,829.27 1.1184 0.357925 27.06% $1,344.29 $1,184.64 $258.17 $0.00 $0.00 $215.72 $1,048.18 $261.20 7.04%
7002054 NY PRESBYTERIAN HOSPITAL (PRESBY) $7,592.51 $6,829.27 1.1184 0.357925 27.06% $1,344.29 $1,184.64 $258.17 $0.00 $0.00 $215.72 $1,048.18 $261.20 7.04%
4324000 NYACK HOSPITAL $6,572.37 $6,829.27 0.9750 0.221363 0.00% $0.00 $320.93 $0.00 $0.00 $0.00 $69.95 $907.35 $261.20 7.04%
7002053 NYU HOSPITALS CENTER $7,250.51 $6,829.27 1.0701 0.313593 19.78% $1,818.53 $2,133.71 $0.00 $0.00 $0.00 $488.02 $1,000.97 $261.20 7.04%
7002053 NYU HOSPITALS CENTER/HOSP FOR JOINT DIS $7,250.51 $6,829.27 1.0701 0.313593 19.78% $1,818.53 $2,133.71 $0.00 $0.00 $0.00 $488.02 $1,000.97 $261.20 7.04%
0401001 OLEAN GENERAL HOSPITAL $5,129.86 $6,829.27 0.7681 0.594815 0.00% $0.00 $527.41 $0.00 $0.00 $0.00 $98.91 $708.20 $171.74 7.04%
2601001 ONEIDA HEALTHCARE $4,876.31 $6,829.27 0.7242 0.483423 0.00% $0.00 $534.54 $0.00 $0.00 $0.00 $147.94 $673.20 $171.74 7.04%
3523000 ORANGE REGIONAL MED CTR $6,753.55 $6,829.27 0.9958 0.286532 0.00% $0.00 $1,187.77 $0.00 $0.00 $0.00 $280.18 $932.36 $171.74 7.04%
3702000 OSWEGO HOSPITAL $5,593.57 $6,829.27 0.8229 0.542099 0.00% $0.00 $652.26 $0.00 $0.00 $0.00 $160.30 $772.22 $171.74 7.04%
0301001 OUR LADY OF LOURDES MEMORIAL $5,447.70 $6,829.27 0.8047 0.477509 2.17% $5.14 $300.04 $0.00 $0.00 $0.00 $72.09 $752.08 $171.74 7.04%
5155000 PECONIC BAY MED CTR $6,785.72 $6,829.27 1.0002 0.272183 0.00% $0.00 $525.76 $0.00 $0.00 $0.00 $117.49 $936.80 $261.20 7.04%
5932000 PHELPS MEMORIAL HOSP $6,713.36 $6,829.27 1.0000 0.364645 6.37% $76.96 $774.54 $0.00 $0.00 $0.00 $179.72 $926.81 $261.20 7.04%
2952005 PLAINVIEW HOSPITAL $7,436.38 $6,829.27 1.1043 0.322045 4.08% $149.59 $307.28 $0.00 $0.00 $0.00 $62.48 $1,026.63 $261.20 7.04%
3950000 PUTNAM COMMUNITY HOSPITAL $6,934.15 $6,829.27 1.0257 0.322545 0.00% $0.00 $608.72 $0.00 $0.00 $0.00 $139.38 $957.29 $171.74 7.04%
7003007 QUEENS HOSPITAL CENTER $7,695.41 $6,829.27 1.1398 0.797790 17.94% $1,015.88 $734.32 $0.00 $242.94 $0.00 $152.40 $1,062.39 $261.20 7.04%
7004010 RICHMOND UNIV MED CTR $6,763.72 $6,829.27 0.9998 0.309371 15.31% $453.87 $359.20 $318.78 $0.00 $22.03 $72.86 $933.76 $261.20 7.04%
2701003 ROCHESTER GENERAL HOSPITAL $5,738.58 $6,829.27 0.8491 0.436120 10.08% $210.18 $671.78 $0.00 $0.00 $6.22 $135.43 $792.24 $171.74 7.04%
3201002 ROME HOSPITAL AND MURPHY $5,251.01 $6,829.27 0.7707 0.454182 0.00% $0.00 $320.40 $0.00 $0.00 $0.00 $78.21 $724.93 $171.74 7.04%
4102002 SAMARITAN HOSPITAL OF TROY $5,417.94 $6,829.27 0.7951 0.398224 0.00% $0.00 $293.67 $0.00 $0.00 $49.98 $68.04 $747.97 $171.74 7.04%
2201000 SAMARITAN MEDICAL CENTER $5,726.17 $6,829.27 0.8444 0.552261 0.96% $24.42 $453.72 $0.00 $0.00 $0.00 $117.16 $790.53 $171.74 7.04%
4501000 SARATOGA HOSPITAL $5,614.12 $6,829.27 0.8322 0.393532 0.00% $0.00 $422.12 $0.00 $0.00 $0.00 $80.04 $775.06 $171.74 7.04%
4102003 SETON HEALTH SYSTEMS $5,333.79 $6,829.27 0.8048 0.356760 0.00% $0.00 $388.48 $0.00 $0.00 $0.00 $80.19 $736.36 $171.74 7.04%
1401013 SISTERS OF CHARITY HOSPITAL $5,610.66 $6,829.27 0.8265 0.468307 4.24% $133.88 $336.96 $36.77 $0.00 $0.00 $75.00 $774.58 $171.74 7.04%
2950001 SOUTH NASSAU COMMUNITIES $6,539.51 $6,829.27 0.9632 0.303927 3.42% $106.37 $615.19 $0.00 $0.00 $0.00 $119.17 $902.81 $261.20 7.04%
5126000 SOUTHAMPTON HOSPITAL $6,807.82 $6,829.27 1.0076 0.337423 4.35% $0.00 $735.21 $0.00 $0.00 $0.00 $200.71 $939.85 $261.20 7.04%
5154000 SOUTHSIDE HOSPITAL $7,051.91 $6,829.27 1.0468 0.321029 4.78% $145.78 $512.80 $0.00 $0.00 $0.00 $119.98 $973.55 $261.20 7.04%
3529000 ST ANTHONY COMMUNITY HOSP $6,174.66 $6,829.27 0.9563 0.277194 0.00% $0.00 $541.29 $0.00 $0.00 $0.00 $128.10 $852.44 $171.74 7.04%
7000014 ST BARNABAS HOSPITAL $6,888.42 $6,829.27 1.0267 0.300863 26.30% $1,041.00 $471.48 $0.00 $0.00 $0.00 $96.28 $950.98 $261.20 7.04%
5157003 ST CATHERINE OF SIENA $7,034.07 $6,829.27 1.0579 0.233955 0.00% $0.00 $497.91 $0.00 $0.00 $0.00 $99.83 $971.09 $261.20 7.04%
5149001 ST CHARLES HOSPITAL $6,575.60 $6,829.27 0.9651 0.262866 0.92% $77.23 $472.04 $0.00 $0.00 $0.00 $105.85 $907.79 $261.20 7.04%
3202002 ST ELIZABETH MEDICAL CENTER $5,685.31 $6,829.27 0.8391 0.447837 5.73% $117.46 $475.22 $0.00 $0.00 $162.13 $92.64 $784.88 $171.74 7.04%
1302000 ST FRANCIS HOSP / POUGH $5,895.89 $6,829.27 0.8640 0.254641 0.00% $0.00 $998.22 $0.00 $0.00 $0.00 $183.70 $813.96 $171.74 7.04%
2953000 ST FRANCIS HOSP / ROSLYN $7,277.27 $6,829.27 1.0656 0.264425 0.52% $189.78 $1,489.00 $0.00 $0.00 $0.00 $245.76 $1,004.66 $261.20 7.04%
5002001 ST JAMES MERCY HOSPITAL $4,405.40 $6,829.27 0.6610 0.470863 0.00% $0.00 $173.43 $0.00 $0.00 $0.00 $59.59 $608.19 $171.74 7.04%
7001024 ST JOHNS EPISCOPAL SO SHORE $8,052.04 $6,829.27 1.1937 0.388042 25.33% $738.37 $262.87 $0.00 $0.00 $0.00 $48.57 $1,111.62 $261.20 7.04%
5907001 ST JOHNS RIVERSIDE HOSPITAL $6,522.97 $6,829.27 0.9705 0.331763 0.00% $0.00 $302.72 $0.00 $0.00 $94.27 $60.31 $900.53 $261.20 7.04%
2952006 ST JOSEPH HOSPITAL $6,886.18 $6,829.27 1.0095 0.292909 0.00% $15.11 $478.96 $0.00 $0.00 $0.00 $90.23 $950.67 $261.20 7.04%
0701001 ST JOSEPHS HOSP / ELMIRA $5,005.28 $6,829.27 0.7429 0.390802 0.00% $0.00 $423.83 $0.00 $0.00 $0.00 $90.44 $691.00 $171.74 7.04%
3301003 ST JOSEPHS HOSP HLTH CTR $6,025.06 $6,829.27 0.8836 0.436160 5.47% $47.84 $673.41 $0.00 $0.00 $106.01 $134.85 $831.79 $171.74 7.04%
5907002 ST JOSEPHS MEDICAL CENTER $6,555.57 $6,829.27 0.9703 0.507587 8.01% $563.18 $784.88 $0.00 $0.00 $0.00 $144.68 $905.03 $261.20 7.04%
7002032 ST LUKES / ROOSEVELT HOSP $8,205.34 $6,829.27 1.2181 0.340470 24.50% $1,284.89 $993.24 $179.84 $0.00 $0.00 $220.88 $1,132.79 $261.20 7.04%
3522000 ST LUKES CORNWALL $6,094.76 $6,829.27 0.9024 0.281003 0.00% $0.00 $603.56 $0.00 $0.00 $0.00 $147.40 $841.41 $171.74 7.04%
2801001 ST MARYS HEALTHCARE $5,111.33 $6,829.27 0.7556 0.455570 0.00% $0.00 $203.70 $0.00 $0.00 $0.00 $52.48 $705.64 $171.74 7.04%
0101004 ST PETERS HOSPITAL $5,884.94 $6,829.27 0.8670 0.319609 2.24% $57.02 $693.30 $0.00 $0.00 $0.00 $152.17 $812.44 $171.74 7.04%
7001037 STATE UNIV HOSP / DOWNSTATE $7,376.46 $6,829.27 1.0909 0.700687 25.55% $1,885.32 $1,310.01 $0.00 $0.00 $0.00 $235.56 $1,018.36 $261.20 7.04%
7004003 STATEN ISLAND UNIV HOSP $6,907.61 $6,829.27 1.0178 0.325427 17.29% $509.17 $258.73 $119.93 $0.00 $0.00 $56.88 $953.63 $261.20 7.04%
2701005 STRONG MEMORIAL HOSPITAL $6,119.54 $6,829.27 0.8996 0.536664 29.02% $714.34 $749.90 $0.00 $0.00 $0.00 $120.89 $844.83 $171.74 7.04%
7001037 SUNY DOWNSTATE MED CTRAT LICH $7,376.46 $6,829.27 1.0909 0.700687 25.55% $1,885.32 $1,310.01 $0.00 $0.00 $0.00 $235.56 $1,018.36 $261.20 7.04%
2754001 THE UNITY HOSPITAL $5,291.58 $6,829.27 0.7752 0.502218 7.65% $46.72 $771.94 $0.00 $0.00 $0.00 $185.29 $730.53 $171.74 7.04%
0427000 TLC HEALTH NETWORK $4,654.56 $6,829.27 0.6824 0.609655 0.00% $0.00 $387.12 $0.00 $0.00 $0.00 $73.05 $642.58 $171.74 7.04%
1227001 TRI-TOWN REGIONAL HEALTHCARE $6,829.27 $6,829.27 1.0000 0.000000 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $942.81 $171.74 7.04%
0303001 UNITED HEALTH SERVICES INC $5,731.83 $6,829.27 0.8484 0.459060 7.53% $199.73 $389.17 $0.00 $0.00 $0.00 $82.62 $791.31 $171.74 7.04%
1801000 UNITED MEMORIAL MED CTR $5,190.50 $6,829.27 0.7647 0.442346 0.00% $0.00 $464.97 $0.00 $0.00 $0.00 $120.47 $716.57 $171.74 7.04%
5151001 UNIV HOSP AT STONY BROOK $6,925.52 $6,829.27 1.0257 0.358170 28.73% $1,053.67 $686.35 $266.97 $0.00 $0.00 $129.14 $956.10 $261.20 7.04%
3301007 UNIV HOSP SUNY HLTH SCI CTR $6,225.54 $6,829.27 0.9184 0.470865 29.03% $1,012.36 $918.52 $0.00 $0.00 $0.00 $169.73 $859.47 $171.74 7.04%
3301007 UPSTATE UNIV HOSPITAL AT COMM GEN $6,225.54 $6,829.27 0.9184 0.470865 29.03% $1,012.36 $918.52 $0.00 $0.00 $0.00 $169.73 $859.47 $171.74 7.04%
1302001 VASSAR BROTHERS MED CTR $6,668.69 $6,829.27 0.9923 0.280449 0.00% $0.00 $662.95 $0.00 $0.00 $0.00 $136.43 $920.65 $171.74 7.04%
5820000 WAYNE HEALTH CARE $5,212.72 $6,829.27 0.7734 0.439657 0.00% $0.00 $427.99 $0.00 $0.00 $0.00 $104.45 $719.64 $171.74 7.04%
5957001 WESTCHESTER MEDICAL CENTER $7,729.72 $6,829.27 1.1393 0.303204 18.54% $1,846.29 $2,527.40 $0.00 $0.00 $0.00 $311.13 $1,067.13 $261.20 7.04%
0632000 WESTFIELD MEMORIAL HOSP $4,611.91 $6,829.27 0.7195 0.628960 0.00% $0.00 $362.14 $0.00 $0.00 $0.00 $368.49 $636.70 $171.74 7.04%
5902001 WHITE PLAINS HOSPITAL $6,979.90 $6,829.27 1.0231 0.419909 0.00% $0.00 $445.53 $0.00 $0.00 $0.00 $100.40 $963.61 $261.20 7.04%
2908000 WINTHROP UNIVERSITY HOSPITAL $6,906.99 $6,829.27 1.0188 0.303881 16.50% $687.16 $653.86 $0.00 $0.00 $0.00 $133.35 $953.54 $261.20 7.04%
0602001 WOMANS CHRISTIAN ASSOC $5,012.60 $6,829.27 0.7416 0.471825 0.00% $0.00 $426.70 $0.00 $0.00 $0.00 $97.39 $692.01 $171.74 7.04%
7001045 WOODHULL MEDICAL $6,883.46 $6,829.27 1.0175 0.908330 20.72% $1,664.49 $495.34 $0.00 $366.82 $0.00 $103.20 $950.30 $261.20 7.04%
7001035 WYCKOFF HEIGHTS HOSPITAL $7,165.16 $6,829.27 1.0677 0.407080 15.91% $945.48 $576.86 $18.28 $0.00 $0.00 $128.76 $989.19 $261.20 7.04%
6027000 WYOMING CO COMMUNITY HOSP $5,264.93 $6,829.27 0.7759 0.954952 0.00% $0.00 $537.30 $0.00 $0.00 $0.00 $122.36 $726.85 $171.74 7.04%
* Note: Effective 1/1/2011, Maimonides Capital per Discharge rate no longer includes a High Cost Outlier add-on.