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CMS Manual System Department of Health & Human Services (DHHS)

Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS)

Transmittal 3138 Date: November 26, 2014

Change Request 8900 Transmittal 3066, dated September 12, 2014, is being rescinded and replaced by Transmittal 3138 dated November 26, 2014 to correct information related to technical errors cited in the correction notice, CMS-1607-CN, published October 3, 2014. Specifically, the updated information includes:

• renamed attachments and changed reference to attachments throughout policy section • revised Table 1 for the corrected FY 2015 IPPS Rates and Factors in attachment 3, FY 2015

Rate Tables • corrected maximum new technology add-on payment for a case involving the Voraxaze • revised attachment 2, Special Wage Index CR8900 • added note to section, Updating the PSF for Wage Index, Reclassifications and Redesignations • new attachments for wage index redesignations and reclassifications • revised reference to Hospital Acquired Condition (HAC) Reduction Program data • revised reference to Table 16b, Hospital Inpatient Value-Based Purchasing (VBP) Program

Adjustment Factors for FY 2015 • revised reference to corrected Table 15B, FY 2015 Readmissions Adjustment Factors • updated attachment 5, Uncompensated Care Payment Per Claim Amounts for Provider

Specific File Revised CR8900 • revised reference to corrected Table 8B, FY 2015 Statewide Average Capital Cost-To-Charge

Ratios (CCRs) For Acute Care Hospitals-CN

All other information remains the same. SUBJECT: Fiscal Year (FY) 2015 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes I. SUMMARY OF CHANGES: This recurring CR provides the FY 2015 update to the IPPS and LTCH PPS. This Recurring Update Notification applies to chapter 3, section 20.2.3.1. EFFECTIVE DATE: October 1, 2014 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: October 6, 2014 Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated) R=REVISED, N=NEW, D=DELETED-Only One Per Row.

R/N/D CHAPTER / SECTION / SUBSECTION / TITLE

N/A N/A III. FUNDING: For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC statement of Work. The contractor is not obliged to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions regarding continued performance requirements. IV. ATTACHMENTS: Recurring Update Notification

Attachment - Recurring Update Notification

Pub. 100-04 Transmittal: 3138 Date: November 26, 2014 Change Request: 8900

Transmittal 3066, dated September 12, 2014, is being rescinded and replaced by Transmittal 3138 dated November 26, 2014 to correct information related to technical errors cited in the correction notice, CMS-1607-CN, published October 3, 2014. Specifically, the updated information includes:

• renamed attachments and changed reference to attachments throughout policy section • revised Table 1 for the corrected FY 2015 IPPS Rates and Factors in attachment 3, FY 2015

Rate Tables • corrected maximum new technology add-on payment for a case involving the Voraxaze • revised attachment 2, Special Wage Index CR8900 • added note to section, Updating the PSF for Wage Index, Reclassifications and Redesignations • new attachments for wage index redesignations and reclassifications • revised reference to Hospital Acquired Condition (HAC) Reduction Program data • revised reference to Table 16b, Hospital Inpatient Value-Based Purchasing (VBP) Program

Adjustment Factors for FY 2015 • revised reference to corrected Table 15B, FY 2015 Readmissions Adjustment Factors • updated attachment 5, Uncompensated Care Payment Per Claim Amounts for Provider Specific

File Revised CR8900 • revised reference to corrected Table 8B, FY 2015 Statewide Average Capital Cost-To-Charge

Ratios (CCRs) For Acute Care Hospitals-CN

All other information remains the same. SUBJECT: Fiscal Year (FY) 2015 Inpatient Prospective Payment System (IPPS) and Long Term Care Hospital (LTCH) PPS Changes EFFECTIVE DATE: October 1, 2014 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: October 6, 2014 I. GENERAL INFORMATION A. Background: This Change Request (CR) outlines changes to the Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Prospective Payment Systems (PPS) for Long Term Care Hospitals (LTCHs) for FY 2015. The policy changes for FY 2015 were displayed in the Federal Register on August 04, 2014, with a publication date of August 22, 2014. All items covered in this instruction are effective for hospital discharges occurring on or after October 1, 2014, unless otherwise noted. B. Policy: IPPS FY 2015 Update The FY 2015 IPPS Final Rule establishes the prospective payment rates applicable for Acute Care Hospitals for FY 2015. A new IPPS Pricer software package will be released prior to October 1, 2014, that will include updated rates that are effective for claims with discharges occurring on or after October 1, 2014. Refer to Table 1 for the corrected FY 2015 IPPS Rates and Factors in Attachment 3, "FY 2015 Tables". MS-DRG Grouper and Medicare Code Editor (MCE) Changes

The Grouper Contractor, 3M Health Information Systems (3M-HIS), developed the new MS-DRG Grouper, Version 32.0, software package effective for discharges on or after October 1, 2014. The GROUPER assigns each case into a MS-DRG on the basis of the reported diagnosis and procedure codes and demographic information (that is age, sex, and discharge status). The MCE Version 32.0 which is also developed by 3M-HIS, uses edits for the ICD-9-CM codes reported to validate correct coding on claims for discharges on or after October 1, 2014. For discharges occurring on or after October 1, 2014, the Fiscal Intermediary Standard System (FISS) calls the appropriate GROUPER based on discharge date. Medicare contractors should receive the GROUPER documentation in early August 2014. For discharges occurring on or after October 1, 2014, the MCE selects the proper internal code edit tables based on discharge date. Medicare contractors should receive the MCE documentation in early August 2014. Note that the MCE version continues to match the Grouper. CMS created the following new MS-DRGs for endovascular cardiac valve replacements:

• MS-DRG 266 (Endovascular Cardiac Valve Replacement w MCC)

• MS-DRG 267 (Endovascular Cardiac Valve Replacement w/o MCC)

CMS deleted MS-DRGs 490 (Back & Neck Procedures Except Spinal Fusion with CC/MCC or Disc Device/Neurostimulator) and 491 (Back & Neck Procedures Except Spinal Fusion without CC/MCC) and created the following three new MS-DRGs to account for a separate CC severity level:

• MS-DRG 518 (Back & Neck Procedure Except Spinal Fusion w MCC or Disc Device/Neurostimulator)

• MS-DRG 519 (Back & Neck Procedure Except Spinal Fusion w CC)

• MS-DRG 520 (Back & Neck Procedure Except Spinal Fusion w/o CC/MCC)

Lastly, CMS modified MS-DRG 483 (Major Joint/Limb Reattachment Procedure of Upper Extremities with CC/MCC) by deleting MS-DRG 484 (Major Joint/Limb Reattachment Procedure of Upper Extremities without CC/MCC) and revising the title for MS-DRG 483 (Major Joint/Limb Reattachment Procedure of Upper Extremities) to create one base DRG. Post-acute Transfer and Special Payment Policy The changes to MS-DRGs for FY 2015 have been evaluated against the general postacute care transfer policy criteria using the FY 2013 MedPAR data according to the regulations under Sec. 412.4 (c). As a result of this review the following MS-DRGs will be added to the list of MS-DRGs subject to the postacute care transfer policy and special payment policy:

• 266, 267 (Endovascular Cardiac Valve Replacement with and without MCC, respectively),

• 518, 519 and 520 (Back & Neck Procedure Except Spinal Fusion with MCC or Disc Device/Neurostimulator, with CC, and without MCC/CC, respectively).

MS-DRG 483 (Major Joint/Limb Reattachment Procedure of Upper Extremities) will be removed from the list of MS-DRGs subject to the postacute care transfer policy. See corrected Table 5 of the FY 2015 IPPS/LTCH PPS Final Rule for a listing of all Post-acute and Special Post-acute MS-DRGs. Click on the following link: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html. Then click on the link on the left side of the screen titled,

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html


“FY 2015 IPPS Final Rule Home Page” or “Acute Inpatient Files for Download”. New Technology Add-On The following items will continue to be eligible for new-technology add-on payments in FY 2015:

• Zenith Fenestrated Graft- Cases involving the Zenith Fenestrated Graft that are eligible for the new technology add-on payment will be identified by ICD-9-CM procedure code 39.78. The maximum add-on payment for a case involving the Zenith Fenestrated Graft is $8,171.50. (For your information the ICD-10-CM procedure codes are : 04U03JZ - Supplement Abdominal Aorta with Synthetic Substitute, Percutaneous Approach; 04U04JZ - Supplement Abdominal Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach; 04V03DZ -Restriction of Abdominal Aorta with Intraluminal Device, Percutaneous Approach or 04V04DZ - Restriction of Abdominal Aorta with Intraluminal Device, Percutaneous Endoscopic Approach.

• Voraxaze- Cases involving Voraxaze that are eligible for the new technology add-on payment will be identified by ICD-9-CM procedure code 00.95. The corrected maximum add-on payment for a case involving the Voraxaze is $47,250. (For your information the ICD-10-CM procedure codes are: 3E033GQ - Introduction of Glucarpidase into Peripheral Vein, Percutaneous Approach or 3E043GQ - Introduction of Glucarpidase into Central Vein, Percutaneous Approach.)

• Argus- Cases involving the Argus ® II System that are eligible for new technology add-on payments will be identified by ICD 9 CM procedure code 14.81. The maximum add-on payment for a case involving the Argus ® II System is $72,028.75. (For your information the ICD-10-CM procedure codes are: 08H005Z - Insertion of Epiretinal Visual Prosthesis into Right Eye, Open Approach or 08H105Z - Insertion of Epiretinal Visual Prosthesis into Left Eye, Open Approach.)

• Kcentra- Cases involving Kcentra that are eligible for new technology add-on payments will be identified by ICD 9 CM procedure code 00.96. The maximum add-on payment for a case of Kcentra™ is $1,587.50. DO NOT MAKE THIS NEW TECH PAYMENT IF ANY OF THE FOLLOWING DIAGNOSIS CODES ARE ON THE CLAIM: 286.0, 286.1, 286.2, 286.3, 286.4, 286.5, 286.7, 286.52, 286.53, 286.59. (For your information the ICD-10-CM procedure codes are: 30280B1 - Transfusion of Nonautologous 4-Factor Prothrombin Complex Concentrate into Vein, Open Approach or 30283B1 - Transfusion of Nonautologous 4-Factor Prothrombin Complex and the ICD-10-CM diagnosis codes are: D66, D67, D68.1, D68.2, D68.0, D68.311, D68.312, D68.318, D68.32 and D68.4.)

• Zilver- Cases involving the Zilver® PTX® that are eligible for new technology add-on payments will be identified by ICD 9 CM procedure code 00.60. The maximum add-on payment for a case of the Zilver® PTX® is, $1,705.25. (For your information the ICD-10-CM procedure codes are: 047K04Z - Dilation of Right Femoral Artery with Drug-eluting Intraluminal Device, Open Approach; 047K34Z - Dilation of Right Femoral Artery with Drug-eluting Intraluminal Device, Percutaneous Approach; 047K44Z - Dilation of Right Femoral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Approach; 047L04Z - Dilation of Left Femoral Artery with Drug-eluting Intraluminal Device, Open Approach; 047L34Z - Dilation of Left Femoral Artery with Drug-eluting Intraluminal Device, Percutaneous Approach or 047L44Z - Dilation of Left Femoral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Approach.)

The following items will be eligible for new-technology add-on payments in FY 2015:

• CardioMEMS™ HF Monitoring System – Cases involving the CardioMEMS™ HF Monitoring System that are eligible for new technology add-on payments will be identified by ICD-9-CM procedure code 38.26. The maximum add-on payment is $8,875. (For your information the ICD-10-

CM procedure code is: 02HQ30Z- Insertion of Pressure Sensor Monitoring Device into Right Pulmonary Artery, Percutaneous Approach.)

• MitraClip® System - Cases involving the MitraClip® System that are eligible for new technology add-on payments will be identified by ICD-9-CM procedure code 35.97. The maximum add-on payment is $15,000. (For your information the ICD-10-CM procedure code is: 02UG3JZ Supplement Mitral Valve with Synthetic Substitute, Percutaneous Approach.)

• RNS® System- Cases involving the RNS® System that are eligible for new technology add-on payments will be identified by ICD-9-CM procedure code 01.20 in combination with 02.93. The maximum add-on payment is $18,475. (For your information the ICD-10-CM procedure codes are: 0NH00NZ-Insertion of Neurostimulator Generator into Skull, Open Approach in combination with 00H00MZ-Insertion of Neurostimulator Lead into Brain, Open Approach.)

Cost of Living Adjustment (COLA) Update for IPPS PPS The IPPS incorporates a COLA for hospitals located in Alaska and Hawaii. There are no changes to the COLAs for FY 2015, and are the same COLAs established for FY 2014. For reference, a table showing the applicable COLAs that will continue to be effective for discharges occurring on or after October 1, 2014, can be found in the FY 2015 IPPS/LTCH PPS final rule and is also displayed in Table 2 in Attachment 2, "FY 2015 Tables". FY 2015 Wage Index Changes and Issues A. New Wage Index Labor Market Areas and Transitional Wage Indexes Effective October 1, 2014, CMS is revising the labor market areas used for the wage index based on the most recent labor market area delineations issued by the Office of Management and Budget (OMB) using 2010 Census data. In order to mitigate potential negative payment impacts due to the adoption of the new OMB delineations, CMS is adopting a one-year transition for FY 2015 for hospitals that are experiencing a decrease in their wage index exclusively due to the implementation of the new OMB delineations. In addition, for the few hospitals that have been located in an urban county prior to October 1, 2014 that are becoming rural effective October 1, 2014, under the new OMB delineations, CMS is assigning a hold-harmless urban wage index value of the labor market area in which they are physically located for FY 2014 for 3 years beginning in FY 2015. That is, for FYs 2015, 2016, and 2017, assuming no other form of wage index reclassification or redesignation is granted, these hospitals are assigned the area wage index value of the urban CBSA in which they were geographically located in FY 2014. In addition, for FY 2015, for hospitals that would receive the 3-year transition, it is possible that receiving the FY 2015 wage index of the CBSA where the hospital is geographically located for FY 2014 might still be less than the FY 2015 wage index that the hospital would have received in the absence of the adoption of the new OMB delineations. Therefore, the assignment of the 3-year transitional wage index is included in the calculation of the FY 2015 portion of the 50/50 blended wage index for that hospital. After FY 2015, such a hospital may revert to the second year of the 3-year transition. Note that for hospitals that are receiving a one-year transition blended wage index or the 3-year hold-harmless wage index, these transitions are only for the purpose of the wage index and do not affect a hospital’ s urban or rural status for any other payment purposes. To ensure hospitals are paid correctly under the IPPS for the policies noted above, MACs followed the steps below in the section titled “Updating the PSF for Wage Index, Reclassifications and Redesignations” to update the PSF.

For new hospitals that open on or after March 31, 2014 and before October 1, 2015, contact [email protected] or [email protected] for instructions on determining whether or not a blended wage index should be applied to the new hospital. B. Treatment of Certain Providers Redesignated Under Section 1886(d)(8)(B) of the Act 42 CFR 412.64(b)(3)(ii) implements section 1886(d)(8)(B) of the Act, which redesignates certain rural counties adjacent to one or more urban areas as urban for the purposes of payment under the IPPS. (These counties are commonly referred to as “Lugar counties”.) Accordingly, hospitals located in Lugar counties are deemed to be located in an urban area and their IPPS payments are determined based upon the urban area to which they are redesignated. A hospital that waives its Lugar status in order to receive the out-migration adjustment has effectively waived its deemed urban status, and is considered rural for all IPPS purposes. C. Section 505 Hospital (Out-Commuting Adjustment) Section 505 of the Medicare Modernization Act of 2003 (MMA), also known as the “outmigration adjustment, is an adjustment that is based primarily on commuting patterns and is available to hospitals that are not reclassified by the MGCRB. Treatment of Certain Urban Hospitals Reclassified as Rural Hospitals Under § 412.103 An urban hospital that reclassifies as a rural hospital under § 412.103 is considered rural for all IPPS purposes. Note, hospitals reclassified as rural under § 412.103 are not eligible for the capital DSH adjustment since these hospitals are considered rural under the capital PPS (see § 412.320(a)(1)). Please reference Table 9C of FY 2015 Final rule. Updating the PSF for Wage Index, Reclassifications and Redesignations MACs updated the PSF by following the steps in the order listed below to determine the appropriate wage index based on policies mentioned above. Step 1: MACs updated the Actual Geographic Location Core-Based Statistical Area (CBSA) field in the PSF (data element 35) effective October 1, 2014 to reflect the new CBSA delineations. They used attachment 6, County to CBSA Crosswalk file. If a hospital is located in a county on attachment 6, then the MACs updated the Actual Geographic Location to the CBSA in the column titled “New CBSA.” Step 2: Except for hospitals that waive Lugar redesignation for the out-migration adjustment shown in the Attachment 7, Hospitals Waiving Lugar Redesignation for the Out-Migration Adjustment FY 2015, for hospitals located in Lugar counties on Attachment 8, Hospitals Located in Lugar Counties FY 2015, MACs entered a "Y" for reclassified in the Special Payment Indicator field (data element 33) and entered the urban CBSA in the Wage Index Location CBSA field (data element 36) and in the Standardized Amount CBSA field (data element 37). Note: Due to the new OMB delineations, counties rural and deemed Lugar in FY 2014 may now be deemed urban and, therefore, no longer be deemed Lugar for FY 2015 (or some counties may no longer meet the Lugar criteria). Only those counties listed on Attachment 8, are deemed Lugar for FY 2015. MACs updated the PSF accordingly for those providers that were located in a county deemed Lugar in FY 2014 and are no longer located in a county deemed Lugar for FY 2015. See Attachment 9, Counties No Longer Lugar in FY 2015 for a list of counties that were deemed Lugar in FY 2014 and are no longer deemed Lugar for FY 2015. Step 3: MACs referred to the FY 2015 Wage Index Homepage at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Wage-Index-Files-Items/FY-2015-Wage-Index-Home-Page.html and selected the zip file titled “FY 2015 Final Rule Wage Index Tables”. The zip file contains two zip files. MACs selected the zip file called “WI_TABLES_FR_FY_15_New_CBSA.zip” and verified the zip file selected contained the word “new” in the file name.

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Wage-Index-Files-Items/FY-2015-Wage-Index-Home-Page.html



Step 4: For hospitals listed on Table 9C-2--HOSPITALS REDESIGNATED AS RURAL UNDER SECTION 1886(d)(8)(E) OF THE ACT - FY 2015; BASED ON FY 2015 CBSA DELINEATIONS, MACs entered the rural CBSA in the Wage Index Location CBSA field (data element 36) and in the Standardized Amount CBSA field (data element 37). Step 5: For hospitals listed on Table 9A-2 - HOSPITAL RECLASSIFICATIONS AND REDESIGNATIONS – FY 2015, MACs entered a "Y" for reclassified in the Special Payment Indicator field (data element 33) and entered the applicable CBSA from the column titled “Reclassified CBSA” in the Wage Index Location CBSA field (data element 36). Step 6: MACs updated the Special Payment Indicator (data element 33) with a "1" or "2" (column is titled “Special Pay Wage Index Indicator”) as appropriate for each provider in Attachment 2, Special Wage Index CR8900 and entered the wage index value shown for the provider in the Special Wage Index field (data element 38) with an effective date of October 1, 2014. While we realize MACs may have replaced the "Y" from Step 2 or Step 5 above, due to the multiple use of the special wage index field, CMS believes this was the most effective method to update the PSF. NOTE: MACs shall make corrections to the PSF provided in the revised Attachment 2 retroactive to October 1, 2014 but no reprocessing is necessary even if the Special Payment Indicator is changing from the original Attachment I (from 1 to 2 or 2 to 1). Medicare-Dependent, Small Rural Hospital (MDH) Program Expiration The MDH program provides enhanced payment to support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. The MDH program is currently effective through March 31, 2015, as provided by section 106 of the Protecting Access to Medicare Act of 2014. Provider Types 14 and 15 continue to be valid through March 31, 2015. Under current law, beginning in April 1, 2015, all previously qualifying hospitals will no longer have MDH status and will be paid based solely on the Federal rate. (We note that, the SCH policy at § 412.92(b) allows MDHs to apply for SCH status and be paid as such under certain conditions, following the expiration of the MDH program.) Provider Types 14 and 15 will no longer be valid beginning April 1. 2015. Hospital Specific (HSP) Rate Update for Sole Community Hospitals (SCHs) and Medicare-Dependent, Small Rural Hospitals (MDHs) For FY 2015, Hospital-Specific (HSP) amount in the PSF for SCHs and MDHs will continue to be entered in FY 2012 dollars. PRICER will apply the cumulative documentation and coding adjustment factor for FYs 2011 - 2014 of 0.9480 and make all updates to the HSP amount for FY 2013 and beyond. (As noted above, under current law, the MDH program expires March 31, 2015.) Low-Volume Hospitals – Criteria and Payment Adjustments for FY 2015 The temporary changes to the low-volume hospital payment adjustment originally provided by the Affordable Care Act, and extended by subsequent legislation, expanded the definition of a low-volume hospital and modified the methodology for determining the payment adjustment for hospitals meeting that definition. Section 105 of the Protecting Access to Medicare Act of 2014 extended the temporary changes to the low-volume hospital payment adjustment through March 31, 2015. Beginning with FY 2015 discharges occurring on or after April 1, 2015, the low-volume hospital qualifying criteria and payment adjustment methodology will revert to that which was in effect prior to the amendments made by the Affordable Care Act and subsequent legislation (that is, the low-volume hospital payment adjustment policy in effect for FYs 2005 through 2010). The regulations implementing the hospital payment adjustment policy are at § 412.101.

Effective October 1, 2014 through March 31, 2015, in order to qualify as a low-volume hospital, a hospital must be located more than 15 road miles from another “ subsection (d) hospital” and have less than 1600 Medicare discharges (which includes Medicare Part C discharges) during the fiscal year . For FY 2015 discharges occurring through March 31, 2015, the applicable low-volume percentage increase is determined using a continuous linear sliding scale equation that results in a low-volume hospital payment adjustment ranging from an additional 25 percent for hospitals with 200 or fewer Medicare discharges to a zero percent additional payment adjustment for hospitals with 1,600 or more Medicare discharges. For FY 2015 discharges occurring before April 1, 2015, qualifying low-volume hospitals and their payment adjustment are determined using Medicare discharge data from the March 2014 update of the FY 2013 MedPAR file. Table 14 of the FY 2015 IPPS/LTCH PPS final rule (which is available through the Internet on the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page.html lists the “ subsection (d)” ’ hospitals with fewer than 1,600 Medicare discharges based on the March 2014 update of the FY 2013 MedPAR file and their low?volume payment adjustment for FY 2015 discharges occurring before April 1, 2015 (if eligible). We note that the list of hospitals with fewer than 1,600 Medicare discharges in Table 14 does not reflect whether or not the hospital meets the mileage criterion (that is, the hospital is located more than 15 road miles from any other subsection (d) hospital, which, in general, is an IPPS hospital). Effective April 1, 2015, in order to qualify as a low-volume hospital, a hospital must be located more than 25 road miles from another “ subsection (d) hospital” and have less than 200 total discharges (including both Medicare and non-Medicare discharges) during the fiscal year . For FY 2015 discharges occurring on or after April 1, 2015, the low-volume hospital adjustment for all qualifying hospitals is 25 percent. For FY 2015 discharges occurring on or after April 1, 2015, the MAC makes the discharge determination based on the hospital’ s number of total discharges, that is, Medicare and non-Medicare discharges as reported on the hospital’ s most recently submitted cost report. To meet the mileage criterion to qualify for the low-volume hospital payment adjustment for FY 2015 discharges occurring on or fate April 1, 2015, a hospital must be located more than 25 road miles (as defined at § 412.101(a)) from the nearest “ subsection (d) hospital” (that is, in general, an IPPS hospital). A hospital must notify and provide documentation to its MAC that it meets the mileage criterion. The use of a Web-based mapping tool, such as MapQuest, as part of documenting that the hospital meets the mileage criterion for low-volume hospitals, is acceptable. The MAC will determine if the information submitted by the hospital, such as the name and street address of the nearest hospitals, location on a map, and distance (in road miles) from the hospital requesting low-volume hospital status, is sufficient to document that it meets the mileage criterion. If not, the MAC will follow up with the hospital to obtain additional necessary information to determine whether or not the hospital meets the low-volume hospital mileage criterion. To receive a low-volume hospital payment adjustment under § 412.101, a hospital must notify and provide documentation to its MAC that it meets the discharge and distance requirements under § 412.101(b)(2)(ii) for FY 2015 discharges occurring before April 1, 2015, and § 412.101(b)(2)(i) for FY 2015 discharges occurring on or after April 1, 2015, if also applicable. Specifically, for FY 2015, a hospital must make a written request for low-volume hospital status that is received by its MAC no later than September 1, 2014, in order for the applicable low-volume hospital payment adjustment to be applied to payments for its discharges occurring on or after October 1, 2014, and through March 31, 2015, or through September 30, 2015, for hospitals that also meet the low-volume hospital payment adjustment qualifying criteria for discharges occurring during the second half of FY 2015. A hospital that qualified for the low-volume payment adjustment in FY 2014 may continue to receive a low-volume payment adjustment for FY 2015 discharges occurring before April l, 2015, without reapplying if it continues to meet the Medicare discharge criterion established for FY 2015 and the distance criterion; however, the hospital must send written verification that is received by its MAC no later than September 1, 2014, stating that it continues to be more than 15 miles from any other “ subsection (d)” hospital. If a hospital’s written request for low-volume hospital status for FY 2015 is received after September 1, 2014, and if the MAC determines that the hospital meets the criteria to qualify as a low-volume hospital, the MAC will apply the applicable low-volume hospital payment adjustment to determine the payment for the hospital’ s FY 2015 discharges, effective

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page.html


prospectively within 30 days of the date of its low-volume hospital status determination. The MAC will determine, based on the most recent data available, if the hospital qualifies as a low-volume hospital, so that the hospital will know in advance whether or not it will receive a payment adjustment for the FY. The MAC and CMS may review available data, in addition to the data the hospital submits with its request for low-volume hospital status, in order to determine whether or not the hospital meets the qualifying criteria. The MAC is to notify CMS Central Office – Baltimore, CM/HAPG/DAC, Michele Hudson and Maria Navarro, of the IPPS hospitals that qualify as low-volume hospitals and the effective date of the determinations for FY 2015 by November 7, 2014. The notification may be sent via e-mail to [email protected] and [email protected], and should include the hospital’ s name, CMS certification number (CCN), address (street, city, state and zip code), the distance to the nearest IPPS hospital (as well as that hospital’ s address: street, city, state and zip code), the number of Medicare discharges from Table 14 of the FY 2015 IPPS/LTCH PPS final rule (and total discharges and begin and end dates from the hospital’ s most recently submitted cost report, if also qualifying for FY 2015 discharges occurring on or after April 1, 2015), and the effective date of the low-volume hospital determination. For low-volume hospital requests received after September 1, 2014, FIs/MACs shall notify CMS Central Office as above within 15 days of the determination. For discharges occurring during FY 2015, if a hospital qualifies as a low-volume hospital, the existing low-volume indicator field on the PSF (position 74 – temporary relief indicator) must contain a value of ‘Y’. In order to implement this policy for FY 2015 discharges occurring on or before March 31, 2015, the Pricer will apply the applicable low-volume hospital payment percentage adjustment shown in Table 14 of the FY 2015 IPPS/LTCH PPS final rule for hospitals that have a value of ‘Y’ in the low-volume indicator field on the PSF. If a hospital qualified for the low-volume hospital payment adjustment in FY 2014 but no longer meets the low-volume hospital definition for FY 2015, and therefore, the hospital is no longer eligible to receive a low-volume hospital payment adjustment in FY 2015, the MAC must update the low- volume indicator field on the PSF (position 74 - temporary relief indicator) to hold a value of ‘blank’. For FY 2015 discharges occurring on or after April 1, 2015, the Pricer will apply the 25 percent low-volume hospital payment adjustment for hospitals that have a value of ‘Y’ in the low-volume indicator field on the PSF. If a hospital qualified for the low-volume hospital payment adjustment FY 2015 discharges occurring on or before March 31, 2015, but no longer meets the low-volume hospital definition for FY 2015 discharges occurring on or after April 1, 2015 , and therefore, the hospital is no longer eligible to receive a low-volume hospital payment adjustment effective April 1, 2015, the MAC must update the low-volume indicator field on the PSF (position 74 - temporary relief indicator) to hold a value of ‘blank’. The low-volume hospital payment is based on and in addition to all other IPPS per discharge payments, including capital, DSH (including the uncompensated care payment), IME and outliers. For SCHs and MDHs, the low-volume hospital payment is based on and in addition to either payment based on the Federal rate or the hospital-specific rate, whichever results in a greater operating IPPS payment. Hospital Quality Initiative The hospitals that will receive the quality initiative bonus are listed at the following Web site: www.qualitynet.org. Should a provider later be determined to have met the criteria after publication of this list, they will be added to the Web site, and MACs shall update the provider file as needed. The MACs received a list of hospitals that received the 2.0 percent reduction to the annual payment update for FY 2015 under the Hospital Inpatient Quality Reporting (IQR) Program. For new hospitals, A/B MACs shall enter a ‘ 1’ in the PSF and provide information to the Quality Improvement Organization (QIO) as soon as possible so that the QIO can enter the provider information into

http://www.qualitynet.org/

the Program Resource System and follow through with ensuring provider participation with the requirements for quality data reporting. This allows the QIOs the opportunity to contact new facilities earlier in the fiscal year to inform them of the Hospital Quality Initiative. The MACs shall provide this information monthly to the QIO in the State in which the hospital has opened. It shall include the following: • State Code • Medicare Accept Date • Provider Name • Contact Name (if available) • Provider ID number • Telephone Number Electronic Health Record Incentive Program (EHR) Section 1886(b) (3) (B) of the Social Security Act as amended by Section 4102(b) (1) of the HITECH Act requires CMS to apply a reduced annual payment update to the Inpatient Prospective Payment System (IPPS) update for subsection(d) hospitals that are not meaningful EHR users or have not been granted a hardship exception. The statute also requires payment adjustments for eligible hospitals in states where hospitals are paid under section 1814(b)(3) of the Act (waiver). For FY2015, the applicable percentage increase to the IPPS payment rate is adjusted downward for those eligible hospitals that are not meaningful EHR users for the associated EHR reporting period for a payment year. This reduction applies to three-quarters of the percentage increase otherwise applicable. The reduction to three-quarters of the applicable update for an eligible hospital that is not a meaningful EHR user is 33 1/3 percent for FY 2015. In other words, for eligible hospitals that are not meaningful EHR users, the percentage increase is reduced for the entire FY by 25% (33 1/3 percent of 75 percent) in 2015. A list of hospitals that will receive the EHR Incentive Payment reduction for FY 2015 is available in Attachment 1. A/B MACs entered a 'Y' in data element 59 in the PSF for hospitals listed in Attachment 1. Hospitals that are meaningful EHR users will have a blank in data element 59 in the PSF. Hospital Acquired Condition Reduction Program (HAC) Section 3008 of the Affordable Care Act (ACA) establishes a program, beginning in FY 2015, for Inpatient Prospective Payment System (IPPS) hospitals to improve patient safety, by imposing financial penalties on hospitals that perform poorly with regard to certain Hospital Acquired Conditions (HACs). HACs are conditions that patients did not have when they were admitted to the hospital, but which developed during the hospital stay. Under the HAC Reduction Program, a 1- percent payment reduction applies to a hospital whose ranking is in the top quartile (25 percent) of all applicable hospitals, relative to the national average, of HACs acquired during the applicable period, and applies to all of the hospital's discharges for the specified fiscal year. The HAC Reduction Program adjustment amount (that is, the 1-percent payment reduction) is calculated after all other IPPS per discharge payments, which includes adjustments for DSH (including the uncompensated care payment), IME, outliers, new technology, readmissions, VBP, low-volume hospital payments, and capital payments. This amount will be displayed in the PPS-FLX6- PAYMENT field in the IPPS PRICER output record. For SCHs and MDHs, the HAC Reduction Program adjustment amount applies to either the Federal rate payment amount or the hospital-specific rate payment amount, whichever results in a greater operating IPPS payment. We did not make the list of providers subject to the HAC Reduction Program for FY 2015 public in the final rule because hospitals have until September 2014 to notify CMS of any errors in the calculation of their

Total HAC Score under the Review and Correction period. Updated hospital level data for the Hospital-Acquired Condition (HAC) Reduction Program will be made publicly available following the review and corrections process. Hospital Value Based Purchasing Section 3001 of the Affordable Care Act added section 1886(o) to the Social Security Act, establishing the Hospital Value-Based Purchasing (VBP) Program. This program began adjusting base operating DRG payment amounts for discharges from subsection (d) hospitals, beginning in FY 2013. CMS has continued to exclude Maryland hospitals from the Hospital VBP Program for the FY 2015 program year. The regulations that implement this provision are in subpart I of 42 CFR part 412 (§ 412.160 through § 412.162). Under the Hospital VBP Program, CMS reduces base operating DRG payment amounts for subsection (d) hospitals by the applicable percent defined in statute .The applicable percent for payment reductions for FY 2015 is 1.50 percent. This percent is gradually increasing each fiscal year from 1.0 in FY 2013 to 2.0 percent in FY 2017. These payment reductions fund value-based incentive payment to hospitals that meet or exceed performance standards on the measures selected for the program. By law, CMS must base value-based incentive payments on hospitals’ performance under the Hospital VBP Program, and the total amount available for value-based incentive payments must be equal to the amount of payment reductions, as estimated by the Secretary. CMS calculates a Total Performance Score (TPS) for each hospital eligible for the Hospital VBP Program. CMS then uses a linear exchange function to convert each hospital’s TPS into a value-based incentive payment. Based on that linear exchange function’ s slope, as well as an individual hospital’ s TPS, the hospitals’ own annual base operating DRG payment amount, and the applicable percent reduction to base operating DRG payment amounts, CMS calculates a value-based incentive payment adjustment factor that will be applied to each discharge at a hospital, for a given fiscal year. In the FY 2013 IPPS/LTCH PPS final rule, CMS established the methodology to calculate the hospital value-based incentive payment adjustment factor, the portion of the IPPS payment that will be used to calculate the value-based incentive payment amount, and review and corrections and appeal processes wherein hospitals can review information used to calculate their TPSes and submit requests for corrections to the information before it is made public. For FY 2015 CMS will implement the base operating DRG payment amount reduction and the value-based incentive payment adjustments, as a single value-based incentive payment adjustment factor applied to claims for discharges occurring in FY 2015. Table 16b of the FY 2015 IPPS/LTCH PPS final rule (which will be available through the Internet on the CMS Web site at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page.html) contains the value-based incentive payment adjustment factors for FY 2015. Table 16b data was used by the claims processing contractors to update the Hospital VBP Program participant indicator (VBP Participant) to hold a value of ‘Y’ if the provider is included in the Hospital VBP Program and the Hospital VBP Program adjustment field (VBP Adjustment) to hold the value-based incentive payment adjustment factor. Note that the values listed in Table 16A of the IPPS/LTCH PPS Final Rule are proxy values. These values are not used to adjust payments. Hospital Readmissions Reduction Program For FY 2015, the readmissions adjustment factor is the higher of a ratio or 0.97 (-3 percent). The readmissions adjustment factor is applied to a hospital’s “base operating DRG payment amount” , or the wage-adjusted DRG payment amount (adjusted under the transfer policy, if applicable) plus new technology add-on payment (if applicable), to determine the amount reduced from a hospital’ s IPPS payment due to excess readmissions. Add-on payments for IME, DSH (including the uncompensated care payment), outliers and low-volume hospitals are not adjusted by the readmissions adjustment factor. In addition, for SCHs, the



difference between the SCH’s operating IPPS payment under the hospital-specific rate and the Federal rate is not adjusted by the readmissions adjustment factor. For FY 2015, for MDHs, the operating IPPS payment amount that is 75 percent difference between payments under the hospital-specific rate and the payments under the Federal rate is adjusted by the readmissions adjustment factor. However, the portion of a MDH’ s payment reduction due to excess readmissions that is based on 75 percent difference between payment under the hospital-specific rate and payment under the Federal rate will be determined at cost report settlement. In determining the claim payment, the PRICER will only apply the readmissions adjustment factor to a MDH’ s wage-adjusted DRG payment amount (adjusted under the transfer policy, if applicable) plus new technology add-on payment (if applicable) to determine the payment reduction due to excess readmissions. Hospitals that are not subject to a reduction under the Hospital Readmissions Reduction Program in FY 2015 (such as Maryland hospitals), have a readmission adjustment factor of 1.0000. For FY 2015, hospitals should only have a readmission adjustment factor between 1.0000 and 0.9700. The Hospital Readmissions Reduction Program participant (HRR Participant) and/or the Hospital Readmissions Reduction Program adjustment (HRR Adjustment) fields in the PSF must be updated by the MAC with an effective date of October 1, 2014. Contractors used the FY 2015 Hospital Readmissions Reduction Program adjustment factors found in Table 15B available on the Internet at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2015-IPPS-Final-Rule-Home-Page.html and included in attachment 4, FY 2015 Revised Readmissions Payment Adjustment Factors.

• If a provider has a readmissions adjustment factor on Table 15B, then Medicare contractors entered a value of ‘1’ in the HRR Participant field and entered in the HRR Adjustment field.

• If a provider is not listed on Table 15B, then Medicare contractors entered a value of ‘0’ in the HRR Participant field and left the HRR Adjustment field blank.

NOTE: Although Maryland hospitals are waived from the payment adjustment under the Hospital Readmissions Reduction Program for FY 2015, a readmissions adjustment factor of 1.0000 (that is no adjustment) is shown for Maryland hospitals in Table 15B. Therefore, MACs followed the instructions in the first bullet above for the PSF for Maryland hospitals. Hospitals located in Puerto Rico are not subject to the Hospital Readmissions Reduction Program and therefore are not listed in Table 15B. Therefore, MACs followed the instructions in the second bullet above for the PSF for Puerto Rico hospitals. Medicare Disproportionate Share Hospitals (DSH) Program Section 3133 of the Affordable Care Act modified the Medicare DSH program beginning in FY 2014. Starting in FY 2014, hospitals received 25 percent of the amount they previously would have received under the current statutory formula for Medicare DSH. The remainder, equal to 75 percent of what otherwise would have been paid as Medicare DSH, will become an uncompensated care payment after the amount is reduced for changes in the percentage of individuals that are uninsured. Each Medicare DSH hospital will receive a portion of this uncompensated care pool based on its share of total uncompensated care reported by Medicare DSH hospitals. A Medicare DSH hospital’ s share of uncompensated care is based on its share of insured low income days, defined as the sum of Medicare SSI days and Medicaid days, relative to all Medicare DSH hospitals’ insured low income days. The Medicare DSH payment will be reduced to 25 percent of the amount they previously would have received under the current statutory formula in PRICER. The calculation of the Medicare DSH payment adjustment will remain unchanged and the 75 percent reduction to the DSH payment will be applied in PRICER.



For FY 2015, the total uncompensated care payment amount to be paid to Medicare DSH hospitals is $7,647,644,885.18, as calculated as the product of 75 percent of Medicare DSH (estimated CMS Office of the Actuary) and the change in percent of uninsured individuals and an additional statutory adjustment at 76.19 percent. The total uncompensated care payment amount to be paid to the Medicare DSH hospitals was finalized in the FY 2015 IPPS Final Rule. The uncompensated care payment will be paid on the claim as an estimated per discharge amount to the hospitals that have been projected to receive Medicare DSH for FY 2015. The estimated per claim amount is determined by dividing the total uncompensated care payment by the average number of claims from the most recent three years of claims data (FY2011-2013). Medicare Contractors used the estimated per discharge uncompensated care payment amount from Attachment 5 to update the Uncompensated Care Payment Amount field in the PSF. If the amount listed is “N/A”, $0 is to be entered. This dollar amount will be added to each claim for FY 2015. The estimated per discharge uncompensated care payment amount will be included in the outlier payment determinations. In addition the estimated per discharge uncompensated care payment amount will be included as a Federal payment for Sole Community Hospitals to determine if a claim is paid under the hospital-specific rate or Federal rate and for Medicare Dependent Hospitals to determine if the claim is paid 75 percent of the difference between payment under the hospital-specific rate and payment under the Federal rate. The total uncompensated care payment amount finalized in the FY 2015 IPPS Final Rule will be reconciled at cost report settlement with the interim estimated uncompensated care payments that are paid on a per discharge basis. The IPPS PRICER will display the uncompensated care payment amount. The hospitals, that were located in urban counties that are becoming rural under our adoption of the new OMB delineations, are subject to a transition for their Medicare DSH payment. For a hospital with more than 99 beds and less than 500 beds that was redesignated from urban to rural, it would be subject to a DSH payment adjustment cap of 12 percent. Under the transition, per the regulations at §412.102, for the first year after a hospital loses urban status, the hospital will receive an additional payment that equals two-thirds of the difference between DSH payment before its redesignation from urban to rural and the DSH payment otherwise applicable to the hospital subsequent to its redesignation from urban to rural. In the second year after a hospital loses urban status, the hospital will receive an additional payment that equals one third of the difference between the DSH payments applicable to the hospital before its redesignation from urban to rural and the DSH payments otherwise applicable to the hospital subsequent to its redesignation from urban to rural. This adjustment will be determined at cost report settlement. In determining the claim payment, the PRICER will only apply the DSH payment adjustment based on its urban/rural status according to the redesignation. Recalled Devices As a reminder, section 2202.4 of the Provider Reimbursement Manual, Part I states, “charges should be related consistently to the cost of the services and uniformly applied to all patients whether inpatient or outpatient.” Accordingly, hospital charges with respect to medical devices must be reasonably related to the cost of the medical device. If a hospital receives a replacement medical device for free, the hospital should not be charging the patient or Medicare for that device. The hospital should not be including costs on the cost report or charges on the Medicare claim. If that medical device was received at a discount, the charges should also be appropriately reduced. Provider Specific File (PSF) The PSF-required data elements for all provider types which require a PSF can be found in Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, §20.2.3.1 and Addendum A. Update the Inpatient PSF for each hospital as needed, but you must update all applicable fields for IPPS hospitals effective October 1, 2014, or effective with cost reporting periods that begin on or after October 1, 2014, or upon receipt of an as-filed (tentatively) settled cost report. Pricer requires a PSF record with a 10/1 effective date. Tables 8a and updated 8b contain the FY 2015 Statewide average operating and capital cost-to-charge ratios, respectively. To access Tables 8a and 8b click on the following

link: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html. On the left side select FY 2015 IPPS Final Rule Home Page and then select FY 2015 Final Rule Tables. Note: Refer to revised Table 8b, which is the excel file named “FY 15 CN Tables 8B.xlsx”. Per the regulations at 42 CFR section 412.84(i)(3), for FY 2015, Statewide average CCRs are used in the following instances: 1. New hospitals that have not yet submitted their first Medicare cost report. (For this purpose, a new hospital is defined as an entity that has not accepted assignment of an existing hospital’ s provider agreement in accordance with 42 CFR section 489.18). 2. Hospitals whose operating CCR is in excess 1.23 or capital CCR is in excess of 0.172 (referred to as the operating CCR ceiling and capital CCR ceiling, respectively). 3. Hospitals for which the FI or MAC is unable to obtain accurate data with which to calculate an operating and/or capital CCR. Note: Hospitals, FIs and Medicare contractors can request an alternative CCR to the statewide average CCR per the instructions in section 20.1.2 of chapter 3 of Pub. 100-04, Medicare Claims Processing Manual. CR8546, Transmittal 2933 dated April 17, 2014 added new fields and renamed fields in the PSF. The new fields are:

• HAC Reduction Indicator

• EHR Incentive Program Reduction Indicator

• Uncompensated Care Payment Amount • PPS-FLX6- PAYMENT for HAC Payment Amount

LTCH PPS FY 2015 Update FY 2015 LTCH PPS Rates and Factors are located in Table 4 in Attachment 3, “FY 2015 Rate Tables”. The LTCH PPS Pricer has been updated with the Version 32.0 MS-LTC-DRG table, weights and factors, effective for discharges occurring on or after October 1, 2014, and on or before September 30, 2015. LTCH Quality Reporting (LTCHQR) Program Section 3004(a) of the Affordable Care Act requires the establishment of the Long-Term Care Hospital Quality Reporting (LTCHQR) Program. Beginning in FY 2015, the annual update to a standard Federal rate will be reduced by 2.0 percentage points if a LTCH does not submit quality reporting data in accordance with the LTCHQR Program for that year. MACs will receive more information under separate cover. Provider Specific File (PSF) The PSF-required fields for all provider types which require a PSF can be found in Pub. 100-04, Medicare Claims Processing Manual, Chapter 3, §20.2.3.1 and Addendum A. Update the Inpatient PSF for each hospital as needed, and update all applicable fields for LTCHs effective October 1, 2014, or effective with cost reporting periods that begin on or after October 1, 2014, or upon receipt of an as-filed (tentatively) settled cost report. Table 8c contains the FY 2015 Statewide average LTCH total cost-to-charge ratios (CCRs) for urban and rural hospitals used for calculating short-stay and high cost outlier payments. Table 8c is available on the Internet at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/LTCHPPS-Regulations-and-Notices.html. Per the regulations in 42


http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/LTCHPPS-Regulations-and-Notices.html

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/LTCHPPS-Regulations-and-Notices.html

CFR sections 412.525(a)(4)(iv)(C) and 412.529(f)(4)(iii), for FY 2015, Statewide average CCRs are used in the following instances: 1. New hospitals that have not yet submitted their first Medicare cost report. (For this purpose, a new hospital is defined as an entity that has not accepted assignment of an existing hospital’ s provider agreement in accordance with 42 CFR section 489.18). 2. LTCHS with a total CCR is in excess of 1.346 (referred to as the total CCR ceiling). 3. Any hospital for which data to calculate a CCR is not available. NOTE: Hospitals, FIs and Medicare contractors can request an alternative CCR to the statewide average CCR per the instructions in section 150.24 of chapter 3 of Pub. 100-04, Medicare Claims Processing Manual. Cost of Living Adjustment (COLA) Update for LTCH PPS There are no changes to the COLAs for FY 2015, and are the same COLAs For reference, a table showing the applicable COLAs that will continue to be effective for discharges occurring on or after October 1, 2014, can be found in the FY 2015 IPPS/LTCH PPS final rule and is also shown in Table 2 in Attachment 3, “FY 2015 Tables”. Core-Based Statistical Area (CBSA)-based Labor Market Area Updates CMS is updating the Core-Based Statistical Area (CBSA)-based labor market area definitions (and associated CBSA codes) used under the LTCH PPS for FY 2015. These revisions to the LTCH PPS geographic classifications is based on the most recent metropolitan statistical area delineations issued by the Office of Management and Budget (OMB) using 2010 Census data. MACs shall update the Actual Geographic Location Core-Based Statistical Area field in the PSF (data element 35) effective October 1, 2014 to reflect the new CBSA delineations. Use the County to CBSA Crosswalk file posted on the web at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/LTCHPPS-Regulations-and-Notices-Items/LTCH-PPS-CMS-1607-F.html?DLPage=1&DLSort=3&DLSortDir=descending (see the Downloads section of this page). (Note, even though some CBSAs comprise the same constituent counties as under the previous labor market delineations, their 5-digit code may have been revised under the new delineations). In order to mitigate potential negative payment impacts due to the adoption of the new OMB delineations, CMS adopted a one-year transition for LTCHs that would experience a decrease in their wage index exclusively due to the implementation of the new OMB delineations. Under this transition policy, for discharges occurring in FY 2015, affected LTCHs will get a “ 50/50 blended area wage index” value that is calculated as the sum of 50 percent of the wage index computed under the FY 2014 CBSA designations (from Tables 12C and 12D, as applicable, of the FY 2015 IPPS/LTCH PPS final rule) and 50 percent of the wage index computed under the new OMB delineations for FY 2015 (from Tables 12A and 12B, as applicable, of the FY 2015 IPPS/LTCH PPS final rule). To implement the “50/50 blended area wage index” value under the transition policy for FY 2015, MACs shall refer to Attachment 10 titled “LTCH PPS Special Wage Index Table – FY 2015” for the LTCHs identified as receiving the blend wage index. For these LTCHs, MACs shall enter a ‘1’ in the Special Payment Indicator in the PSF (data element 33) and enter the wage index value as listed in that attachment in the Special Wage Index field in the PSF (data element 38) with an effective date of October 1, 2014. All other LTCHs will receive the applicable wage index from Table 12A or 12B of the FY 2015 IPPS/LTCH PPS final rule based on the updated CBSA field in the PSF (data element 35). In addition, under the short-stay outlier policy at § 412.529, for LTCHs that would experience a decrease in their “ IPPS comparable” wage index exclusively due to the implementation of the new OMB delineations, under this transition policy, for discharges occurring in FY 2015, affected LTCHs will get a “ 50/50 blended ‘ IPPS comparable’ wage index” value that is calculated as the sum of 50 percent of the “ IPPS comparable” wage index computed under the FY 2014 CBSA designations and 50 percent of the “ IPPS comparable” wage index computed under the new OMB delineations for FY 2015. The LTCH

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/LongTermCareHospitalPPS/LTCHPPS-Regulations-and-Notices-Items/LTCH-PPS-CMS-1607-F.html?DLPage=1&DLSort=3&DLSortDir=descending



PPS Pricer includes a table of the blended “IPPS comparable” wage index” values for affected LTCHs. For new LTCHs that open on or after March 31, 2014 and before October 1, 2014, contact [email protected] for instructions on determining whether or not a blended wage index under the transition policy is applicable. Additional LTCH PPS Policy Changes for FY 2015 The statutory moratoria on the full implementation of the “ 25 percent threshold” payment adjustment originally put in place by the MMSEA of 2007 has been extended until the start of LTCH cost reporting periods beginning on either July or October, 2014, as applicable as provided by the Pathway for SGR Reform Act. The new extension generally maintained the same policies that have been in place, except that “grandfathered” LTCH hospitals-within-hospitals (HwH) are totally exempt from the application of the 25 percent threshold. For additional details, refer to the discussion in the FY 2015 IPPS/LTCH PPS final rule. The FY 2015 IPPS/LTCH final rule also included the removal of the “5 percent” policy adjustment. Therefore, the policy specified at 42 CFR 412.532, Special Payment Provisions for Patients Who are Transferred to Onsite Providers and Readmitted to an LTCH, is no longer in effect. II. BUSINESS REQUIREMENTS TABLE "Shall" denotes a mandatory requirement, and "should" denotes an optional requirement. Number Requirement Responsibility A/B

MAC DME

MAC

Shared-System

Maintainers

Other

A B HHH

FISS

MCS

VMS

CWF

8900.1 FISS shall install and pay claims with the FY 2015 IPPS Pricer for discharges on or after October 1, 2014.

X

8900.2 FISS shall install and pay claims with the FY 2015 LTCH Pricer for discharges on or after October 1, 2014.

X

8900.3 FISS shall install and edit claims with the MCE version 32.0 and Grouper version 32.0 software with the implementation of the FY 2015 October quarterly release.

X

8900.4 FISS shall establish yearly recurring hours to allow for updates to the list of ICD-9-CM diagnosis codes that are exempt from reporting Present on Admission (POA). NOTE: There are no changes to the list of ICD-9-CM diagnosis codes exempt from reporting POA.

X

8900.5 Medicare contractors shall inform the QIO of any new hospital that has opened for hospital quality purposes.

X

8900.6 Medicare contractors shall update ALL relevant X

Number Requirement Responsibility A/B

MAC DME

MAC

Shared-System

Maintainers

Other

A B HHH

FISS

MCS

VMS

CWF

portions of the PSF in accordance with this CR by October 8, 2014.

8900.6.1 Medicare contractors shall update the PSF for CBSA and special wage index changes per the policy sections of this CR.

X

8900.7 Medicare contractors shall notify CMS Central Office - Baltimore, CM/HAPG/DAC, Michele Hudson and Maria Navarro, of the IPPS hospitals that qualify as a low-volume hospital and the effective date of the determination for discharges occurring in FY 2015 by November 07, 2014. Contractors shall also notify CMS Central Office - Baltimore, CM/HAPG/DAC, Michele Hudson and Maria Navarro of IPPS hospitals qualified as low-volume hospitals after September 1, 2014, within 15 days of the determination.

X

8900.7.1 Medicare contractors shall remove the 'Y' low-volume indicator in the PSF (position 74 - temporary relief indicator) for providers who no longer qualify as a low volume provider.

X

8900.8 Medicare contractors shall be aware of any manual updates included within this CR. NOTE: There are no manual updates for FY15 in this CR.

X

8900.9 The CWF shall update edit and IUR 7272 for the post acute DRGs listed in Table 5 of the IPPS Final Rule.

X

III. PROVIDER EDUCATION TABLE Number Requirement Responsibility

A/B

MAC DME

MAC

CEDI A B H

HH

8900.10 MLN Article: A provider education article related to this instruction will be available at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/ shortly after the CR is

X

Number Requirement Responsibility

A/B MAC

DME

MAC

CEDI A B H

HH

released. You will receive notification of the article release via the established "MLN Matters" listserv. Contractors shall post this article, or a direct link to this article, on their Web sites and include information about it in a listserv message within one week of the availability of the provider education article. In addition, the provider education article shall be included in the contractor’s next regularly scheduled bulletin. Contractors are free to supplement MLN Matters articles with localized information that would benefit their provider community in billing and administering the Medicare program correctly.

IV. SUPPORTING INFORMATION Section A: Recommendations and supporting information associated with listed requirements: N/A "Should" denotes a recommendation. X-Ref Requirement Number

Recommendations or other supporting information:

Section B: All other recommendations and supporting information: N/A V. CONTACTS Pre-Implementation Contact(s): Cami DiGiacomo, [email protected], Sarah Shirey-Losso, [email protected] Post-Implementation Contact(s): Contact your Contracting Officer’s Representative (COR) VI. FUNDING Section A: For Medicare Administrative Contractors (MACs): The Medicare Administrative Contractor is hereby advised that this constitutes technical direction as defined in your contract. CMS does not construe this as a change to the MAC Statement of Work. The contractor is not obligated to incur costs in excess of the amounts allotted in your contract unless and until specifically authorized by the Contracting Officer. If the contractor considers anything provided, as described above, to be outside the current scope of work, the contractor shall withhold performance on the part(s) in question and immediately notify the Contracting Officer, in writing or by e-mail, and request formal directions regarding continued performance requirements. ATTACHMENTS: 10

Attachment 1 - EHR Provider List Subject to Incentive Payment Reduction

CCN MAC ID MAC Name NPI010025 10025 10001 MAC - Jurisdiction 10 1356344915010054 10054 05901 MAC - J5 National 1285904276010126 10126 05901 MAC - J5 National 1770814626030126 30126 03001 MAC - Jurisdiction 3 1669639639040118 40118 05901 MAC - J5 National 1386699353040132 40132 07001 MAC - Jurisdiction 7 1124021811050014 50014 01011 MAC - Jurisdiction E 1447494323050016 50016 01011 MAC - Jurisdiction E 1770659336050040 50040 01011 MAC - Jurisdiction E 1134143415050101 50101 01011 MAC - Jurisdiction E 1366686248050108 50108 01011 MAC - Jurisdiction E 1811946734050116 50116 01011 MAC - Jurisdiction E 1417089350050122 50122 01011 MAC - Jurisdiction E 1538163886050129 50129 01011 MAC - Jurisdiction E 1689769911050149 50149 01011 MAC - Jurisdiction E 1114081056050189 50189 01011 MAC - Jurisdiction E 1114917564050191 50191 01011 MAC - Jurisdiction E 1194840421050245 50245 01011 MAC - Jurisdiction E 1720158009050283 50283 01011 MAC - Jurisdiction E 1144389941050290 50290 01011 MAC - Jurisdiction E 1124026273050291 50291 01011 MAC - Jurisdiction E 1740413798050292 50292 01011 MAC - Jurisdiction E 1821159195050309 50309 01011 MAC - Jurisdiction E 1356390264050342 50342 01011 MAC - Jurisdiction E 1073519443050373 50373 01011 MAC - Jurisdiction E 1598773715050376 50376 01011 MAC - Jurisdiction E 1477574838050417 50417 01011 MAC - Jurisdiction E 1457367062050498 50498 01011 MAC - Jurisdiction E 1194774299050531 50531 01011 MAC - Jurisdiction E 1114021250050537 50537 01011 MAC - Jurisdiction E 1770532608050545 50545 01011 MAC - Jurisdiction E 1154372498050546 50546 01011 MAC - Jurisdiction E 1588615835050547 50547 01011 MAC - Jurisdiction E 1851344220050548 50548 01011 MAC - Jurisdiction E 1225089592050552 50552 01011 MAC - Jurisdiction E 1134170566050644 50644 01011 MAC - Jurisdiction E 1639195175050668 50668 01011 MAC - Jurisdiction E 1235172560050697 50697 01011 MAC - Jurisdiction E 1942204490050698 50698 01011 MAC - Jurisdiction E 1790952760050717 50717 01011 MAC - Jurisdiction E 1336154020050727 50727 01011 MAC - Jurisdiction E 1720371065060107 60107 04011 MAC - Jurisdiction 4 1326015777070008 70008 13001 MAC - Jurisdiction K 1932123569070015 70015 13001 MAC - Jurisdiction K 1619938016070038 70038 13001 MAC - Jurisdiction K 1740296508070040 70040 13001 MAC - Jurisdiction K 1740261213


080003 80003 12001 MAC - Jurisdiction 12 1295738896100108 100108 09001 MAC - Jurisdiction 9 1467534917100134 100134 09001 MAC - Jurisdiction 9 1104926401100240 100240 09001 MAC - Jurisdiction 9 1710071097100277 100277 09001 MAC - Jurisdiction 9 1851440218100298 100298 09001 MAC - Jurisdiction 9 1710945118110203 110203 10001 MAC - Jurisdiction 10 1770560294110209 110209 12001 MAC - Jurisdiction 12 1205809571120005 120005 01011 MAC - Jurisdiction E 1780757856130002 130002 02001 MAC - Jurisdiction 2 1932154705130006 130006 02001 MAC - Jurisdiction 2 1770586794130067 130067 02001 MAC - Jurisdiction 2 1851371959140033 140033 05901 MAC - J5 National 1992856819140100 140100 06101 MAC - Jurisdiction 6 - IL150100 150100 08001 MAC - Jurisdiction 8 1427082957150149 150149 08001 MAC - Jurisdiction 8 1114023512150153 150153 08001 MAC - Jurisdiction 8 1982681748150160 150160 08001 MAC - Jurisdiction 8 1508979683150164 150164 08001 MAC - Jurisdiction 8 1831123942150166 150166 08001 MAC - Jurisdiction 8 1801969670150176 150176 08001 MAC - Jurisdiction 8 1760659205160101 160101 05001 MAC - Jurisdiction 5 1467447508170023 170023 05001 MAC - Jurisdiction 5 1659360196170166 170166 05001 MAC - Jurisdiction 5 1770511297170180 170180 05901 MAC - J5 National 1902961857170183 170183 05001 MAC - Jurisdiction 5 1306827878170201 170201 05001 MAC - Jurisdiction 5 1952629370180011 180011 04011 MAC - Jurisdiction 4 1992701429180016 180016 15101 MAC - Jurisdiction 15 - 1689673717180025 180025 04011 MAC - Jurisdiction 4 1871588772180040 180040 15101 MAC - Jurisdiction 15 - 1275539587180064 180064 15101 MAC - Jurisdiction 15 - 1679679146190003 190003 07001 MAC - Jurisdiction 7 1144274127190183 190183 07001 MAC - Jurisdiction 7 1326485749190199 190199 07001 MAC - Jurisdiction 7 1639228174190241 190241 05901 MAC - J5 National 1477509859190255 190255 07001 MAC - Jurisdiction 7 1215996632190300 190300 07001 MAC - Jurisdiction 7 1639323595190302 190302 07001 MAC - Jurisdiction 7 1992720791190307 190307 07001 MAC - Jurisdiction 7 1891126728210038 210038 12001 MAC - Jurisdiction 12 1669565180220154 220154 14011 MAC - Jurisdiction K220171 220171 14011 MAC - Jurisdiction K 1558392563230046 230046 08001 MAC - Jurisdiction 8 1003878539230144 230144 08001 MAC - Jurisdiction 8 1669493664230297 230297 08001 MAC - Jurisdiction 8 1316900277240071 240071 06201 MAC - Jurisdiction 6 - 1194751313


240084 240084 06201 MAC - Jurisdiction 6 - 1083617120250006 250006 10001 MAC - Jurisdiction 10 1780648352250025 250025 05901 MAC - J5 National 1942255724250034 250034 10001 MAC - Jurisdiction 10 1053375576250044 250044 10001 MAC - Jurisdiction 10 1396709978250060 250060 07001 MAC - Jurisdiction 7 1043204555250079 250079 07001 MAC - Jurisdiction 7 1013004795250100 250100 10001 MAC - Jurisdiction 10 1609830173250141 250141 10001 MAC - Jurisdiction 10 1194789818250151 250151 07001 MAC - Jurisdiction 7 1831184951250152 250152 07001 MAC - Jurisdiction 7250162 250162 07001 MAC - Jurisdiction 7 1588629968250163 250163 07001 MAC - Jurisdiction 7 1811181407260057 260057 05001 MAC - Jurisdiction 5 1811905375260207 260207 05901 MAC - J5 National 1114924768260227 260227 05001 MAC - Jurisdiction 5 1548546138280003 280003 05001 MAC - Jurisdiction 5 1528006103280009 280009 05001 MAC - Jurisdiction 5 1336184019280020 280020 04011 MAC - Jurisdiction 4 1336155738280023 280023 05001 MAC - Jurisdiction 5 1982675955280030 280030 04011 MAC - Jurisdiction 4 1811242969280133 280133 05001 MAC - Jurisdiction 5 1649595448290007 290007 01011 MAC - Jurisdiction E 1548393127290009 290009 01011 MAC - Jurisdiction E 1801152566290042 290042 12001 MAC - Jurisdiction 12310003 310003 12001 MAC - Jurisdiction 12 1093736001310006 310006 12001 MAC - Jurisdiction 12 1699748996320011 320011 04011 MAC - Jurisdiction 4 1154307593320038 320038 04011 MAC - Jurisdiction 4 1720084999320084 320084 04011 MAC - Jurisdiction 4 1073517058320086 320086 04011 MAC - Jurisdiction 4 1972878361320087 320087 04011 MAC - Jurisdiction 4 1427112473320089 320089 04011 MAC - Jurisdiction 4330043 330043 13001 MAC - Jurisdiction K 1457369381330108 330108 13001 MAC - Jurisdiction K 1295731123330119 330119 13001 MAC - Jurisdiction K 1477616571330135 330135 13001 MAC - Jurisdiction K 1659360709330141 330141 13001 MAC - Jurisdiction K 1053354100330151 330151 13001 MAC - Jurisdiction K 1013985399330158 330158 13001 MAC - Jurisdiction K 1346213469330181 330181 13001 MAC - Jurisdiction K 1295743060330205 330205 13001 MAC - Jurisdiction K 1598755324330246 330246 13001 MAC - Jurisdiction K 1164481529330265 330265 13001 MAC - Jurisdiction K 1366505463330332 330332 13001 MAC - Jurisdiction K 1013998426330387 330387 13001 MAC - Jurisdiction K330403 330403 13001 MAC - Jurisdiction K 1083788939


330405 330405 13001 MAC - Jurisdiction K 1063525442330408 330408 13001 MAC - Jurisdiction K 1225226962330409 330409 13001 MAC - Jurisdiction K 1013234723340014 340014 11501 MAC - Jurisdiction 11 - 1447200233340015 340015 11501 MAC - Jurisdiction 11 - 1508843566340036 340036 05901 MAC - J5 National 1801866140340085 340085 11501 MAC - Jurisdiction 11 - 1801848767340096 340096 11501 MAC - Jurisdiction 11 - 1417958331340148 340148 11501 MAC - Jurisdiction 11 - 1538111828340153 340153 11501 MAC - Jurisdiction 11 - 1629029954340158 340158 11501 MAC - Jurisdiction 11 - 1710915756340168 340168 11501 MAC - Jurisdiction 11 - 350015 350015 03001 MAC - Jurisdiction 3 1538245634360131 360131 15201 MAC - Jurisdiction 15 - 1942385794360172 360172 15201 MAC - Jurisdiction 15 - 1245274950360234 360234 15201 MAC - Jurisdiction 15 - 1912007931360241 360241 15201 MAC - Jurisdiction 15 - 1598863086360245 360245 15201 MAC - Jurisdiction 15 - 1790761922360247 360247 15201 MAC - Jurisdiction 15 - 1720011828360261 360261 15201 MAC - Jurisdiction 15 - 1124083878360270 360270 15201 MAC - Jurisdiction 15 - 1629011234360271 360271 15201 MAC - Jurisdiction 15 - 1043383417360347 360347 15201 MAC - Jurisdiction 15 - 1164627733360352 360352 15201 MAC - Jurisdiction 15 - 1740398890370190 370190 04011 MAC - Jurisdiction 4370192 370192 04011 MAC - Jurisdiction 4370199 370199 04011 MAC - Jurisdiction 4 1639170699370203 370203 04011 MAC - Jurisdiction 4370214 370214 04011 MAC - Jurisdiction 4370216 370216 04011 MAC - Jurisdiction 4 1033185293370220 370220 04011 MAC - Jurisdiction 4 1851344188370222 370222 04011 MAC - Jurisdiction 4 1932145505370233 370233 04011 MAC - Jurisdiction 4 1386800019380005 380005 02001 MAC - Jurisdiction 2 1386644029380090 380090 02001 MAC - Jurisdiction 2 1225016561390025 390025 12001 MAC - Jurisdiction 12390027 390027 12001 MAC - Jurisdiction 12390096 390096 04011 MAC - Jurisdiction 4 1699734665390266 390266 12001 MAC - Jurisdiction 12 1023000296390267 390267 12001 MAC - Jurisdiction 12 1679592380390272 390272 12001 MAC - Jurisdiction 12 1528026671390302 390302 12001 MAC - Jurisdiction 12390304 390304 12001 MAC - Jurisdiction 12 1083986129390312 390312 12001 MAC - Jurisdiction 12420043 420043 05901 MAC - J5 National 1508800186430089 430089 03001 MAC - Jurisdiction 3430096 430096 03001 MAC - Jurisdiction 3 1487644035


440016 440016 10001 MAC - Jurisdiction 10 1710941356440091 440091 10001 MAC - Jurisdiction 10 1255428736440130 440130 10001 MAC - Jurisdiction 10 1114981768440131 440131 10001 MAC - Jurisdiction 10 1316901937440147 440147 10001 MAC - Jurisdiction 10 1194779520440162 440162 10001 MAC - Jurisdiction 10 1871552539450085 450085 04011 MAC - Jurisdiction 4 1881691061450090 450090 04011 MAC - Jurisdiction 4 1922009331450099 450099 04011 MAC - Jurisdiction 4 1386902138450123 450123 04011 MAC - Jurisdiction 4 1336476845450296 450296 05901 MAC - J5 National 1043281330450446 450446 04011 MAC - Jurisdiction 4 1689639254450565 450565 04011 MAC - Jurisdiction 4 1972590602450605 450605 04011 MAC - Jurisdiction 4 1245315647450674 450674 04011 MAC - Jurisdiction 4 1023065794450770 450770 04011 MAC - Jurisdiction 4 1063450534450796 450796 12001 MAC - Jurisdiction 12 1003842212450825 450825 04011 MAC - Jurisdiction 4450831 450831 04011 MAC - Jurisdiction 4 1891718789450834 450834 04011 MAC - Jurisdiction 4450841 450841 04011 MAC - Jurisdiction 4 1346239753450865 450865 04011 MAC - Jurisdiction 4 1750499273450872 450872 04011 MAC - Jurisdiction 4450875 450875 04011 MAC - Jurisdiction 4 1912948845450891 450891 04011 MAC - Jurisdiction 4 1316933609490045 490045 11301 MAC - Jurisdiction 11 - 1417005760490089 490089 11301 MAC - Jurisdiction 11 - 1710970918490104 490104 11301 MAC - Jurisdiction 11 - 490129 490129 11301 MAC - Jurisdiction 11 - 1912018078490134 490134 11301 MAC - Jurisdiction 11 - 490135 490135 11301 MAC - Jurisdiction 11 - 500011 500011 02001 MAC - Jurisdiction 2 1558333682500015 500015 12001 MAC - Jurisdiction 12 1255327201500052 500052 02001 MAC - Jurisdiction 2 1861522088500148 500148 02001 MAC - Jurisdiction 2 1295071520510024 510024 11401 MAC - Jurisdiction 11 - 1659489631520113 520113 06001 MAC - Jurisdiction 6 - 1043397177520194 520194 06001 MAC - Jurisdiction 6 - 1669584983520195 520195 06001 MAC - Jurisdiction 6 - 1952461824670002 670002 04011 MAC - Jurisdiction 4 1093956070670010 670010 04011 MAC - Jurisdiction 4 1881641058670021 670021 04011 MAC - Jurisdiction 4 1801805395670045 670045 04011 MAC - Jurisdiction 4 1235299132670046 670046 04011 MAC - Jurisdiction 4 1568656502670058 670058 04011 MAC - Jurisdiction 4 1164665899670062 670062 04011 MAC - Jurisdiction 4 1407010622670066 670066 04011 MAC - Jurisdiction 4 1871739714


670069 670069 04011 MAC - Jurisdiction 4 1952538431670072 670072 04011 MAC - Jurisdiction 4 1689869216670073 670073 04011 MAC - Jurisdiction 4 1023338142670078 670078 04011 MAC - Jurisdiction 4 1669752234


LBNChattahoochee Valley Hospital Society HH HEALTH SYSTEM - MORGAN, INC.THE TROY HOSPITAL HEALTH CARE AUTHORITYApache Junction Hospital, LLCBAPTIST MEMORIAL HOSPITAL-JONESBORO INC

Sutter Health Sacramento Sierra RegionDIGNITY HEALTHCOUNTY OF LOS ANGELES AUDITOR CONTROLLERSutter Health Sacramento Sierra RegionSutter Health Sacramento Sierra Region

DAMERON HOSPITAL ASSOCIATIONDIGNITY HEALTH

Southern Monterey County Memorial Hospital

COUNTY OF SAN BERNARDINOThe Hospital Committee for the Livermore-Pleasanton Areas

Sutter West Bay HospitalsCOUNTY OF RIVERSIDESutter Health Sacramento Sierra RegionPioneers Memorial Healthcare DistrictCOUNTY OF LOS ANGELES AUDITOR CONTROLLERCOUNTY OF LOS ANGELES AUDITOR CONTROLLERSutter Coast HospitalSutter Health Sacramento Sierra RegionJupiter Bellflower Doctors HospitalSutter Health Sacramento Sierra Region

LOS ANGELES DOCTORS CORP

COUNTY OF LOS ANGELES AUDITOR CONTROLLERLONG BEACH MEMORIAL MEDICAL

Hebrew Home and Hospital, Inc


St. Francis Hospital,Inc.

BAKER COUNTY MEDICAL SERVICES, INCAnne Bates Leach Eye Hospital

Wesley Woods Center of Emory University, Inc

Hilo Medical CenterST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTDST LUKE'S REGIONAL MEDICAL CENTERMountain River Birthing and Surgery Center LLCWAUKEGAN ILLINOIS HOSPITAL COMPANY LLC

ST MARYS MEDICAL CENTER OF EVANSVILLE INC

St. Vincent Heart Center of Indiana, LLC

Monroe Hospital, LLC

Broadlawns Medical CenterSt. Catherine HospitalMorton County Hospital

KANSAS SURGERY & RECOVERY CENTER LLC

SAINT JOSEPH HEALTH SYSTEM INCJewish Hospital & St. Marys HealthCare IncFLAGET HEALTHCARE INCJewish Hospital & St. Marys HealthCare IncSAINT JOSEPH HEALTH SYSTEM INCDauterive Hospital CorporationSOUTHERN REGIONAL MEDICAL CORPORATIONVILLA FELICIANA MEDICAL COMPLEX

Maryland General Hospital

REGENTS OF THE UNIVERSITY OF MICHIGAN

Barbara Ann Karmanos Cancer HospitalRice County District One Hospital


ESSENTIA HEALTH VIRGINIA LLCBaptist Memorial Hospital Union County, Inc.AMORY HMA INCBAPTIST MEMORIAL HOSPITAL NORTH MISSISSIPPI, INCBaptist Memorial Hospital-Booneville, Inc.Jefferson County HospitalSharkey-Issaquena Community HospitalBaptist Memorial Hospital-Golden Triangle, IncBAPTIST MEMORIAL HOSPITAL-DESOTO, INC.

Hancock Medical Center

CAMERON REGIONAL MEDICAL CENTER INCSGOH ACQUISITION INC

Bryan Medical CenterGOOD SAMARITAN HOSPITALSaint Elizabeth Regional Medical CenterSaint Francis Medical CenterCASA ACQUISITION LLCNebraska Spine Hospital LLCUniversity Medical Center of Southern NevadaPRIME HEALTHCARE SERVICES RENO LLC

Palisades Medical CenterST MARYS HOSPITALPRESBYTERIAN HEALTHCARE SERVICESREHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICESRoosevelt County Special Hospital DistrictLOVELACE HEALTH SYSTEMS INC

Southside HospitalSt. Joseph's HospitalLENOX HILL HOSPITALBon Secours Community HospitalBROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER

Good Samaritan HospitalNSHS @ Glen Cove Rehabilitation UnitST. ANTHONY'S COMMUNITY HOSPITALSt. Charles HospitalClifton Springs Sanitarium Company


UNIVERSITY HOSPITAL OF BROOKLYN

BURDETT CARE CENTER, INC.FORSYTH MEMORIAL HOSPITAL., INCROWAN REGIONAL MEDICAL CENTER, INC.Louisburg Novant LLCCommunity General Health Partners, Inc.Lexington Memorial Hospital IncMedical Park Hospital, Inc.PRESBYTERIAN ORTHOPAEDIC HOSPITAL LLCBRUNSWICK COMMUNITY HOSPITAL LLC

SANFORD BISMARCKAlliance Community HospitalCOMMUNITY HEALTH PARTNERS REGIONAL MEDICAL CENTERMERCY HOSPITALS WEST

Mercy Health - Defiance Hospital LLC

Tulsa Spine & Specialty Hospital

MCBRIDE CLINIC ORTHOPEDIC HOSPITAL, LLC

Bay Area Hospital District

ST JOSEPH REGIONAL HEALTH NETWORKGROVE CITY MEDICAL CENTERWEST PENN ALLEGHENY HEALTH SYSTEM, INC.Valley Forge Medical Center & Hospital, Inc.

Prime Healthcare Services Roxborough LLC

Gaffney HMA LLC

LEWIS & CLARK SPECIALTY HOSPITAL LLC


BAPTIST MEMORIAL HOSPITAL-HUNTINGDONMemorial Health Care System Inc.BAPTIST MEMORIAL HOSPICE-UNION CITYBaptist Memorial Hospital-TiptonBaptist Memorial Regional Rehabilation Service, Inc

GRAHAM REGIONAL MEDICAL CENTERGainesville Hospital DistrictPrime Healthcare Services Pampa LLC

Cleveland Regional Medical Center LPRiverside General HospitalPalo Pinto County Hospital District

CHCA WOMANS HOSPITAL LPCAMERON HOSPITAL INC

Brownsville Doctors Hospital LLCSETON FAMILY OF HOSPITALS

Prince William HospitalCARILION FRANKLIN MEMORIAL HOSPITAL

HIGHLINE MEDICAL CENTERMULTICARE HEALTH SYSTEMGroup Health CooperativeWENATCHEE VALLEY HOSPITALMONONGALIA COUNTY GENERAL HOSPITAL COBay Area Medical Center Inc

Columbia Center, Inc.

COOK CHILDRENS NORTHEAST HOSPITAL


WESTBURY COMMUNITY HOSPITAL, LLC


STAR - Name StateGeorge Lanier Memorial Hospital Alabama

AlabamaAlabamaArizonaArkansas

Levi Hospital ArkansasSutter Amador Hospital CaliforniaArroyo Grande Community Hospital CaliforniaLAC Olive View - UCLA Med Center CaliforniaSutter Solano Medical Center CaliforniaSutter General Hospital CaliforniaNorthridge Hospital - Roscoe Campus California

CaliforniaSt. Bernadine Medical Center CaliforniaCalifornia Hospital Med Center CaliforniaMee Memorial Hospital CaliforniaSt. Mary Medical Center CaliforniaArrowhead Regional MC CaliforniaValleyCare Health System CaliforniaSt. Johns Hospital - Santa Monica CaliforniaSutter Medical Center Santa Rosa California

CaliforniaSutter Roseville Medical Center California

CaliforniaLAC USC Medical Center CaliforniaLAC Harbor UCLA Med Ctr California

CaliforniaSutter Auburn Faith Hospital California

CaliforniaSutter Davis Hospital CaliforniaLanterman State Hospital CaliforniaPorterville State Hospital CaliforniaSonoma State Hospital CaliforniaFairview State Hospital CaliforniaMotion Picture and Television Fund Hospital CaliforniaLos Angeles Metropolitan Med Center CaliforniaLaguna Honda Hospital CaliforniaPatient's Hospital of Redding CaliforniaSan Diego Hospice Acute Care Center CaliforniaLAC Rancho Los Amigos California

CaliforniaNational Jewish Health ColoradoJohnson Memorial Hospital ConnecticutNew Milford Hospital ConnecticutThe Connecticut Hospice Connecticut

Connecticut


DelawareTrinity Community Hospital FloridaEd Fraser Memorial Hospital Florida

FloridaDouglas Gardens Hospital FloridaFlorida State Hospital Florida

GeorgiaTurning Point Care Center Georgia

HawaiiIdahoIdahoIdahoIllinois

Midwestern Regional Medical Center IllinoisIndiana

Deaconess Womens Hospital of Southern IN IndianaIndiana

Indiana Orthopaedic Hospital IndianaIndiana

Pinnacle Hospital IndianaKentuckiana Medical Center Indiana

IowaKansasKansas

Meadowbrook Rehab Hospital KansasKansas

Blue Valley Hospital KansasKentucky

Jewish Hospital Shelbyville KentuckyKentucky

Jewish Hospital KentuckyKentuckyLouisianaLouisianaLouisiana

Physicians Medical Center LouisianaPark Place Surgical Hospital LouisianaSt Charles Surgical Hospital LouisianaOmega Hospital LouisianaSouth Cameron Memorial Hospital Louisiana

MarylandThe Soldier's Home MassachuseLahey Clinic Hospital Massachuse

MichiganForest Health Medical Center Michigan

MichiganMinnesota


MinnesotaMississippi

Gilmore Regional Medical Center MississippiMississippiMississippiMississippiMississippiMississippiMississippi

Alliance Health Center MississippiMississippi Mthodist Hospital Mississippi

MississippiGuardian Angel Healthcare Mississippi

MissouriOzarks Community Hospital MissouriBlack River Community Medical Center Missouri

NebraskaNebraskaNebraskaNebraska

Alegent Creighton Health NebraskaNebraskaNevadaNevada

THI of Nevada at Las Vegas NevadaPalisades General Hospital New Jersey

New JerseyEspanola Hospital New

New New

LOVELACE REGIONAL HOSPITAL - ROSWELL New Physicians Medical Center of Santa Fe, New UNM Sandoval Regional Medical Center New

New YorkNew YorkNew YorkNew YorkNew York

St. James Mercy Hospital New YorkNew York

Glen Cove Hospital New YorkNew YorkNew YorkNew York

WSNCHS North, Inc New YorkRockefeller University Hospital New YorkMonroe Community Hospital New York


Helen Hayes Hospital New YorkTri-Town Regional Healthcare New York

New YorkNorth North

Novant Health Franklin Medical Center North Thomasville Medical Center North

North North North

Brunswick Novant Medical Center North Wilmington Treatment Center, North

North Ohio

Mercy Regional Medical Center OhioMercy Franciscan Hospital - Mt. Airy OhioEdwin Shaw Rehab OhioGlenbeigh Health Sources OhioParkside Behavioral Healthcare Acquisitions OhioThree Gables Surgery Center Ohio

OhioUCPHA, Inc OhioMedical Center of Newark OhioThe Surgery Center at Southwoods OhioSOUTHWESTERN REGIONAL MEDICAL CENTER OklahomaNorthwest Surgical Hospital OklahomaLakeside Womens Center of Oklahoma City OklahomaCommunity Hospital OklahomaLINDSAY MUNICIPAL HOSPITAL Oklahoma

OklahomaOrthopedic Hospital Oklahoma

OklahomaPinnacle Specialty Hospital OklahomaASHLAND COMMUNITY HEALTHCARE SERVICES Oregon

OregonKensington Hospital PennsylvaniTemple University Hospital Pennsylvani

PennsylvaniPennsylvani

Forbes Regional Hospital PennsylvaniPennsylvani

Bariatric Care Centers of Pennsylvania PennsylvaniRoxborough Memorial Hospital PennsylvaniCancer Treatment Centers of America PennsylvaniNovant Health Gaffney Medical Center South Siouxland Surgery Center Hospital South

South


TennesseeMEMORIAL HOSPITAL/MEMORIAL NORTH PARK Tennessee

TennesseeTennesseeTennessee

HealthSouth Chattanooga Rehabilitation Hosp TennesseeTexas

North Texas Medical Center TexasPampa Regional Medical Center TexasRenaissance Hospital Groves Texas

TexasTexas

Palo Pinto General TexasCARE REGIONAL MEDICAL CENTER Texas

TexasCentral Texas Hospital TexasNorthwest Surgical Hospital LLC TexasCornerstone Regional Hospital TexasVista Community Medical Center LLC TexasThe Physicians Centre TexasBrownsville Surgical Hospital TexasSeton Southwest Healthcare Center TexasUSMD Surgical Hospital of Arlington TexasQuail Creek Surgical Hospital TexasTexas Hlth Ctr - Diagnostics & Surgery Plano Texas

VirginiaVirginia

HIRAM DAVIS MEDICAL CENTER VirginiaCapital Hospice VirginiaPIEDMONT GERIATRIC HOSPITAL VirginiaCATAWBA HOSPITAL Virginia

WashingtonMULTICARE AUBURN MEDICAL CENTER Washington

WashingtonWashingtonWest Wisconsin

Orthopaedic Hospital of Wisconsin WisconsinWisconsin

South Hampton Community Hospital TexasMayhill Hospital TexasInnova Hospital San Antonio, LP Texas

TexasUSMD Hospital of Ft. Worth TexasEmerus Hospital TexasEmerus Hospital TexasBasin Healthcare Center, LLC Texas


Methodist McKinney Hospital TexasTexas

Methodist Hospital for Surgery TexasBAPTIST EMERGENCY HOSPITAL Texas

Attachment 2 Special Wage Index

Provider Number

Name

Post Reclass CBSA Under New

Delineations

National FY 2015 Wage Index

Eligible for

National Blended

Wage Index

Hospital Reclassified Under New

CBSA Delineations (N -provider

did not reclassify; W -

provider reclassified

for wage index ; L provider

reclassified under

1886(d)(8)(B) of the SSA; S-

provider redesignated as rural under

Sec. 401 of BIPA)

Section 505

Eligible

Section 401

Hospital

Three Year Hold Harmless

010007 MIZELL MEMORIAL HOSPITAL 01 0.6874 x N010008 CRENSHAW COMMUNITY HOSPITAL 01 0.6973 x N x010012 DEKALB REGIONAL MEDICAL CENTER 01 0.7091 x N x010021 DALE MEDICAL CENTER 01 0.7015 x N x010027 ELBA GENERAL HOSPITAL 01 0.6945 x N x010032 WEDOWEE HOSPITAL 01 0.7238 x N x010036 ANDALUSIA REGIONAL HOSPITAL 01 0.6874 x N010038 STRINGFELLOW MEMORIAL HOSPITAL 11500 0.7393 N x010045 FAYETTE MEDICAL CENTER 46220 0.8061 x W010047 GEORGIANA MEDICAL CENTER 01 0.6946 x N x010049 MEDICAL CENTER ENTERPRISE 01 0.6945 x N x010051 GREENE COUNTY HOSPITAL 01 0.9537 N x x010052 LAKE MARTIN COMMUNITY HOSPITAL 01 0.6999 x N x


010054DECATUR MORGAN HOSPITAL-PARKWAY CAMPUS 19460 0.7112 x N x

010066 FLORALA MEMORIAL HOSPITAL 01 0.6874 x N010069 MEDICAL CENTER BARBOUR 01 0.6874 x N010073 CLAY COUNTY HOSPITAL 01 0.6874 x N

010078 NORTHEAST ALABAMA REGIONAL MED CENTER 11500 0.7393 N x

010085 DECATUR MORGAN HOSPITAL-DECATUR CAMPUS 19460 0.7112 x N x010086 NORTHWEST MEDICAL CENTER 01 0.6874 x N010091 GROVE HILL MEMORIAL HOSPITAL 01 0.6929 x N x010092 D C H REGIONAL MEDICAL CENTER 46220 0.8574 x N010095 HALE COUNTY HOSPITAL 46220 0.8574 x N010099 D W MCMILLAN MEMORIAL HOSPITAL 01 0.6874 x N010102 J PAUL JONES HOSPITAL 01 0.6874 x N010110 BULLOCK COUNTY HOSPITAL 01 0.6996 x N x010112 BRYAN W WHITFIELD MEM HOSP INC 01 0.6874 x N

010118VAUGHAN REGIONAL MEDICAL CENTER PARKWAY CAMPUS 46220 0.8061 x W

010120 MONROE COUNTY HOSPITAL 01 0.6874 x N010125 LAKELAND COMMUNITY HOSPITAL 01 0.7317 x N x010126 TROY REGIONAL MEDICAL CENTER 01 0.6874 x N010128 JACKSON MEDICAL CENTER 01 0.6929 x N x010129 NORTH BALDWIN INFIRMARY 19300 0.7385 N x010138 HILL HOSPITAL OF SUMTER COUNTY 01 0.704 x N x010146 JACKSONVILLE MEDICAL CENTER 11500 0.7393 N x010148 EVERGREEN MEDICAL CENTER 01 0.6874 x N010158 RUSSELLVILLE HOSPITAL 25 0.7553 x W010169 ATMORE COMMUNITY HOSPITAL 01 0.6874 x N040019 FORREST CITY MEDICAL CENTER 04 0.7623 N x040047 FIVE RIVERS MEDICAL CENTER 04 0.7471 N x040067 MAGNOLIA HOSPITAL 04 0.7427 N x050013 ST HELENA HOSPITAL 34900 1.5887 N x


050016MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE 42020 1.2964 N x

050133 RIDEOUT MEMORIAL HOSPITAL 49700 1.3204 N x050232 FRENCH HOSPITAL MEDICAL CENTER 42020 1.2964 N x050444 MERCY MEDICAL CENTER 32900 1.3279 N x050506 SIERRA VISTA REGIONAL MEDICAL CENTER 42020 1.2964 N x050633 TWIN CITIES COMMUNITY HOSPITAL 42020 1.2964 N x050773 SAN LEANDRO HOSPITAL 36084 1.6501 N x060030 MCKEE MEDICAL CENTER 22660 0.9454 N x060119 MEDICAL CENTER OF THE ROCKIES 22660 0.9454 N x070002 ST FRANCIS HOSPITAL & MEDICAL CENTER 25540 1.1837 x N070003 DAY KIMBALL HOSPITAL 49340 1.1991 x N070004 SHARON HOSPITAL 07 1.1837 x S YES070005 WATERBURY HOSPITAL 07 1.1837 x S YES070008 JOHNSON MEMORIAL HOSPITAL 25540 1.1837 x N070011 CHARLOTTE HUNGERFORD HOSPITAL 35300 1.2257 x L070012 ROCKVILLE GENERAL HOSPITAL 25540 1.1837 x N070016 SAINT MARYS HOSPITAL 35300 1.2257 x N070017 MIDSTATE MEDICAL CENTER 35300 1.2257 x N070019 MILFORD HOSPITAL, INC 35300 1.2257 x N070020 MIDDLESEX HOSPITAL 35300 1.2257 x W

070021 WINDHAM COMM MEM HOSP & HATCH HOSP 49340 1.1991 x N070024 WILLIAM W BACKUS HOSPITAL 35980 1.2093 x N070025 HARTFORD HOSPITAL 25540 1.1837 x N070027 MANCHESTER MEMORIAL HOSPITAL 25540 1.1837 x N070029 BRISTOL HOSPITAL 25540 1.1837 x N070031 GRIFFIN HOSPITAL 35300 1.2257 x N070035 HOSPITAL OF CENTRAL CONNECTICUT, THE 25540 1.1837 x N070036 JOHN DEMPSEY HOSPITAL 35300 1.2257 x W070038 CONNECTICUT HOSPICE INC,THE 35300 1.2257 x N070039 MASONIC HOME AND HOSPITAL 35300 1.2257 x N070040 HEBREW HOME AND HOSPITAL INC 25540 1.1837 x N080001 CHRISTIANA CARE HEALTH SERVICES, INC. 48864 1.0552 N x


080003 ST FRANCIS HOSPITAL 48864 1.0552 N x080006 NANTICOKE MEMORIAL HOSPITAL 20100 1.0211 x W

080009 BAYHEALTH - MILFORD MEMORIAL HOSPITAL 41540 0.9787 x N090001 GEORGE WASHINGTON UNIV HOSPITAL 47894 1.0178 x N090003 HOWARD UNIVERSITY HOSPITAL 47894 1.0178 x N

090004 MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL 47894 1.0178 x N090005 SIBLEY MEMORIAL HOSPITAL 47894 1.0178 x N090006 PROVIDENCE HOSPITAL 47894 1.0178 x N090008 UNITED MEDICAL CENTER 47894 1.0178 x N090011 MEDSTAR WASHINGTON HOSPITAL CENTER 47894 1.0178 x N110100 JEFFERSON HOSPITAL 11 0.8156 N x

110101COOK MEDICAL CENTER A CAMPUS OF TIFT REG MED CTR 11 0.7529 N x

110142 EVANS MEMORIAL HOSPITAL 11 0.7716 N x110190 FLINT RIVER HOSPITAL 47580 0.7873 x W110205 NORTH GEORGIA MEDICAL CENTER 11 0.8002 N x120005 HILO MEDICAL CENTER 12 1.0627 x N120014 WILCOX MEMORIAL HOSPITAL 12 1.0627 x N120019 KONA COMMUNITY HOSPITAL 12 1.0627 x N120028 NORTH HAWAII COMMUNITY HOSPITAL 12 1.0627 x N130066 NORTHWEST SPECIALTY HOSPITAL 17660 0.9499 N x130067 IDAHO DOCTORS HOSPITAL 13 0.9111 N x140001 GRAHAM HOSPITAL ASSOCIATION 14 0.834 N x140012 KATHERINE SHAW BETHEA HOSPITAL 20994 1.0084 x W140026 ST MARYS HOSPITAL 14 0.8569 N x140029 COPLEY MEMORIAL HOSPITAL 20994 1.0217 x N x140030 SHERMAN HOSPITAL 20994 1.0217 x N x140167 IROQUOIS MEMORIAL HOSPITAL 14 0.8743 N x140174 PRESENCE MERCY MEDICAL CENTER 20994 1.0217 x N x140211 DELNOR COMMUNITY HOSPITAL 20994 1.0217 x N x140217 PRESENCE SAINT JOSEPH HOSPITAL - ELGIN 20994 1.0217 x N x140234 ILLINOIS VALLEY COMMUNITY HOSPITAL 14 0.8569 N x


140286 KISHWAUKEE COMMUNITY HOSPITAL 20994 1.0179 x N

150006INDIANA UNIVERSITY HEALTH LA PORTE HOSPITAL 33140 0.9337 N x

150011 MARION GENERAL HOSPITAL 26900 0.9863 x W

150015FRANCISCAN ST ANTHONY HEALTH - MICHIGAN CITY 33140 0.9337 N x

150022FRANCISCAN ST ELIZABETH HEALTH - CRAWFORDSVILLE 15 0.865 N x

150023 UNION HOSPITAL INC 26900 0.9863 x W150030 HENRY COUNTY MEMORIAL HOSPITAL 26900 0.9863 x L

150051INDIANA UNIVERSITY HEALTH BLOOMINGTON HOSPITAL 26900 0.9863 x W

150072 MEMORIAL HOSPITAL 15 0.8373 N x

150088 ST VINCENT ANDERSON REGIONAL HOSPITAL INC 26900 1.0128 x N x

150113COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY 26900 1.0128 x N x

160013 TRINITY MUSCATINE 16 0.8548 N x170013 HAYS MEDICAL CENTER 28 0.8676 x W170074 GEARY COMMUNITY HOSPITAL 17 0.9537 N x x170150 SOUTH CENTRAL KS MED CENTER 17 0.7878 N x180002 WHITESBURG ARH HOSPITAL 49 0.7744 x W180009 KING'S DAUGHTERS' MEDICAL CENTER 26580 0.8693 x N

180020MIDDLESBORO APPALACHIAN REGIONAL HEALTHCARE HOSPIT 49 0.7744 x W

180036 OUR LADY OF BELLEFONTE HOSPITAL 26580 0.8693 x N

180050HARLAN APPALACHIAN REGIONAL HEALTHCARE HOSPITAL 49 0.7744 x W

180064 SAINT JOSEPH MOUNT STERLING 18 0.7989 N x180066 LOGAN MEMORIAL HOSPITAL 18 0.8246 N x180079 HARRISON MEMORIAL HOSPITAL 18 0.7942 N x

190001WASHINGTON ST TAMMANY REGIONAL MEDICAL CENTER 19 0.7487 x N

190002 LAFAYETTE GENERAL MEDICAL CENTER 29180 0.7808 x N


190003 DAUTERIVE HOSPITAL 29180 0.7809 N x190004 THIBODAUX REGIONAL MEDICAL CENTER 26380 0.7546 x N190006 UNIVERSITY HOSPITAL & CLINICS 29180 0.7808 x N190007 NATCHITOCHES REGIONAL MEDICAL CENTER 19 0.7487 x N190013 WEST CALCASIEU CAMERON HOSPITAL 29340 0.7603 x N190014 TECHE REGIONAL MEDICAL CENTER 29180 0.7702 x W190017 OPELOUSAS GENERAL HEALTH SYSTEM 29180 0.7702 x L190025 SAVOY MEDICAL CENTER 19 0.7487 x N190034 ABBEVILLE GENERAL HOSPITAL 29180 0.7864 N x190041 CHRISTUS HEALTH SHREVEPORT - BOSSIER 43340 0.8291 x N190044 AMERICAN LEGION HOSPITAL 29180 0.7902 N x190050 BEAUREGARD MEMORIAL HOSPITAL 19 0.7509 x N x190053 JENNINGS AMERICAN LEGION HOSPITAL 29340 0.7603 x L

190054 IBERIA GENERAL HOSPITAL AND MEDICAL CENTER 29180 0.7809 N x190060 LAKE CHARLES MEMORIAL HOSPITAL 19 0.7487 x S YES190081 WEST CARROLL MEMORIAL HOSPITAL 19 0.7487 x N190088 SPRINGHILL MEDICAL CENTER 43340 0.8501 N x190090 WINN PARISH MEDICAL CENTER 19 0.7487 x N190098 BRF HOSPITAL HOLDINGS LLC 43340 0.8291 x N190099 AVOYELLES HOSPITAL 19 0.7565 x N x

190102OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC 29180 0.7808 x N

190106 OAKDALE COMMUNITY HOSPITAL 19 0.7532 x N x190111 WILLIS KNIGHTON MEDICAL CENTER 43340 0.8291 x N190114 HOMER MEMORIAL HOSPITAL 19 0.7648 x N x190116 MOREHOUSE GENERAL HOSPITAL 19 0.7537 x N x190118 DESOTO REGIONAL HEALTH SYSTEM 43340 0.8291 x N190133 ALLEN PARISH HOSPITAL 19 0.7532 x N x190140 FRANKLIN MEDICAL CENTER 19 0.7507 x N x190144 MINDEN MEDICAL CENTER 43340 0.8512 x N x190145 LASALLE GENERAL HOSPITAL 19 0.7524 x N x190151 RICHARDSON MEDICAL CENTER 19 0.7487 x N190161 W O MOSS REGIONAL MEDICAL CENTER 29340 0.7603 x N


190183 LEONARD J CHABERT MEDICAL CENTER 26380 0.7546 x N190184 CITIZENS MEDICAL CENTER 19 0.7607 x N x190190 CALDWELL MEMORIAL HOSPITAL 19 0.7607 x N x190201 LAKE AREA MEDICAL CENTER 29340 0.7603 x N

190205 THE REGIONAL MEDICAL CENTER OF ACADIANA 29180 0.7808 x N190208 EAST CARROLL PARISH HOSPITAL 19 0.7487 x N190218 SABINE MEDICAL CENTER 19 0.7487 x N190236 WILLIS KNIGHTON BOSSIER HEALTH CENTER 43340 0.8291 x N190241 PHYSICIANS MEDICAL CENTER 26380 0.7546 x N190257 GREEN CLINIC SURGICAL HOSPITAL 19 0.7523 x N x190259 LAFAYETTE SURGICAL SPECIALTY HOSPITAL 29180 0.7808 x N190263 HEART HOSPITAL OF LAFAYETTE 29180 0.7808 x N190268 LAFAYETTE GENERAL SURGICAL HOSPITAL 29180 0.7808 x N190278 SPECIALISTS HOSPITAL SHREVEPORT 43340 0.8291 x N190297 DOCTORS HOSPITAL AT DEER CREEK LLC 19 0.7487 x N190303 CYPRESS POINTE SURGICAL HOSPITAL 25220 0.9526 N x190304 IBERIA REHABILITATION HOSPITAL 29180 0.7809 N x190307 SOUTH CAMERON MEMORIAL HOSPITAL 29340 0.7603 x N210001 MERITUS MEDICAL CENTER 25180 0.9175 N x210003 PRINCE GEORGES HOSPITAL CENTER 47894 1.0178 x N210023 ANNE ARUNDEL MEDICAL CENTER 12580 0.9819 N x210028 MEDSTAR SAINT MARY'S HOSPITAL 15680 0.893 N x

210035UNIVERSITY OF MD CHARLES REGIONAL MEDICAL CENTER 47894 1.0178 x N

210039 CALVERT MEMORIAL HOSPITAL 47894 1.0178 x N

210043UNIVERITY OF MD BALTO WASHINGTON MEDICAL CENTER 12580 0.9819 N x

210048 HOWARD COUNTY GENERAL HOSPITAL 12580 0.9848 N x210051 DOCTORS' COMMUNITY HOSPITAL 47894 1.0178 x N210054 SOUTHERN MARYLAND HOSPITAL CENTER 47894 1.0178 x N210055 LAUREL REGIONAL MEDICAL CENTER 47894 1.0178 x N210060 FORT WASHINGTON HOSPITAL 47894 1.0178 x N210061 ATLANTIC GENERAL HOSPITAL 41540 0.9397 N x


210062MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER 47894 1.0178 x N

230035SPECTRUM HEALTH UNITED MEMORIAL - UNITED CAMPUS 24340 0.9013 N x

230075 BRONSON BATTLE CREEK HOSPITAL 12980 0.9906 N x230093 SPECTRUM HEALTH BIG RAPIDS HOSPITAL 23 0.8302 N x230208 CARSON CITY HOSPITAL 24340 0.9013 N x240044 WINONA HEALTH SERVICES 24 1.02 N x240064 GRAND ITASCA CLINIC AND HOSPITAL 24 0.9285 N x240093 MAYO CLINIC HEALTH SYSTEM - MANKATO 33460 1.0887 x W240101 ESSENTIA HEALTH ST MARYS 24 0.925 N x240117 MAYO CLINIC HEALTH SYSTEM - AUSTIN 24 1.0036 N x

240141 FAIRVIEW NORTHLAND REGIONAL HOSPITAL 33460 1.1038 N x250002 TISHOMINGO HEALTH SERVICES INC 44 0.7553 x W

250006 BAPTIST MEMORIAL HOSPITAL UNION COUNTY 25 0.7553 x N250007 BILOXI REGIONAL MEDICAL CENTER 25060 0.7886 x N250009 MAGNOLIA REGIONAL HEALTH CENTER 27180 0.7555 x W250010 TIPPAH COUNTY HOSPITAL 25 0.7553 x N250015 GRENADA LAKE MEDICAL CENTER 25 0.7553 x N250017 TRACE REGIONAL HOSP AND SWING BED 25 0.7553 x N250018 JASPER GENERAL HOSPITAL 25 0.7553 x N250019 MEMORIAL HOSPITAL AT GULFPORT 25060 0.7886 x N250020 WEBSTER GENERAL HOSPITAL/SWING BED 25 0.7553 x N

250025GILMORE MEMORIAL REGIONAL MEDICAL CENTER 25 0.7553 x N

250027 WINSTON MEDICAL CENTER & SWINGBED 25 0.7553 x N250036 GEORGE COUNTY HOSPITAL 25 0.7779 N x x250040 SINGING RIVER HOSPITAL 25060 0.8021 N x250043 NESHOBA COUNTY GENERAL HOSPITAL 25 0.7553 x N250044 BAPTIST MEMORIAL HOSPITAL BOONEVILLE 25 0.7553 x N250049 BEACHAM MEMORIAL HOSPITAL 25 0.7553 x N250050 OCH REGIONAL MEDICAL CENTER 25 0.7553 x N


250051 KILMICHAEL HOSPITAL 25 0.7553 x N

250057KING'S DAUGHTERS MEDICAL CENTER-BROOKHAVEN 25 0.7553 x N

250058 SOUTH CENTRAL REG MED CTR 25 0.7553 x N250059 MONTFORT JONES MEMORIAL HOSPITAL 25 0.7553 x N250061 YALOBUSHA GENERAL HOSPITAL 25 0.7553 x N250067 CLAY COUNTY MEDICAL CENTER 25 0.7553 x N250069 RUSH FOUNDATION HOSPITAL 46220 0.8061 x W250077 WAYNE GENERAL HOSPITAL 25 0.7553 x N

250079 SHARKEY ISSAQUENA COMMUNITY HOSPITAL 25 0.7553 x N250081 ANDERSON RMC SOUTH 25 0.7553 x N250084 NATCHEZ REGIONAL MEDICAL CENTER 25 0.7553 x N250085 MARION GENERAL HOSPITAL 25 0.7553 x N250095 SOUTH SUNFLOWER COUNTY HOSPITAL 25 0.7553 x N250100 BAPTIST MEM HOSP/GOLDEN TRIANGLE INC 46220 0.8061 x W250104 ANDERSON REGIONAL MEDICAL CTR 25 0.7553 x N250117 HIGHLAND COMMUNITY HOSPITAL 25 0.8177 x N x250122 NATCHEZ COMMUNITY HOSPITAL 25 0.7553 x N250123 GARDEN PARK MEDICAL CENTER 25060 0.7886 x N250128 TRI LAKES MEDICAL CENTER 25 0.7959 x N x250151 ALLIANCE HEALTH CENTER 25 0.7553 x N250162 HANCOCK MEDICAL CENTER 25060 0.7915 x N x260059 MERCY HOSPITAL LEBANON 26 0.8055 N x260116 MINERAL AREA REGIONAL MEDICAL CENTER 26 0.8113 N x

260160SOUTHEASTHEALTH CENTER OF STODDARD COUNTY 26 0.8155 N x

260163 PARKLAND HEALTH CENTER 26 0.8113 N x280032 MARY LANNING HEALTHCARE 28 0.8793 x N280077 FREMONT HEALTH MEDICAL CENTER 28 0.8895 x N x280111 COLUMBUS COMMUNITY HOSPITAL 28 0.8793 x N280125 FAITH REGIONAL HEALTH SERVICES 43580 0.8793 x W300011 ST JOSEPH HOSPITAL 31700 1.1396 N x300012 ELLIOT HOSPITAL 31700 1.1396 N x


300017 PARKLAND MEDICAL CENTER 40484 1.1852 N x300019 CHESHIRE MEDICAL CENTER 15764 1.1147 x W300020 SOUTHERN NH MEDICAL CENTER 31700 1.1396 N x300023 EXETER HOSPITAL INC 40484 1.1852 N x300029 PORTSMOUTH REGIONAL HOSPITAL 40484 1.1852 N x300034 CATHOLIC MEDICAL CENTER 31700 1.1396 N x310001 HACKENSACK UNIVERSITY MEDICAL CENTER 35614 1.2973 x N310002 NEWARK BETH ISRAEL MEDICAL CENTER 35614 1.2821 x W310003 PALISADES MEDICAL CENTER 35614 1.2973 x N310005 HUNTERDON MEDICAL CENTER 35084 1.1132 x N310006 ST MARY'S HOSPITAL, PASSAIC 35614 1.2973 x N310008 HOLY NAME MEDICAL CENTER 35614 1.2973 x N310009 CLARA MAASS MEDICAL CENTER 35614 1.2821 x W

310010UNIV MEDICAL CENTER OF PRINCETON AT PLAINSBORO 35614 1.3075 N x

310011 CAPE REGIONAL MEDICAL CENTER INC 36140 1.1119 x N310012 VALLEY HOSPITAL 35614 1.2973 x N310014 COOPER UNIVERSITY HOSPITAL 37964 1.1127 x W310015 MORRISTOWN MEDICAL CENTER 35614 1.2821 x W310016 CAREPOINT HEALTH-CHRIST HOSPITAL 35614 1.2973 x N310017 CHILTON MEDICAL CENTER 35614 1.2821 x W310019 ST JOSEPH'S REGIONAL MEDICAL CENTER 35614 1.2973 x N310021 ST FRANCIS MEDICAL CENTER 45940 1.1346 x N x310022 VIRTUA WEST JERSEY HOSPITALS BERLIN 15804 1.1145 x N x

310024ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY 35084 1.1132 x N

310025 CAREPOINT HEALTH - BAYONNE MEDICAL CENTER 35614 1.2973 x N310027 TRINITAS REGIONAL MEDICAL CENTER 35084 1.1132 x N310028 NEWTON MEMORIAL HOSPITAL 35084 1.1132 x N310029 OUR LADY OF LOURDES MEDICAL CENTER 15804 1.1145 x N x

310038 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL 35614 1.3075 N x310039 RARITAN BAY MEDICAL CENTER 35614 1.3075 N x


310040 CAREPOINT HEALTH-HOBOKEN UMC 35614 1.2973 x N

310044 CAPITAL HEALTH MEDICAL CENTER - HOPEWELL 45940 1.1346 x N x

310045 ENGLEWOOD HOSPITAL AND MEDICAL CENTER 35614 1.2973 x N

310048ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL SOMERSET 35084 1.1119 x N

310050 SAINT CLARE'S HOSPITAL 35614 1.2821 x W310051 OVERLOOK MEDICAL CENTER 35084 1.1132 x N310054 HACKENSACK-UMC MOUNTAINSIDE 35614 1.2821 x W

310057VIRTUA MEMORIAL HOSPITAL OF BURLINGTON COUNTY 15804 1.1119 x N

310058 BERGEN REGIONAL MEDICAL CENTER 35614 1.2973 x N310060 ST LUKE'S WARREN HOSPITAL 10900 1.1119 x N

310061LOURDES MEDICAL CENTER OF BURLINGTON COUNTY 15804 1.1119 x N

310069 INSPIRA MEDICAL CENTER ELMER 48864 1.1119 x N310070 SAINT PETER'S UNIVERSITY HOSPITAL 35614 1.3075 N x310074 JERSEY CITY MEDICAL CENTER 35614 1.2973 x N310076 SAINT BARNABAS MEDICAL CENTER 35614 1.2821 x W310081 INSPIRA MEDICAL CENTER WOODBURY 15804 1.1119 x N310083 EAST ORANGE GENERAL HOSPITAL 35614 1.2821 x W

310086KENNEDY UNIVERSITY HOSPITAL - STRATFORD DIV 15804 1.1145 x N x

310091 MEMORIAL HOSPITAL OF SALEM COUNTY 48864 1.1119 x N310092 CAPITAL HEALTH SYSTEM-FULD CAMPUS 45940 1.1346 x N x310096 SAINT MICHAEL'S MEDICAL CENTER, INC 35614 1.2821 x W

310108JFK MEDICAL CTR - ANTHONY M. YELENCSICS COMMUNITY 35614 1.3075 N x

310110ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL HAMILTON 45940 1.1346 x N x

310115 HACKETTSTOWN REGIONAL MEDICAL CENTER 10900 1.1119 x N


310118 MEADOWLANDS HOSPITAL MEDICAL CENTER 35614 1.2973 x N310119 UNIVERSITY HOSPITAL 35614 1.2821 x W310130 35614 1.2973 x N

330004HEALTH ALLIANCE HOSPITAL BROADWAY CAMPUS 28740 1.0017 N x

330006 ST JOSEPH'S MEDICAL CENTER 35614 1.2973 x N330008 WYOMING COUNTY COMMUNITY HOSPITAL 33 1.0035 N x x330009 BRONX-LEBANON HOSPITAL CENTER 35614 1.2973 x N330014 JAMAICA HOSPITAL MEDICAL CENTER 35614 1.2973 x N

330019NEW YORK COMMUNITY HOSPITAL OF BROOKLYN, INC. 35614 1.2973 x N

330024 MOUNT SINAI HOSPITAL 35614 1.2973 x N330028 RICHMOND UNIVERSITY MEDICAL CENTER 35614 1.2973 x N330033 CHENANGO MEMORIAL HOSPITAL, INC 33 0.8434 x N x330046 ST LUKE'S ROOSEVELT HOSPITAL 35614 1.2973 x N330047 ST MARY'S HOSPITAL AT AMSTERDAM 33 0.8289 x N x

330055NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS 35614 1.2973 x N

330056BROOKLYN HOSPITAL CENTER AT DOWNTOWN CAMPUS 35614 1.2973 x N

330059 MONTEFIORE MEDICAL CENTER 35614 1.2973 x N330061 LAWRENCE HOSPITAL CENTER 35614 1.2973 x N330064 NEW YORK DOWNTOWN HOSPITAL 35614 1.2973 x N

330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER 35614 1.2973 x N330084 ALICE HYDE MEDICAL CENTER 33 0.8213 x N330086 MONTEFIORE MOUNT VERNON HOSPITAL 35614 1.2973 x N330094 COLUMBIA MEMORIAL HOSPITAL 07 1.0792 x W330096 JONES MEMORIAL HOSPITAL 33 0.8213 x N330100 NY EYE AND EAR INFIRMARY 35614 1.2973 x N330101 NEW YORK-PRESBYTERIAN HOSPITAL 35614 1.2973 x N330103 OLEAN GENERAL HOSPITAL 39 0.842 x W330104 NYACK HOSPITAL 35614 1.2973 x N


330108 ST JOSEPH'S HOSPITAL, INC 33 0.8213 x S YES330119 LENOX HILL HOSPITAL 35614 1.2973 x N330126 ORANGE REGIONAL MEDICAL CENTER 35614 1.3307 N x330127 JACOBI MEDICAL CENTER 35614 1.2973 x N330128 ELMHURST HOSPITAL CENTER 35614 1.2973 x N330132 TLC HEALTH NETWORK 33 0.8401 x N x330135 BON SECOURS COMMUNITY HOSPITAL 35614 1.3307 N x330144 IRA DAVENPORT MEMORIAL HOSPITAL, INC 33 0.8295 x N x330151 ST JAMES MERCY HOSPITAL 33 0.8295 x N x330158 GOOD SAMARITAN HOSPITAL OF SUFFERN 35614 1.2973 x N330160 STATEN ISLAND UNIVERSITY HOSPITAL 35614 1.2973 x N330162 NORTHERN WESTCHESTER HOSPITAL 35614 1.2973 x N330166 WESTFIELD MEMORIAL HOSPITAL, INC 33 0.8213 x N330169 BETH ISRAEL MEDICAL CENTER 35614 1.2973 x N330184 MONTEFIORE NEW ROCHELLE HOSPITAL 35614 1.2973 x N330191 GLENS FALLS HOSPITAL 24020 0.8561 N x330193 FLUSHING HOSPITAL MEDICAL CENTER 35614 1.2973 x N330194 MAIMONIDES MEDICAL CENTER 35614 1.2973 x N330195 LONG ISLAND JEWISH MEDICAL CENTER 35614 1.2973 x N330196 CONEY ISLAND HOSPITAL 35614 1.2973 x N330197 CANTON-POTSDAM HOSPITAL 33 0.8213 x N330199 METROPOLITAN HOSPITAL CENTER 35614 1.2973 x N330201 KINGSBROOK JEWISH MEDICAL CENTER 35614 1.2973 x N330202 KINGS COUNTY HOSPITAL CENTER 35614 1.2973 x N330204 BELLEVUE HOSPITAL CENTER 35614 1.2973 x N330205 ST ANTHONY COMMUNITY HOSPITAL 35614 1.3307 N x330208 ST JOHN'S RIVERSIDE HOSPITAL 35614 1.2973 x N330211 CLAXTON-HEPBURN MEDICAL CENTER 33 0.8213 x N330214 NYU HOSPITALS CENTER 35614 1.2973 x N330221 WYCKOFF HEIGHTS MEDICAL CENTER 35614 1.2973 x N330223 MASSENA MEMORIAL HOSPITAL 33 0.8213 x N

330224HEALTH ALLIANCE HOSPITAL MARY'S AVENUE CAMPUS 20524 1.1252 x W

330225 LONG BEACH MEDICAL CENTER 35004 1.2859 N x


330229 BROOKS MEMORIAL HOSPITAL 33 0.8213 x N330231 QUEENS HOSPITAL CENTER 35614 1.2973 x N330233 BROOKDALE HOSPITAL MEDICAL CENTER 35614 1.2973 x N330235 AUBURN COMMUNITY HOSPITAL 33 0.8213 x S YES330236 NEW YORK METHODIST HOSPITAL 35614 1.2973 x N330239 WOMAN'S CHRISTIAN ASSOCIATION 33 0.8213 x N330240 HARLEM HOSPITAL CENTER 35614 1.2973 x N330261 PHELPS MEMORIAL HOSPITAL ASSN 35614 1.2973 x N330264 ST LUKE'S CORNWALL HOSPITAL 35614 1.3307 N x330267 HUDSON VALLEY HOSPITAL CENTER 35614 1.2973 x N330268 COBLESKILL REGIONAL HOSPITAL 33 0.8213 x S YES330270 HOSPITAL FOR SPECIAL SURGERY 35614 1.2973 x N330276 NATHAN LITTAUER HOSPITAL 33 0.8254 x N x330277 CORNING HOSPITAL 27060 0.8975 x W330304 WHITE PLAINS HOSPITAL CENTER 35614 1.2973 x N330306 LUTHERAN MEDICAL CENTER 35614 1.2973 x N

330316NEW YORK WESTCHESTER SQUARE MEDICAL CENTER 35614 1.2973 x N

330350UNIVERSITY HOSPITAL OF BROOKLYN ( DOWNSTATE ) 35614 1.2973 x N

330353 FOREST HILLS HOSPITAL 35614 1.2973 x N330385 NORTH CENTRAL BRONX HOSPITAL 35614 1.2973 x N330386 CATSKILL REGIONAL MEDICAL CENTER 33 1.3576 N x x

330395 ST JOHN'S EPISCOPAL HOSPITAL AT SOUTH SHORE 35614 1.2973 x N

330396WOODHULL MEDICAL AND MENTAL HEALTH CENTER 35614 1.2973 x N

330397 INTERFAITH MEDICAL CENTER 35614 1.2973 x N330399 ST BARNABAS HOSPITAL 35614 1.2973 x N

330404WINIFRED MASTERSON BURKE REHABILITATION HOSPITAL 35614 1.2973 x N

330405 HELEN HAYES HOSPITAL 35614 1.2973 x N340001 CAROLINAS MEDICAL CENTER-NORTHEAST 16740 0.8937 x N340003 NORTHERN HOSPITAL OF SURRY COUNTY 34 0.7931 x N


340010 WAYNE MEMORIAL HOSPITAL 34 0.7931 x S YES340011 SPRUCE PINE COMMUNITY HOSPITAL 34 0.7931 x N

340014 NOVANT HEALTH FORSYTH MEDICAL CENTER 49180 0.8669 x N340016 MEDWEST HARRIS 34 0.7931 x N340024 SAMPSON REGIONAL MEDICAL CENTER 34 0.8023 x N x340032 CAROMONT REGIONAL MEDICAL CENTER 16740 0.8937 x N340037 KINGS MOUNTAIN HOSPITAL INC 34 0.8132 x N x340039 IREDELL MEMORIAL HOSPITAL INC 16740 0.8995 N x340047 NORTH CAROLINA BAPTIST HOSPITAL 49180 0.8669 x N

340053NOVANT HEALTH PRESBYTERIAN MEDICAL CENTER 16740 0.8937 x N

340064 WILKES REGIONAL MEDICAL CENTER 34 0.7931 x N340069 WAKEMED, RALEIGH CAMPUS 39580 0.9013 N x340084 ANSON COMMUNITY HOSPITAL 34 0.9174 N x x

340085NOVANT HEALTH THOMASVILLE MEDICAL CENTER 49180 0.8808 N x

340087 THE MCDOWELL HOSPITAL 34 0.7931 x N340096 LEXINGTON MEMORIAL HOSPITAL INC 49180 0.8808 N x340098 CAROLINAS MEDICAL CENTER-PINEVILLE 16740 0.8937 x N340099 VIDANT ROANOKE CHOWAN HOSPITAL 34 0.7931 x N340106 SANDHILLS REGIONAL MEDICAL CENTER 34 0.7931 x N

340113 CAROLINAS MEDICAL CENTER/BEHAV HEALTH 16740 0.8937 x N340114 REX HOSPITAL 39580 0.9013 N x340116 FRYE REGIONAL MEDICAL CENTER 25860 0.8444 N x340119 STANLY REGIONAL MEDICAL CENTER 16740 0.8937 x N340120 VIDANT DUPLIN HOSPITAL 34 0.7931 x N340129 LAKE NORMAN REGIONAL MEDICAL CENTER 16740 0.8995 N x340130 CAROLINAS MEDICAL CENTER-UNION 16740 0.8937 x N340132 MARIA PARHAM MEDICAL CENTER 34 0.7931 x N340133 MARTIN GENERAL HOSPITAL 34 0.8476 x N x340142 CARTERET GENERAL HOSPITAL 34 0.8037 x N x340143 CATAWBA VALLEY MEDICAL CENTER 25860 0.8444 N x


340144 DAVIS REGIONAL MEDICAL CENTER 16740 0.8995 N x340145 CAROLINAS MEDICAL CENTER-LINCOLN 16740 0.9302 N x340148 NOVANT HEALTH PARK HOSPITAL 49180 0.8669 x N340151 HALIFAX REGIONAL MEDICAL CENTER INC 34 0.8014 x N x

340153NOVANT HEALTH CHARLOTTE ORTHOPEDIC HOSPITAL 16740 0.8937 x N

340158 NOVANT HEALTH BRUNSWICK MEDICAL CENTER 34820 0.8587 x N340160 MURPHY MEDICAL CENTER INC 34 0.7931 x N340166 CAROLINAS MED CTR-UNIVERSITY 16740 0.8937 x N340171 PRESBYTERIAN HOSPITAL MATTHEWS 16740 0.8937 x N340173 WAKEMED, CARY HOSPITAL 39580 0.9013 N x

340183NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER 16740 0.8937 x N

340186 VIDANT BEAUFORT HOSPITAL 34 0.843 x N x360002 SAMARITAN REGIONAL HEALTH SYSTEM 36 0.8419 N x360040 KNOX COMMUNITY HOSPITAL 36 0.8718 N x360044 WAYNE HOSPITAL 36 0.8475 N x360070 MERCY MEDICAL CENTER 15940 0.8375 N x360071 VAN WERT COUNTY HOSPITAL 36 0.8417 N x360084 AULTMAN HOSPITAL 15940 0.8375 N x360107 BELLEVUE HOSPITAL 36 0.8464 N x360131 ALLIANCE COMMUNITY HOSPITAL 15940 0.8375 N x360151 AFFINITY MEDICAL CENTER 15940 0.8375 N x360156 MEMORIAL HOSPITAL 36 0.8464 N x360175 CLINTON MEMORIAL HOSPITAL 36 0.8523 N x360261 THREE GABLES SURGERY CENTER 26580 0.8693 x N370015 INTEGRIS MAYES COUNTY MEDICAL CENTER 37 0.8006 N x370023 DUNCAN REGIONAL HOSPITAL, INC 37 0.7871 N x370072 LATIMER COUNTY GENERAL HOSPITAL 37 0.7893 N x

370083 PUSHMATAHA CTY-TN OF ANTLERS HOSP AUTH 37 0.7834 N x370100 CHOCTAW MEMORIAL HOSPITAL 37 0.7841 N x370156 PAULS VALLEY GENERAL HOSPITAL 37 0.7939 N x


370169 EPIC MEDICAL CENTER 37 0.7903 N x370172 CHOCTAW NATION HEALTHCARE 99 1.4521 N x370214 LINDSAY MUNICIPAL HOSPITAL 37 0.7939 N x380022 SAMARITAN ALBANY GENERAL HOSPITAL 10540 1.1014 x N x380040 ST CHARLES MEDICAL CENTER - REDMOND 38 1.0011 x S YES

380052 ST ALPHONSUS MEDICAL CENTER - ONTARIO, INC 38 1.0011 x N390001 GEISINGER - COMMUNITY MEDICAL CENTER 42540 0.8344 x N390002 UPMC MCKEESPORT 38300 0.8582 x N390008 ELLWOOD CITY HOSPITAL 39 0.8368 x N x390009 SAINT VINCENT HOSPITAL 21500 0.8344 x N390012 LANSDALE HOSPITAL 33874 1.0821 x N x390016 JAMESON MEMORIAL HOSPITAL 38300 0.8523 x L390028 UPMC MERCY 38300 0.8582 x N

390031SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET 39 0.8443 x N x

390032 ALLE KISKI MEDICAL CENTER 38300 0.8582 x N390035 ST LUKE'S QUAKERTOWN HOSPITAL 33874 1.0332 x N390036 HERITAGE VALLEY BEAVER 38300 0.8582 x N390037 HERITAGE VALLEY SEWICKLEY 38300 0.8582 x N390039 SOMERSET HOSPITAL 39 0.8351 x N x390041 UNIONTOWN HOSPITAL 38300 0.8582 x N390042 WASHINGTON HOSPITAL, THE 38300 0.8582 x N

390043 SOLDIERS AND SAILORS MEMORIAL HOSPITAL 39 0.837 x N x390044 READING HOSPITAL 33874 1.0136 x W390046 YORK HOSPITAL 49620 0.9689 x N x390050 ALLEGHENY GENERAL HOSPITAL 38300 0.8582 x N390052 PENN HIGHLANDS CLEARFIELD 39 0.8528 x N x390056 J C BLAIR MEMORIAL HOSPITAL 39 0.8494 x N x390057 GRAND VIEW HOSPITAL 33874 1.0332 x N390061 LANCASTER REGIONAL MEDICAL CENTER 29540 0.9536 N x390063 UPMC HAMOT 21500 0.8344 x N390065 GETTYSBURG HOSPITAL 23900 1.0324 N x


390068HEART OF LANCASTER REGIONAL MEDICAL CENTER 29540 0.9536 N x

390070 LOWER BUCKS HOSPITAL 33874 1.0332 x N390071 LOCK HAVEN HOSPITAL 48700 0.856 x L390076 BRANDYWINE HOSPITAL 33874 1.0555 x N x390084 SUNBURY COMMUNITY HOSPITAL 39 0.899 x N x390086 PENN HIGHLANDS DUBOIS 39 0.8528 x N x390090 WESTERN PENNSYLVANIA HOSPITAL 38300 0.8582 x N390091 UPMC NORTHWEST 38300 0.8523 x W390093 CLARION HOSPITAL 39 0.8344 x N390096 ST JOSEPH MEDICAL CENTER 33874 1.0136 x W

390097HOLY REDEEMER HOSPITAL AND MEDICAL CENTER 33874 1.0821 x N x

390100 LANCASTER GENERAL HOSPITAL 29540 0.9536 N x390101 MEMORIAL HOSPITAL 49620 0.9689 x N x390102 UPMC ST MARGARET 38300 0.8582 x N390104 KANE COMMUNITY HOSPITAL 39 0.8344 x N390107 UPMC PASSAVANT 38300 0.8582 x N390110 CONEMAUGH VALLEY MEMORIAL HOSPITAL 27780 0.877 N x390112 WINDBER HOSPITAL 39 0.8351 x N x390113 MEADVILLE MEDICAL CENTER 36 0.8454 x W

390114MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM 38300 0.8582 x N

390116 MERCY SUBURBAN HOSPITAL 33874 1.0821 x N x390117 UPMC BEDFORD MEMORIAL 39 0.845 x N x390118 BRADFORD REGIONAL MEDICAL CENTER 39 0.8344 x N390119 MOSES TAYLOR HOSPITAL 42540 0.8344 x N390122 TITUSVILLE HOSPITAL 39 0.8344 x N390123 POTTSTOWN MEMORIAL MEDICAL CENTER 33874 1.0821 x N x390125 WAYNE MEMORIAL HOSPITAL 39 0.8344 x N390127 PHOENIXVILLE HOSPITAL 33874 1.0555 x N x390130 MINERS MEDICAL CENTER 39 0.8344 x S YES390138 WAYNESBORO HOSPITAL 47894 1.0178 x W390139 MAIN LINE HOSPITAL BRYN MAWR CAMPUS 33874 1.0821 x N x


390145 EXCELA HEALTH WESTMORELAND HOSPITAL 38300 0.8582 x N390146 WARREN GENERAL HOSPITAL 39 0.8344 x N390147 MONONGAHELA VALLEY HOSPITAL 38300 0.8582 x N390150 SOUTHWEST REGIONAL MEDICAL CENTER 39 0.8366 x N x390153 MAIN LINE HOSPITAL PAOLI 33874 1.0555 x N x390154 PENN HIGHLANDS ELK 39 0.8344 x N390157 OHIO VALLEY GENERAL HOSPITAL 38300 0.8582 x N390160 CANONSBURG GENERAL HOSPITAL 38300 0.8582 x N390162 EASTON HOSPITAL 35084 1.1132 x W390163 ACMH HOSPITAL 38300 0.8582 x N390164 UPMC PRESBYTERIAN SHADYSIDE 38300 0.8582 x N390168 BUTLER MEMORIAL HOSPITAL 38300 0.8582 x N390173 INDIANA REGIONAL MEDICAL CENTER 39 0.8364 x N x390178 UPMC HORIZON 49660 0.8344 x N390179 CHESTER COUNTY HOSPITAL 33874 1.0555 x N x390183 ST LUKE'S MINERS MEMORIAL HOSPITAL 39 0.8344 x S YES390184 HIGHLANDS HOSPITAL 38300 0.8582 x N390192 TYLER MEMORIAL HOSPITAL 42540 0.8344 x N390195 MAIN LINE HOSPITAL LANKENAU 33874 1.0821 x N x390198 MILLCREEK COMMUNITY HOSPITAL 21500 0.8344 x N390199 PUNXSUTAWNEY AREA HOSPITAL 39 0.8344 x N390201 POCONO MEDICAL CENTER 20700 1.0203 N x390203 DOYLESTOWN HOSPITAL 33874 1.0332 x N390211 SHARON REGIONAL HEALTH SYSTEM 39 0.8344 x S YES390217 EXCELA HEALTH FRICK HOSPITAL 38300 0.8582 x N390219 EXCELA HEALTH LATROBE HOSPITAL 38300 0.8582 x N390220 JENNERSVILLE REGIONAL HOSPITAL 33874 1.0555 x N x390225 EPHRATA COMMUNITY HOSPITAL 29540 0.9536 N x390228 ST CLAIR MEMORIAL HOSPITAL 38300 0.8582 x N390231 ABINGTON MEMORIAL HOSPITAL 33874 1.0821 x N x390233 HANOVER HOSPITAL 39 0.8344 x S YES390236 MEMORIAL HOSPITAL, INC TOWANDA 39 0.8409 x N x390237 REGIONAL HOSPITAL OF SCRANTON 42540 0.8344 x N390258 ST MARY MEDICAL CENTER 33874 1.0332 x N


390265 JEFFERSON REGIONAL MEDICAL CENTER 38300 0.8582 x N390266 GROVE CITY MEDICAL CENTER 49660 0.8344 x N390267 FORBES REGIONAL HOSPITAL 38300 0.8582 x N

390272 VALLEY FORGE MEDICAL CENTER AND HOSPITAL 33874 1.0821 x N x390278 EAGLEVILLE HOSPITAL 33874 1.0821 x N x390302 BARIX CLINICS OF PENNSYLVANIA 33874 1.0332 x N390307 EDGEWOOD SURGICAL HOSPITAL 49660 0.8344 x N390316 SURGICAL INSTITUTE OF READING 33874 1.0136 x W390322 BUCKS COUNTY SPECIALTY HOSPITAL 33874 1.0332 x N390323 ADVANCED SURGICAL HOSPITAL 38300 0.8582 x N390324 PHYSICIAN'S CARE SURGICAL HOSPITAL 33874 1.0821 x N x390325 OSS ORTHOPAEDIC HOSPITAL 49620 0.9689 x N x390326 ST LUKE'S HOSPITAL - ANDERSON CAMPUS 10900 0.9431 N x

390327WELLSPAN SURGERY AND REHABILITATION HOSPITAL 49620 0.9689 x N x

390328 UPMC EAST 38300 0.8582 x N390329 EINSTEIN MEDICAL CENTER MONTGOMERY 33874 1.0821 x N x400001 PRESBYTERIAN COMMUNITY HOSP 41980 0.4399 x N400003 HOSPITAL METROPOLITANO DR PILA 38660 0.4105 x N400004 ASOCIACION HOSPITAL DEL MAESTRO, INC 41980 0.4399 x N400005 HIMA SAN PABLO HUMACAO 41980 0.4399 x N400006 DOCTORS' CENTER HOSPITAL SAN JUAN 41980 0.4399 x N400007 RYDER MEMORIAL HOSPITAL INC 41980 0.4399 x N400011 HOSPITAL ORIENTE 41980 0.4399 x N

400012HOSPITAL ONCOLOGICO DR ISAAC GONZALEZ MARTINEZ 41980 0.4399 x N

400013 HOSPITAL MENONITA DE CAYEY 41980 0.4399 x N400015 SAN JUAN MUNICIPAL HOSPITAL 41980 0.4399 x N400016 AUXILIO MUTUO HOSPITAL 41980 0.4399 x N400018 MENNONITE GENERAL HOSPITAL INC 41980 0.4399 x N400019 HOSPITAL PAVIA SANTURCE 41980 0.4399 x N400022 HOSPITAL DAMAS INC 38660 0.4105 x N400032 HOSPITAL HERMANOS MELENDEZ INC 41980 0.4399 x N


400044 SAN LUKE'S MEMORIAL HOSPITAL INC 38660 0.4105 x N400061 HOSPITAL UNIVERSITARIO DE ADULTO 41980 0.4399 x N400087 HOSPITAL DR CAYETANO COLL Y TOSTE 11640 0.4281 x N400098 HOSPITAL SAN FRANCISCO 41980 0.4399 x N400102 DOCTORS CENTER HOSPITAL BAYAMON 41980 0.4399 x N400104 HOSPITAL MENONITA CAGUAS INC 41980 0.4399 x N400105 HOSPITAL UNIVERSITARIO DR RUIZ ARNAU 41980 0.4399 x N400106 METROPOLITAN HOSPITAL 41980 0.4399 x N400109 HIMA SAN PABLO BAYAMON 41980 0.4399 x N400112 HOSPITAL UPR, DR FEDERICO TRILLA 41980 0.4399 x N400113 HOSPITAL SAN CRISTOBAL 38660 0.4105 x N400114 MANATI MEDICAL CENTER DR OTERO LOPEZ 41980 0.4399 x N400115 CENTRO MEDICO WILMA N VAZQUEZ 41980 0.4399 x N400117 HOSPITAL DR SUSONI INC 11640 0.4281 x N400118 DOCTORS' CENTER HOSPITAL, INC 41980 0.4399 x N400120 HIMA SAN PABLO-CAGUAS 41980 0.4399 x N400121 HOSPITAL SAN GERARDO 41980 0.4399 x N400122 PROFESSIONAL HOSPITAL GUAYNABO INC 41980 0.4399 x N400124 CENTRO CARDIOVASCULAR 41980 0.4399 x N400127 ADMIN DE SERVICIOS MEDICOS PUERTO RIC 41980 0.4399 x N400128 HOSPITAL PAVIA HATO REY, INC 41980 0.4399 x N410006 NEWPORT HOSPITAL 39300 1.1461 x N410008 SOUTH COUNTY HOSPITAL INC 39300 1.1461 x N410009 KENT COUNTY MEMORIAL HOSPITAL 39300 1.1461 x N410013 WESTERLY HOSPITAL 39300 1.1461 x N420002 PIEDMONT MEDICAL CENTER 16740 0.8937 x N420011 CANNON MEMORIAL HOSPITAL 24860 0.8961 x N420015 BAPTIST EASLEY HOSPITAL 24860 0.8961 x N420019 CHESTER REGIONAL MEDICAL CENTER 16740 0.9067 N x420023 ST FRANCIS-DOWNTOWN 24860 0.8961 x N420027 ANMED HEALTH 24860 0.9087 N x420033 GHS GREER MEMORIAL HOSPITAL 24860 0.8961 x N420036 SPRINGS MEMORIAL HOSPITAL 16740 0.8957 N x420037 GHS-HILLCREST MEMORIAL HOSPITAL 24860 0.8961 x N


420043 NOVANT HEALTH GAFFNEY MEDICAL CENTER 42 0.8411 N x420062 CHESTERFIELD GENERAL HOSPITAL 42 0.8393 N x420072 HAMPTON REGIONAL MEDICAL CENTER 42 0.8337 N x

420078 GHS GREENVILLE MEMORIAL MEDICAL CENTER 24860 0.8961 x N420098 WACCAMAW COMMUNITY HOSPITAL 42 0.8307 N x420102 GHS PATEWOOD MEMORIAL HOSPITAL 24860 0.8961 x N440003 SUMNER REGIONAL MEDICAL CENTER 34980 0.8919 x N440006 TRISTAR SKYLINE MEDICAL CENTER 34980 0.8919 x N440007 UNITED REGIONAL MEDICAL CENTER 44 0.7554 x N x440009 CUMBERLAND MEDICAL CENTER 44 0.735 x N440010 WAYNE MEDICAL CENTER 44 0.735 x N440011 BLOUNT MEMORIAL HOSPITAL 28940 0.735 x N

440012 WELLMONT BRISTOL REGIONAL MEDICAL CENTER 28700 0.7363 x N x440015 UNIVERSITY OF TN MEMORIAL HOSPITAL 28940 0.735 x N

440016 BAPTIST MEMORIAL HOSPITAL HUNTINGDON 44 0.7368 x N x

440017 WELLMONT HOLSTON VALLEY MEDICAL CENTER 44 0.735 x S YES440029 WILLIAMSON MEDICAL CENTER 34980 0.8919 x N

440030 MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION 34100 0.735 x N440031 ROANE MEDICAL CENTER 28940 0.735 x N

440032WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL 28700 0.735 x N

440033TENNOVA HEALTHCARE-LAFOLLETT MEDICAL CENTER 28940 0.735 x N

440034 METHODIST MEDICAL CENTER OF OAK RIDGE 28940 0.735 x N440035 GATEWAY MEDICAL CENTER 17300 0.7723 N x440039 VANDERBILT UNIVERSITY HOSPITAL 34980 0.8919 x N440040 PERRY COMMUNITY HOSPITAL 44 0.735 x N440046 TRISTAR HORIZON MEDICAL CENTER 34980 0.8919 x N


440047 GIBSON GENERAL HOSPITAL 44 0.7393 x N x440051 MCNAIRY REGIONAL HOSPITAL 44 0.736 x N x440053 SAINT THOMAS RUTHERFORD HOSPITAL 34980 0.8919 x N

440054 STARR REGIONAL MEDICAL CENTER ETOWAH 44 0.735 x N

440056TENNOVA HEALTHCARE-JEFFERSON MEMORIAL HOSPITAL 28940 0.735 x W

440057 CLAIBORNE COUNTY HOSPITAL 44 0.735 x N440060 MILAN GENERAL HOSPITAL 44 0.7393 x N x440061 VOLUNTEER COMMUNITY HOSPITAL 44 0.735 x N440065 NORTHCREST MEDICAL CENTER 34980 0.8919 x N440067 LAKEWAY REGIONAL HOSPITAL 28700 0.735 x W440070 DECATUR COUNTY GENERAL HOSPITAL 44 0.7364 x N x440081 LECONTE MEDICAL CENTER 44 0.735 x N440082 SAINT THOMAS WEST HOSPITAL 34980 0.8919 x N440084 SWEETWATER HOSPITAL ASSOCIATION 44 0.735 x N440102 LINCOLN MEDICAL CENTER 44 0.735 x N440109 HARDIN MEDICAL CENTER 44 0.7359 x N x440110 FORT LOUDOUN MEDICAL CENTER 28940 0.735 x N440111 METRO NASHVILLE GENERAL HOSPITAL 34980 0.8919 x N440115 HUMBOLDT GENERAL HOSPITAL INC 44 0.7393 x N x440120 TENNOVA HEALTHCARE 28940 0.735 x N440125 FORT SANDERS REGIONAL MEDICAL CENTER 28940 0.735 x N440132 HENRY COUNTY MEDICAL CENTER 44 0.735 x N440133 SAINT THOMAS MIDTOWN HOSPITAL 34980 0.8919 x N440137 HERITAGE MEDICAL CENTER 44 0.8037 x N x440141 CUMBERLAND RIVER HOSPITAL 44 0.735 x N

440148STONES RIVER HOSPITAL AND DEKALB COMMUNITY HOSP 44 0.7625 x N x

440150 TRISTAR SUMMIT MEDICAL CENTER 34980 0.8919 x N440151 RIVER PARK HOSPITAL 44 0.735 x N

440153TENNOVA HEALTHCARE-NEWPORT MEDICAL CENTER 44 0.735 x N

440161 TRISTAR CENTENNIAL MEDICAL CENTER 34980 0.8919 x N


440173 PARKWEST MEDICAL CENTER 28940 0.735 x N440176 INDIAN PATH MEDICAL CENTER 28700 0.7363 x N x440180 JELLICO COMMUNITY HOSPITAL 28940 0.735 x N440181 BOLIVAR GENERAL HOSPITAL 44 0.7671 x N x440182 MCKENZIE REGIONAL HOSPITAL 44 0.7368 x N x440193 UNIVERSITY MEDICAL CENTER 34980 0.8919 x N440194 TRISTAR HENDERSONVILLE MEDICAL CENTER 34980 0.8919 x N440197 TRISTAR SOUTHERN HILLS MEDICAL CENTER 34980 0.8919 x N

440200STONES RIVER HOSPITAL & DEKALB COMMUNITY HOSPITAL 34980 0.8919 x N

440218 SAINT THOMAS HOSPITAL FOR SPINAL SURGERY 34980 0.8919 x N440227 TRISTAR STONECREST MEDICAL CENTER 34980 0.8919 x N440231 TRUSTPOINT HOSPITAL 34980 0.8919 x N440232 HOUSTON COUNTY COMMUNITY HOSPITAL 44 0.735 x N450042 PROVIDENCE HEALTH CENTER 47380 0.8173 x N450090 NORTH TEXAS MEDICAL CENTER 45 0.8634 N x450099 PAMPA REGIONAL MEDICAL CENTER 45 0.7949 N x450163 CHRISTUS SPOHN HOSPITAL KLEBERG 45 0.8027 N x

450194 EAST TEXAS MEDICAL CENTER JACKSONVILLE 45 0.8083 N x450210 ETMC CARTHAGE 45 0.8126 N x450236 HOPKINS COUNTY MEMORIAL HOSPITAL 45 0.8343 N x450370 COLUMBUS COMMUNITY HOSPITAL 45 0.8178 N x450389 EAST TEXAS MEDICAL CENTER ATHENS 46340 0.891 x L450451 GLEN ROSE MEDICAL CENTER 23104 0.9834 N x450460 TYLER COUNTY HOSPITAL 45 0.8009 N x450497 BOWIE MEMORIAL HOSPITAL 45 0.8456 N x450539 COVENANT HOSPITAL PLAINVIEW 45 0.8086 N x450565 PALO PINTO GENERAL HOSPITAL 45 0.8378 N x450573 CHRISTUS JASPER MEMORIAL HOSPITAL 45 0.8122 N x450596 LAKE GRANBURY MEDICAL CENTER 23104 1.0048 N x450597 CUERO COMMUNITY HOSPITAL 45 0.8056 N x450615 ATLANTA HOSPITAL AUTHORITY 45 0.7977 N x


450641 NOCONA GENERAL HOSPITAL 45 0.8456 N x450698 LAMB HEALTHCARE CENTER 45 0.8229 N x450755 COVENANT HOSPITAL LEVELLAND 45 0.8585 N x450813 COMMUNITY GENERAL HOSPITAL 45 0.8019 N x450886 SOUTHWEST SURGICAL HOSPITAL 23104 0.9317 N x460001 UTAH VALLEY REGIONAL MEDICAL CENTER 39340 0.9336 N x460013 MOUNTAIN VIEW HOSPITAL 39340 0.9336 N x460017 BRIGHAM CITY COMMUNITY HOSPITAL 36260 0.9379 N x460023 AMERICAN FORK HOSPITAL 39340 0.9336 N x460039 BEAR RIVER VALLEY HOSPITAL 36260 0.9379 N x460043 OREM COMMUNITY HOSPITAL 39340 0.9336 N x460052 TIMPANOGOS REGIONAL HOSPITAL 39340 0.9336 N x460057 PARK CITY MEDICAL CENTER 46 0.9577 N x490001 NORTON COMMUNITY HOSPITAL 49 0.7732 x N490002 RUSSELL COUNTY MEDICAL CENTER 49 0.7732 x N490004 ROCKINGHAM MEMORIAL HOSPITAL 49 0.7732 x S YES490005 WINCHESTER MEDICAL CENTER 47894 1.0178 x W490012 WELLMONT LEE REGIONAL MEDICAL CENTER 49 0.7732 x N490019 CULPEPER REGIONAL HOSPITAL 47894 1.122 x N x490022 MARY WASHINGTON HOSPITAL, INC 47894 1.0178 x N490023 FAUQUIER HOSPITAL 47894 1.0178 x N490033 WARREN MEMORIAL HOSPITAL 47894 1.0178 x N490037 RIVERSIDE SHORE MEMORIAL HOSPITAL 49 0.7732 x N490038 SMYTH COUNTY COMMUNITY HOSPITAL 49 0.7732 x N490040 INOVA ALEXANDRIA HOSPITAL 47894 1.0178 x N490043 INOVA LOUDOUN HOSPITAL 47894 1.0178 x N

490045NOVANT HEALTH PRINCE WILLIAM MEDICAL CENTER 47894 1.0178 x N

490050 VIRGINIA HOSPITAL CENTER 47894 1.0178 x N490053 JOHNSTON MEMORIAL HOSPITAL 28700 0.7732 x N490060 CLINCH VALLEY MEDICAL CENTER 49 0.7732 x N490063 INOVA FAIRFAX HOSPITAL 47894 1.0178 x N490084 RIVERSIDE TAPPAHANNOCK HOSPITAL 49 0.798 x N x490092 SOUTHAMPTON MEMORIAL HOSPITAL 49 0.7732 x N


490097 SOUTHERN VIRGINIA REGIONAL MEDICAL CENTER 49 0.7732 x N

490098 COMMUNITY MEMORIAL HEALTHCENTER, INC 49 0.7732 x N490101 INOVA FAIR OAKS HOSPITAL 47894 1.0178 x N

490105SOUTHWESTERN VIRGINIA MENTAL HEALTH INSTITUTE 49 0.7732 x N

490107 RESTON HOSPITAL CENTER 47894 1.0178 x N490110 LEWISGALE HOSPITAL MONTGOMERY 13980 0.8553 N x490111 WYTHE COUNTY COMMUNITY HOSPITAL 49 0.7732 x N

490113 SENTARA NORTHERN VIRGINIA MEDICAL CENTER 47894 1.0178 x N490114 WELLMONT LONESOME PINE HOSPITAL 49 0.7732 x N490115 TWIN COUNTY REGIONAL HOSPITAL 49 0.7732 x N490116 LEWISGALE HOSPITAL PULASKI 49 0.7732 x S YES490117 CARILION TAZEWELL COMMUNITY HOSPITAL 49 0.7732 x N490122 INOVA MOUNT VERNON HOSPITAL 47894 1.0178 x N490123 RAPPAHANNOCK GENERAL HOSPITAL 49 0.7732 x N490126 LEWISGALE HOSPITAL ALLEGHANY 49 0.7732 x N490127 BUCHANAN GENERAL HOSPITAL 49 0.7732 x N490134 PIEDMONT GERIATRIC HOSPITAL 49 0.7732 x N490140 STAFFORD HOSPITAL, LLC 47894 1.0178 x N490141 SPOTSYLVANIA REGIONAL MEDICAL CENTER 47894 1.0178 x N500019 PROVIDENCE CENTRALIA HOSPITAL 50 1.0954 N x510007 ST MARY'S MEDICAL CENTER 26580 0.8693 x N510012 PLEASANT VALLEY HOSPITAL 51 0.7466 x N x510013 REYNOLDS MEMORIAL HOSPITAL 48540 0.7351 x N510030 DAVIS MEMORIAL HOSPITAL 51 0.7351 x N510038 STONEWALL JACKSON MEMORIAL HOSPITAL 51 0.7351 x N510039 OHIO VALLEY MEDICAL CENTER 51 0.7351 x S YES510046 PRINCETON COMMUNITY HOSPITAL 49 0.7732 x W510048 LOGAN REGIONAL MEDICAL CENTER 51 0.7351 x N510053 ST JOSEPH HOSPITAL 51 0.7351 x N510055 CABELL HUNTINGTON HOSPITAL INC 26580 0.8693 x N


510058 CAMDEN CLARK MEDICAL CENTER 37620 0.7763 x N510072 WETZEL COUNTY HOSPITAL 51 0.7351 x N510077 WILLIAMSON MEMORIAL HOSPITAL 51 0.7351 x N510082 SUMMERSVILLE REGIONAL MEDICAL CENTER 51 0.7351 x N510086 WELCH COMMUNITY HOSPITAL 51 0.7351 x N520013 SACRED HEART HOSPITAL 33460 1.0887 x W520028 THE MONROE CLINIC 31540 1.1504 N x520035 AURORA SHEBOYGAN MEM MED CTR 43100 0.9468 N x520041 DIVINE SAVIOR HEALTHCARE 31540 1.1109 x N520044 ST NICHOLAS HOSPITAL 43100 0.9468 N x520045 THEDA CLARK MED CTR 36780 0.9532 N x520048 MERCY MEDICAL CTR OF OSHKOSH 36780 0.9532 N x520066 MERCY HEALTH SYSTEM CORP 27500 0.9416 N x520076 BEAVER DAM COM HOSPITAL 52 0.9246 N x520083 ST MARYS HOSPITAL 31540 1.1109 x N520088 ST AGNES HOSPITAL 22540 0.9123 N x520089 MERITER HOSPITAL 31540 1.1109 x N

520098UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY 31540 1.1109 x N

520100 BELOIT MEMORIAL HOSPITAL 27500 0.9416 N x

520116UW HLTH PARTNERS WATERTOWN REGIONAL MEDICAL CTR 52 0.9268 N x

520198 AURORA MEDICAL CTR OSHKOSH 36780 0.9532 N x520208 ST MARYS JANESVILLE HOSPITAL 27500 0.9416 N x

010B29EAST ALABAM MEDICAL CENTER-GEORGE LINIER CAMPUS 01 0.7081 X N x

390B42 EINSTEIN MEDICAL CENTER 33874 1.0821 X N x


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Attachment 3 – FY15 Rate Tables

Table 1--FY 2015 IPPS Rates and Factors

Standardized Amount Applicable Percentage Increase

• 1.022 if Quality = ‘1’ and EHR = ‘blank’ in PSF; or • 1.01475 if Quality = ‘0’and EHR = ‘blank’ in PSF;

or • 1.01475 if Quality = ‘1’and EHR = ‘Y’ in PSF; or • 1.0075 if Quality = ’0’and EHR = ’Y’ in PSF

Common Fixed Loss Cost Outlier Threshold

$24.626.00

Federal Capital Rate

$434.97

Puerto Rico Capital Rate

$209.45

Operating Rates

Wage Index > 1

Hospital Submitted Quality Data and is a Meaningful EHR User

(Update = 2.2 Percent)

Hospital Did NOT Submit Quality Data and is a Meaningful EHR User (Update =

1.475 Percent)

Hospital Submitted Quality Data and is NOT a Meaningful

EHR User (Update = 1.475 Percent)

Hospital Did NOT Submit Quality Data

and is NOT a Meaningful EHR User


Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor

National $3,784.75 $1,653.10 $3,757.90 $1,641.37 $3,757.90 $1,641.37 $3,731.05 $1,629.65 PR National $3,784.75 $1,653.10 $3,784.75 $1,653.10 $3,784.75 $1,653.10 $3,784.75 $1,653.10 Puerto Rico Specific $1,609.97 $937.45 $1,609.97 $937.45 $1,609.97 $937.45 $1,609.97 $937.45

Wage Index < or = 1

Hospital Submitted Quality Data and is a Meaningful EHR User


Hospital Did NOT Submit Quality Data and is a Meaningful EHR User (Update =

1.475 Percent)

Hospital Submitted Quality Data and is NOT a Meaningful

EHR User (Update = 1.475 Percent)

Hospital Did NOT Submit Quality Data

and is NOT a Meaningful EHR User


Labor Nonlabor Labor Nonlabor Labor Nonlabor Labor Nonlabor

National $3,371.47 $2,066.38 $3,347.55 $2,051.72 $3,347.55 $2,051.72 $3,323.63 $2,037.07 PR National $3,371.47 $2,066.38 $3,371.47 $2,066.38 $3,371.47 $2,066.38 $3,371.47 $2,066.38 Puerto Rico Specific $1,579.40 $968.02 $1,579.40 $968.02 $1,579.40 $968.02 $1,579.40 $968.02

Attachment 3 – FY15 Rate Tables

Table 3- Hospital-Specific (HSP) Rate Update for Sole Community Hospitals (SCHs) and Medicare-Dependent, Small Rural Hospitals (MDHs)

Hospital Specific (HSP) Rate Applicable Percentage Increase for FY 2015 based on the Hospital Quality Indicator in PSF (data element 34) and EHR Program Reduction indicator in PSF (data element 59)

• 1.022 if Quality = ‘1’ and EHR = ‘blank’; or • 1.01475 if Quality = ‘0’ and EHR = ‘blank’; or • 1.01475 if Quality = ‘1’ and EHR = ‘Y’; or • 1.0075 if Quality = ’0’ and EHR = ’Y’

HSP Budget Neutrality Factor for FY 2015 0.998761

Attachment 4 - FY 2015 Readmissions Payment Adjustment Factors - Corrected September

CMS Certification

Number (CCN)

Revised FY 2015

Readmissions Payment

Adjustment Factors

010090 0.9908030043 0.9907030055 0.9968030121 0.9870040074 0.9864050132 0.9919050367 0.9930050455 0.9897050625 0.9985050752 0.9890050771 0.9963070008 0.9921100045 0.9938100110 0.9840100151 0.9979100173 0.9941100209 0.9829100217 0.9846110026 0.9761140082 0.9846150161 0.9980150164 0.9886150177 0.9850180018 0.9898190002 0.9966190081 0.9932190297 0.9760220126 0.9892230002 0.9872230130 0.9832230142 0.9778240036 0.9995260095 0.9930290005 0.9937290051 0.9830310112 0.9910330045 0.9860

330136 0.9909330396 0.9894340084 0.9957360041 0.9916360179 0.9877390116 0.9980390132 0.9870390198 0.9950420009 0.9909420071 0.9964440153 0.9950450200 0.9866450832 0.9912490005 0.9853490021 0.9890490130 0.9911500141 0.9890510002 0.9883510006 0.9965510023 0.9977520037 0.9980520078 0.9949670068 0.9964

final_CN_92514ucpdshpuf

Page 1

Attachment 5

PROV

Estimated Per Claim Amount

Projected to

Receive DSH for FY 2015

010001 $580.69 YES010005 $539.26 YES010006 $432.68 YES010007 $257.10 YES010008 $572.01 YES010009 n/a NO010011 $742.72 YES010012 $479.83 SCH010015 n/a NO010016 $632.96 YES010018 $174.68 YES010019 $536.84 YES010021 $657.36 YES010022 $261.40 YES010023 $1,246.61 YES010024 $639.88 YES010025 $697.24 YES010029 $568.77 YES010032 $288.10 YES010033 $1,578.23 YES010034 $353.26 YES010035 $386.67 SCH010036 $491.49 YES010038 $294.30 YES010039 $701.68 YES010040 $689.67 YES010044 $179.73 YES010045 $278.85 YES010046 $341.65 YES010047 $252.83 YES010049 $619.89 YES010051 $452.47 YES010052 $200.57 YES010054 $493.69 YES010055 $430.10 YES

FY 2015 IPPS Final Rule: Uncompensated Care Payment Per Claim Amounts for Provider Specific File


Page 2

010056 n/a NO010058 n/a NO010059 $323.28 YES010061 $493.08 YES010062 $259.25 YES010065 $469.69 YES010069 $321.42 YES010073 $663.67 YES010078 $515.17 YES010079 $514.50 YES010083 $407.52 YES010085 $536.61 YES010086 $181.22 YES010087 $3,249.21 YES010089 $615.29 YES010090 $559.40 YES010091 $1,051.02 YES010092 $718.04 YES010095 $484.22 YES010097 $426.75 YES010099 $608.94 YES010100 n/a NO010101 $774.05 YES010102 $342.65 YES010103 $652.95 YES010104 $767.98 YES010108 $336.75 YES010109 $369.88 SCH010110 $840.38 YES010112 $919.68 YES010113 $680.83 YES010114 $777.42 YES010118 $903.88 YES010120 $532.55 YES010125 $312.40 YES010126 $343.68 YES010128 $436.65 YES010129 $751.11 YES010130 n/a NO010131 n/a NO010138 $816.00 YES010139 $560.19 YES010144 $424.70 YES010146 $728.15 YES


Page 3

010148 $345.25 YES010149 $1,631.48 YES010150 $333.63 YES010157 n/a NO010158 $361.21 YES010164 $701.51 YES010168 n/a NO010169 $288.77 YES010171 n/a NO020001 $1,458.82 YES020006 $540.87 SCH020008 n/a NO020012 $817.42 SCH020017 $630.03 YES020018 $3,310.41 YES020024 n/a NO020026 $2,011.69 YES020027 n/a NO030001 $4,257.88 YES030002 $1,855.79 YES030006 $1,399.08 YES030007 $751.50 SCH030010 $822.77 YES030011 $678.84 YES030012 n/a NO030013 $681.47 SCH030014 $726.87 YES030016 $885.75 YES030022 $12,698.43 YES030023 $1,438.07 SCH030024 $2,498.37 YES030030 $1,659.95 YES030033 $205.90 SCH030036 $1,001.70 YES030037 $1,481.99 YES030038 $612.08 YES030043 $586.31 SCH030055 $621.26 SCH030061 n/a NO030062 $736.25 SCH030064 $2,356.41 YES030065 $2,125.03 YES030067 n/a NO030068 $987.78 SCH


Page 4

030069 $267.31 YES030071 $2,944.75 YES030073 $2,327.81 YES030074 $4,548.11 YES030077 $1,467.29 YES030078 $5,897.21 YES030083 $1,161.09 YES030084 $1,802.57 YES030085 $553.23 YES030087 n/a NO030088 n/a NO030089 $1,722.16 YES030092 $647.66 YES030093 $392.01 YES030094 $1,634.92 YES030100 n/a NO030101 $301.33 YES030103 n/a NO030105 n/a NO030107 n/a NO030108 n/a NO030110 $1,135.66 YES030111 $2,580.08 YES030112 n/a NO030113 $3,554.01 YES030114 n/a NO030115 $1,875.26 YES030117 $510.02 YES030118 $785.18 YES030119 $760.87 YES030120 $367.35 YES030121 $817.15 YES030122 $1,220.72 YES030123 n/a NO030126 $407.76 YES030128 n/a NO030129 n/a NO030130 $1,867.46 YES030131 n/a NO030132 $635.72 YES030134 n/a NO040001 $607.07 YES040002 $715.82 YES040004 $391.75 YES


Page 5

040007 $562.58 YES040010 $360.84 YES040011 $216.39 YES040014 $450.21 YES040015 $772.85 YES040016 $1,985.95 YES040017 $401.81 YES040018 $387.70 YES040019 $1,572.71 YES040020 $520.28 YES040022 $847.63 YES040026 $315.62 YES040027 $199.05 YES040029 $402.32 YES040036 $328.81 YES040039 $468.36 YES040041 $678.25 YES040042 $800.47 YES040047 $160.22 YES040050 $480.75 YES040051 $490.71 YES040055 $632.15 YES040062 $683.31 YES040067 $458.02 YES040069 $1,213.72 YES040071 $701.94 SCH040072 $350.64 YES040074 $158.15 YES040076 $90.92 YES040078 $475.39 YES040080 $540.98 YES040084 $369.98 YES040085 $489.43 YES040088 $317.50 SCH040091 n/a NO040114 $670.28 YES040118 $271.39 YES040119 $686.20 YES040132 n/a NO040134 n/a NO040137 $152.78 YES040147 n/a NO040152 n/a NO040153 n/a NO


Page 6

050002 $1,456.17 YES050006 $619.54 YES050007 $316.06 YES050008 $654.83 YES050009 $503.44 YES050013 $677.31 YES050014 $380.78 SCH050016 n/a NO050017 $1,121.18 YES050018 $4,163.96 YES050022 $2,039.15 YES050024 $1,298.15 YES050025 $1,848.71 YES050026 $1,076.84 YES050028 $985.91 YES050030 $689.92 YES050036 $2,102.63 YES050038 $5,281.61 YES050039 $466.38 YES050040 $11,993.55 YES050042 $625.51 SCH050043 $844.53 YES050045 $1,118.89 YES050046 n/a NO050047 $984.34 YES050054 $975.35 YES050055 $1,882.20 YES050056 $2,030.69 YES050057 $1,081.86 YES050058 $1,867.84 YES050060 $2,746.17 YES050063 $3,230.47 YES050067 $1,135.45 YES050069 $1,029.81 YES050070 n/a NO050071 n/a NO050072 n/a NO050073 n/a NO050075 n/a NO050076 n/a NO050077 $1,551.04 YES050078 $967.87 YES050079 $837.39 YES050082 $1,164.56 YES


Page 7

050084 $1,108.19 YES050089 $5,007.22 YES050090 $322.67 YES050091 $1,210.42 YES050093 $667.38 YES050096 $212.94 YES050099 $527.55 YES050100 $1,770.53 YES050101 $1,231.80 YES050102 $2,923.41 YES050103 $3,846.45 YES050104 $5,714.74 YES050107 $1,191.72 YES050108 $1,878.18 YES050110 $609.02 YES050111 $1,014.18 YES050112 $916.68 YES050113 $3,228.19 YES050115 $1,111.25 YES050116 $1,141.82 YES050118 $536.69 YES050121 $891.43 YES050122 $1,753.75 YES050124 $244.05 YES050125 $1,152.47 YES050126 $3,692.77 YES050127 $999.78 YES050128 $1,130.98 YES050129 $1,975.43 YES050131 n/a NO050132 $1,727.07 YES050133 $719.79 SCH050135 $3,005.21 YES050136 $380.74 YES050137 n/a NO050138 n/a NO050139 n/a NO050140 n/a NO050145 n/a NO050146 n/a NO050149 $7,946.49 YES050150 $308.32 YES050152 $1,336.03 YES050153 $1,195.66 YES


Page 8

050158 $305.45 YES050159 $3,988.60 YES050167 $6,746.11 YES050168 $486.61 YES050169 $1,024.01 YES050174 $530.31 YES050179 $1,085.22 YES050180 n/a NO050189 $2,393.98 SCH050191 $3,434.58 YES050192 $3,151.34 YES050194 $1,690.32 YES050195 $757.64 YES050196 $23,375.30 YES050197 n/a NO050204 $843.49 YES050205 $1,049.55 YES050211 $456.27 YES050219 n/a NO050222 $1,422.45 YES050224 n/a NO050225 $519.23 YES050226 $1,263.30 YES050228 $3,971.08 YES050230 $2,011.49 YES050231 $4,676.90 YES050232 $285.49 YES050234 n/a NO050235 $898.58 YES050236 $375.28 YES050238 $771.80 YES050239 $1,694.80 YES050242 $579.19 YES050243 $1,798.90 YES050245 $9,347.45 YES050248 $5,685.17 YES050254 $416.09 YES050257 $1,636.06 YES050261 $1,384.43 YES050262 $1,811.07 YES050272 $1,327.99 YES050276 $5,081.17 YES050277 $2,879.90 YES050278 $1,477.13 YES


Page 9

050279 $1,097.45 YES050280 $649.48 YES050281 $1,231.32 YES050283 $525.92 YES050289 $795.74 YES050290 n/a NO050291 $1,540.76 YES050292 $6,766.70 YES050295 $1,007.03 YES050296 $604.41 YES050298 $638.06 SCH050300 $1,241.74 YES050301 $538.41 YES050305 $2,704.54 YES050308 $361.75 YES050309 $460.99 YES050313 $764.32 YES050315 $12,258.96 YES050320 $4,884.55 YES050324 n/a NO050325 n/a NO050327 $3,899.44 YES050329 $1,288.23 YES050334 $561.42 YES050335 $335.70 SCH050336 $603.64 YES050342 $1,280.82 YES050348 $2,644.88 YES050350 $2,073.16 YES050351 $520.42 YES050352 $534.76 SCH050353 $772.29 YES050357 n/a NO050359 $1,652.42 YES050360 $436.75 YES050367 $938.47 YES050373 $16,320.86 YES050376 $10,813.81 YES050378 $3,452.61 YES050380 $681.03 YES050382 $2,384.59 YES050385 $189.82 YES050390 $725.06 YES050393 $1,177.24 YES


Page 10

050394 $620.03 YES050396 $645.80 YES050397 $322.01 SCH050407 $1,134.10 YES050411 n/a NO050414 $402.42 YES050417 $294.55 SCH050423 $899.95 SCH050424 n/a NO050425 n/a NO050426 $694.87 YES050434 $802.98 SCH050435 $413.55 SCH050438 $741.05 YES050441 $670.33 YES050444 $1,120.16 YES050448 n/a NO050454 $1,863.59 YES050455 $1,209.05 YES050457 $478.40 YES050464 $2,694.14 YES050468 $2,414.37 YES050471 $1,797.80 YES050481 $539.17 YES050485 $999.37 YES050488 $787.51 YES050492 $1,553.28 YES050496 $425.19 YES050498 $239.86 YES050502 $912.49 YES050503 n/a NO050506 $1,097.27 YES050510 n/a NO050512 n/a NO050515 n/a NO050516 $1,324.96 YES050517 $2,761.16 YES050523 $874.06 YES050526 $510.21 YES050528 $1,842.17 SCH050531 $5,257.28 YES050534 $2,042.55 YES050537 $1,177.89 YES050541 n/a NO


Page 11

050543 $25,976.18 YES050545 $0.00 YES050546 $124.08 YES050547 $72.74 YES050548 $13.24 YES050549 n/a NO050551 $414.86 YES050552 n/a NO050557 $907.29 YES050561 n/a NO050567 $448.08 YES050568 $1,904.25 YES050570 $2,518.68 YES050573 n/a NO050575 $790.75 YES050580 $733.67 YES050581 $966.98 YES050586 $770.98 YES050588 $460.34 YES050589 n/a NO050590 $1,894.03 YES050597 $1,058.72 YES050599 $1,987.02 YES050603 n/a NO050604 n/a NO050608 $2,120.47 YES050609 n/a NO050616 $35.99 YES050618 $185.79 SCH050624 $651.66 YES050625 $681.97 YES050633 $358.48 YES050636 $498.91 YES050641 $4,442.88 YES050644 $3,734.40 YES050660 n/a NO050663 $2,321.77 YES050668 $776.80 YES050674 n/a NO050677 n/a NO050678 $1,105.89 YES050684 $351.02 YES050686 n/a NO050688 $597.72 YES


Page 12

050689 n/a NO050690 n/a NO050696 $1,096.77 YES050697 n/a NO050698 n/a NO050701 $1,270.08 YES050704 $1,668.59 YES050708 n/a NO050709 $934.44 YES050710 n/a NO050714 $2,104.47 YES050717 $19,395.13 YES050723 n/a NO050724 $256.20 YES050726 n/a NO050727 $652.68 YES050732 n/a NO050735 $2,152.33 YES050736 $3,411.57 YES050737 $2,510.45 YES050738 $3,710.72 YES050739 $1,064.84 YES050740 n/a NO050742 $537.30 YES050744 $6,840.87 YES050745 $796.31 YES050746 $4,269.18 YES050747 $5,293.42 YES050748 n/a NO050751 $91.02 YES050754 n/a NO050755 $495.76 YES050757 $534.76 YES050758 $2,412.56 YES050760 n/a NO050761 $673.87 YES050763 $4,061.71 YES050764 $420.31 YES050765 n/a NO050766 n/a NO050767 n/a NO050769 n/a NO050770 n/a NO050771 $2,190.69 YES


Page 13

050772 n/a NO050773 $587.19 YES050774 n/a NO060001 $606.83 YES060003 $451.25 YES060004 $948.96 YES060006 $359.06 SCH060008 $846.72 YES060009 $778.04 YES060010 $405.25 YES060011 $6,101.97 YES060012 $615.07 YES060013 $435.38 SCH060014 $3,130.34 YES060015 $556.92 YES060016 $353.76 SCH060020 $762.49 YES060022 $1,019.60 YES060023 $685.39 SCH060024 $1,244.90 YES060027 n/a NO060028 $3,111.86 YES060030 $364.60 YES060031 $453.61 YES060032 $849.41 YES060034 $580.00 YES060036 $377.04 YES060043 n/a NO060044 $533.99 SCH060049 n/a NO060054 n/a NO060064 n/a NO060065 $1,423.65 YES060071 n/a NO060075 $1,291.27 SCH060076 n/a NO060096 $736.87 SCH060100 $727.09 YES060103 $2,125.54 YES060104 $728.53 YES060107 $3,918.15 YES060112 n/a NO060113 n/a NO060114 n/a NO


Page 14

060116 n/a NO060117 n/a NO060118 $851.00 YES060119 n/a NO060124 n/a NO060125 n/a NO070002 $762.91 YES070003 $486.34 YES070004 $229.54 SCH070005 $559.02 YES070006 $783.66 YES070007 $531.63 YES070008 $540.48 YES070010 $1,479.06 YES070011 $243.62 YES070012 n/a NO070015 n/a NO070016 $618.35 YES070017 $483.06 YES070018 n/a NO070019 n/a NO070020 $296.33 YES070021 $423.16 YES070022 $1,543.90 YES070024 $434.56 YES070025 $759.52 YES070027 $479.80 YES070028 $682.96 YES070029 $373.28 YES070031 $437.42 YES070033 $404.90 YES070034 $553.56 YES070035 $591.83 YES070036 $811.63 YES070038 $108,740.69 YES070039 n/a NO070040 n/a NO080001 $589.18 YES080003 $762.17 YES080004 $649.03 YES080006 $490.17 YES080007 $251.98 YES080009 $624.87 YES090001 $1,301.84 YES


Page 15

090003 $2,586.73 YES090004 $1,119.49 YES090005 n/a NO090006 $1,343.37 YES090008 $2,015.29 YES090011 $1,036.43 YES100001 $2,853.86 YES100002 $1,066.09 YES100006 $2,384.55 YES100007 $924.77 YES100008 $1,825.14 YES100009 $1,358.72 YES100012 $858.44 YES100014 n/a NO100017 $979.11 YES100018 $388.22 YES100019 $567.75 YES100022 $6,408.82 YES100023 n/a NO100025 $1,466.48 YES100026 $450.07 YES100028 $370.80 YES100029 $1,911.41 YES100030 $928.49 YES100032 $1,721.56 YES100034 $1,578.41 YES100035 $979.64 YES100038 $2,399.72 YES100039 $4,204.70 YES100040 $459.64 YES100043 $352.78 YES100044 n/a NO100045 $617.90 YES100046 $386.74 YES100047 $236.21 YES100048 $278.98 YES100049 $380.92 YES100050 $1,032.43 YES100051 $419.50 YES100052 $671.25 YES100053 $2,404.93 YES100054 n/a NO100055 $326.07 YES100057 $374.61 YES


Page 16

100062 $465.64 YES100063 $1,109.97 YES100067 $825.76 YES100068 $458.13 YES100069 $512.94 YES100070 n/a NO100071 $897.39 YES100072 $366.06 YES100073 n/a NO100075 $2,137.21 YES100077 $553.07 YES100079 n/a NO100080 $654.63 YES100081 $261.98 YES100084 $403.92 YES100086 $1,042.71 YES100087 $497.22 YES100088 $1,084.03 YES100090 $316.39 SCH100092 $563.68 YES100093 $666.35 YES100099 $366.67 YES100102 $1,243.79 YES100105 $339.87 YES100106 $377.02 YES100107 $428.22 YES100109 $313.50 YES100110 $1,075.45 YES100113 $1,752.98 YES100117 n/a NO100118 n/a NO100121 $511.65 YES100122 $331.72 YES100124 $566.36 YES100125 $2,618.49 YES100126 n/a NO100127 $717.97 YES100128 $2,108.22 YES100130 $1,650.75 YES100131 $679.87 YES100132 $833.32 YES100134 n/a NO100135 $1,307.97 YES100137 $710.27 YES


Page 17

100140 $445.27 YES100142 $501.85 YES100150 $569.65 SCH100151 n/a NO100154 $1,805.24 YES100156 n/a NO100157 $795.19 YES100161 $618.14 YES100166 n/a NO100167 $3,026.48 YES100168 n/a NO100173 $723.41 YES100175 $698.55 YES100176 n/a NO100177 n/a NO100179 $762.62 YES100180 $909.08 YES100181 $1,091.04 YES100183 $1,266.14 YES100187 $2,319.14 YES100189 $744.24 YES100191 $526.80 YES100200 $625.69 YES100204 $339.16 YES100206 $307.12 YES100209 $2,336.00 YES100211 $589.57 YES100212 $291.57 YES100213 n/a NO100217 n/a NO100220 $411.79 YES100223 $486.78 YES100224 n/a NO100226 $628.84 YES100228 n/a NO100230 $1,028.82 YES100231 $314.08 YES100232 $439.62 YES100234 $1,417.34 YES100236 n/a NO100238 $469.33 YES100239 $368.57 YES100240 n/a NO100242 $906.40 YES


Page 18

100243 $1,050.84 YES100244 $352.28 YES100246 $1,093.93 YES100248 n/a NO100249 $244.73 YES100252 $279.53 SCH100253 n/a NO100254 $839.48 YES100255 $715.41 YES100256 $392.59 YES100258 n/a NO100259 n/a NO100260 $321.15 YES100264 n/a NO100265 $557.42 YES100266 n/a NO100267 n/a NO100268 $1,410.06 YES100269 $1,752.68 YES100271 n/a NO100275 $1,390.13 YES100276 $2,041.82 YES100277 n/a NO100281 $1,690.05 YES100284 $1,283.88 YES100285 $2,470.03 YES100286 $277.93 YES100287 $598.86 YES100288 $7,752.80 YES100289 n/a NO100290 n/a NO100291 $601.52 YES100292 $438.66 YES100296 $976.35 YES100298 n/a NO100299 n/a NO100302 $454.51 YES100307 $546.97 YES100313 $204.84 YES100314 $1,720.66 YES100315 n/a NO100316 $575.77 YES100317 n/a NO100319 n/a NO


Page 19

100320 n/a NO110001 $830.35 YES110002 $678.37 SCH110003 $393.60 SCH110004 $1,058.25 YES110005 $791.81 YES110006 $620.72 YES110007 $1,621.53 YES110008 $642.10 YES110010 $630.36 YES110011 $575.46 YES110015 $905.43 YES110016 $647.86 YES110018 $588.53 YES110023 $590.31 YES110024 $1,194.87 YES110025 $594.28 SCH110026 n/a NO110027 $655.99 YES110028 $773.01 YES110029 $647.82 YES110030 $565.57 YES110031 $636.66 YES110032 $740.55 YES110034 $2,110.03 YES110035 $642.05 YES110036 $1,316.76 YES110038 $776.79 YES110039 $480.87 YES110040 $234.72 YES110041 $478.30 YES110042 $215.28 YES110043 $321.32 YES110044 $814.94 YES110045 $435.16 YES110046 $479.72 YES110050 n/a NO110051 $87.65 SCH110054 $993.09 YES110059 n/a NO110064 $2,668.61 YES110069 $715.40 YES110071 $904.05 YES110073 $486.97 YES


Page 20

110074 $711.72 YES110075 $876.60 YES110076 $1,912.83 YES110078 $1,477.82 YES110079 $3,612.11 YES110082 n/a NO110083 n/a NO110086 $868.44 YES110087 $1,083.57 YES110089 $678.01 SCH110091 $1,230.48 YES110092 $689.88 YES110095 $756.95 YES110100 $229.64 YES110101 $812.63 YES110104 $814.07 YES110105 $758.78 SCH110107 $1,161.65 YES110109 $560.76 SCH110111 $327.91 YES110113 $734.82 YES110115 $4,256.65 YES110121 $613.39 YES110122 $838.89 YES110124 $637.48 SCH110125 $925.03 YES110128 $737.91 YES110129 $392.11 YES110130 $3,297.77 YES110132 $858.13 YES110135 $835.16 YES110142 $264.22 YES110143 $1,126.44 YES110146 $1,231.56 SCH110150 $790.84 YES110153 n/a NO110161 $4,236.91 YES110164 $668.15 YES110165 $1,985.91 YES110168 n/a NO110177 $1,078.24 YES110183 $311.14 YES110184 $506.57 YES110186 $1,185.62 YES


Page 21

110187 $328.03 YES110189 $393.91 YES110190 $558.85 YES110191 $712.42 YES110192 $697.14 YES110194 $937.35 YES110198 $744.21 YES110200 n/a NO110201 n/a NO110203 n/a NO110205 $249.88 YES110209 $213.59 YES110215 $550.21 YES110225 $405.36 YES110226 $915.68 YES110229 $595.43 YES110230 n/a NO110233 n/a NO120001 $1,783.06 YES120002 $1,868.37 SCH120004 $1,047.88 YES120005 $1,559.83 SCH120006 $1,460.78 YES120007 n/a NO120010 n/a NO120011 n/a NO120014 $1,082.85 SCH120019 $1,547.29 SCH120022 $872.26 YES120026 $1,194.29 YES120027 n/a NO120028 $1,224.17 SCH130002 $496.45 SCH130003 $419.99 SCH130006 $1,138.33 YES130007 $854.62 YES130013 $826.34 YES130014 $887.41 YES130018 $874.62 YES130025 $1,546.24 YES130028 $505.75 SCH130049 $621.18 YES130063 n/a NO130065 $1,483.08 YES


Page 22

130066 n/a NO130067 n/a NO140001 $355.44 SCH140002 $327.21 YES140007 $363.39 YES140008 $429.50 YES140010 n/a NO140011 n/a NO140012 $348.51 YES140013 n/a NO140015 $269.50 SCH140018 $3,524.32 YES140019 $123.98 SCH140026 $237.08 YES140029 $834.71 YES140030 $491.89 YES140032 $217.05 YES140033 n/a NO140034 $306.88 YES140040 $293.20 YES140043 $240.48 YES140046 $327.98 YES140048 $919.66 YES140049 $1,169.22 YES140052 $345.72 YES140053 $727.64 YES140054 $1,005.40 YES140058 $177.32 SCH140059 $166.18 YES140062 n/a NO140063 $360.87 YES140064 $272.10 YES140065 n/a NO140067 $1,028.43 YES140068 $2,502.07 YES140077 $2,392.13 YES140080 $715.82 YES140082 $613.88 YES140083 $1,659.73 YES140084 $593.88 YES140088 $1,828.05 YES140089 $276.42 SCH140091 $927.36 YES140093 $384.26 YES


Page 23

140095 $2,536.23 YES140100 n/a NO140101 n/a NO140103 $2,351.92 YES140110 $420.28 YES140113 $391.82 YES140114 $896.74 YES140115 $1,203.25 YES140116 n/a NO140117 n/a NO140118 $794.44 YES140119 $1,178.88 YES140120 $376.05 YES140122 n/a NO140124 $4,671.17 YES140125 $1,406.80 YES140127 $452.89 YES140130 n/a NO140133 $848.69 YES140135 $342.41 YES140137 $643.98 YES140143 n/a NO140145 $325.33 YES140147 $352.47 YES140148 $309.28 YES140150 $2,485.46 YES140155 $431.68 YES140158 $1,145.47 YES140160 $340.10 YES140161 $413.28 SCH140162 $315.85 YES140164 $521.55 YES140166 $747.16 YES140167 $205.16 SCH140172 $447.07 YES140174 $634.54 YES140176 $351.03 YES140177 $1,665.66 YES140179 $398.30 YES140180 $2,519.85 YES140181 $993.70 YES140182 $1,346.62 YES140184 $589.20 YES140185 $441.08 YES


Page 24

140186 $740.73 YES140187 $431.94 YES140189 $287.32 SCH140191 $813.22 YES140197 $1,450.29 YES140200 n/a NO140202 $521.08 YES140206 $2,776.85 YES140208 $849.81 YES140209 $689.36 YES140210 $118.03 SCH140211 n/a NO140213 $302.01 YES140217 $321.22 YES140223 $663.93 YES140224 $694.55 YES140228 $752.74 YES140231 n/a NO140233 n/a NO140234 $247.72 YES140239 $999.74 YES140240 $1,232.57 YES140242 $418.87 YES140250 $432.48 YES140251 $510.87 YES140252 n/a NO140258 $365.29 YES140275 $368.33 YES140276 $850.01 YES140280 $501.82 YES140281 $780.39 YES140286 n/a NO140288 $273.76 YES140289 $463.83 YES140290 $686.75 YES140291 n/a NO140292 $1,370.28 YES140294 $179.05 YES140300 $1,826.59 YES140301 n/a NO140304 $742.06 YES140306 n/a NO150001 $370.59 YES150002 $926.36 YES


Page 25

150003 $249.23 YES150004 $586.02 YES150005 $331.12 YES150006 $404.29 YES150007 $404.24 YES150008 $877.74 YES150009 $484.78 YES150010 $611.31 YES150011 $539.96 YES150012 $459.46 YES150015 $397.18 YES150017 $632.57 YES150018 $477.98 YES150021 $986.47 YES150022 n/a NO150023 $472.80 YES150024 $2,775.35 YES150026 $451.95 YES150030 $364.82 YES150033 n/a NO150034 $304.75 YES150035 $335.08 YES150037 $223.72 YES150038 $389.98 YES150042 $226.08 YES150044 $340.97 YES150045 $640.96 YES150046 $357.26 YES150047 $1,324.98 YES150048 $323.06 SCH150051 $526.69 YES150056 $1,860.03 YES150057 n/a NO150058 $1,263.24 YES150059 $377.76 YES150061 $414.94 YES150064 $381.79 YES150065 $605.19 YES150069 $369.88 SCH150072 $473.12 SCH150074 $1,050.35 YES150075 $346.85 YES150076 $343.42 YES150082 $418.71 YES


Page 26

150084 $1,131.58 YES150086 $382.01 YES150088 $491.90 YES150089 $570.36 YES150090 n/a NO150091 $706.88 YES150097 $333.24 YES150100 $563.67 YES150101 $598.77 YES150102 $178.81 YES150104 $476.86 YES150109 $667.99 YES150112 $450.58 YES150113 $422.58 YES150115 $247.28 YES150125 $340.86 YES150126 n/a NO150128 $339.60 YES150129 $178.44 YES150133 $416.42 YES150146 $424.15 YES150149 $51,946.76 YES150150 $2,029.38 YES150153 n/a NO150154 n/a NO150157 n/a NO150158 $426.16 YES150160 n/a NO150161 $724.98 YES150162 $602.55 YES150163 $129.66 YES150164 n/a NO150165 n/a NO150166 n/a NO150167 n/a NO150168 n/a NO150169 $895.21 YES150170 n/a NO150172 n/a NO150173 $380.75 YES150175 n/a NO150176 $70.53 YES150177 n/a NO150178 n/a NO


Page 27

150179 $303.32 YES150180 n/a NO150181 n/a NO150182 n/a NO160001 $381.17 SCH160005 n/a NO160008 $302.16 YES160013 $430.35 SCH160016 $265.92 SCH160024 $906.31 YES160028 $861.75 YES160029 n/a NO160030 n/a NO160032 n/a NO160033 $387.29 YES160040 n/a NO160045 $748.64 YES160047 $493.88 YES160057 $390.96 YES160058 $1,945.19 YES160064 $354.85 SCH160067 $882.30 YES160069 $232.96 YES160079 n/a NO160080 $289.71 SCH160082 $743.20 YES160083 $810.70 YES160089 $423.98 SCH160101 $7,154.86 YES160104 $306.69 YES160110 $425.40 YES160112 n/a NO160117 $261.29 YES160122 $358.13 YES160124 n/a NO160146 $1,145.01 YES160147 n/a NO160153 $314.45 YES170006 $236.94 SCH170009 $289.15 YES170010 n/a NO170012 $352.33 SCH170013 n/a NO170014 $317.24 YES


Page 28

170016 $364.75 YES170017 $319.47 YES170020 n/a NO170023 $657.61 SCH170027 $128.04 SCH170039 $330.44 YES170040 $987.03 YES170049 $294.04 YES170058 n/a NO170068 $791.91 SCH170074 n/a NO170075 n/a NO170086 $633.51 YES170094 $184.50 SCH170103 $328.51 YES170104 $417.95 YES170105 n/a NO170109 n/a NO170110 n/a NO170120 $313.18 SCH170122 $667.04 YES170123 $1,326.41 YES170133 $701.74 YES170137 $286.39 SCH170142 $265.15 YES170145 $250.39 YES170146 $484.97 YES170150 $354.23 YES170166 n/a NO170175 $587.18 SCH170176 $1,537.39 YES170180 n/a NO170182 n/a NO170183 n/a NO170185 n/a NO170186 n/a NO170187 n/a NO170188 n/a NO170190 n/a NO170191 n/a NO170192 n/a NO170194 $84.06 YES170195 n/a NO170196 n/a NO


Page 29

170197 n/a NO170198 n/a NO170199 $47.38 YES170200 n/a NO170201 n/a NO170203 n/a NO180001 $360.58 YES180002 $611.96 YES180004 $730.58 YES180005 $724.98 YES180009 $607.71 YES180010 $266.85 YES180011 $769.31 YES180012 $451.58 YES180013 $661.80 YES180016 $206.69 YES180017 $638.00 YES180018 $672.34 YES180019 $525.67 YES180020 $745.85 YES180021 $459.59 YES180024 $647.99 YES180025 $327.03 YES180027 $437.62 YES180029 $778.41 YES180035 $588.78 YES180036 $445.98 YES180038 $512.50 SCH180040 $1,340.17 YES180043 $808.94 YES180044 $624.13 SCH180045 $375.92 YES180046 $920.78 YES180048 $511.11 YES180049 $856.56 YES180050 $622.19 YES180051 $624.43 YES180053 $329.55 YES180056 $711.72 YES180064 $578.93 YES180066 $267.92 YES180067 $2,010.63 YES180069 $547.92 YES180070 $533.49 YES


Page 30

180078 $771.12 YES180079 $415.04 YES180080 $914.98 YES180087 $462.10 YES180088 $1,485.40 YES180092 $544.47 YES180093 $405.79 SCH180095 $268.18 YES180101 $476.65 YES180102 $268.91 YES180103 $700.57 YES180104 $396.34 YES180105 $534.35 YES180106 $431.49 YES180115 $296.68 YES180116 $458.90 YES180117 $399.93 YES180124 n/a NO180127 $617.80 YES180128 $655.52 YES180130 n/a NO180132 $707.52 YES180138 $607.31 YES180139 $479.24 YES180141 $2,110.97 YES180143 $1,227.64 YES180149 $596.52 YES190001 $1,193.72 YES190002 $679.15 YES190003 $831.68 YES190004 $349.62 YES190005 $6,180.36 YES190006 $3,863.98 YES190007 $307.48 SCH190008 $1,018.19 YES190009 $2,740.21 YES190011 $4,382.00 YES190013 $298.09 YES190014 $1,076.84 SCH190015 $677.40 YES190017 $1,001.79 YES190019 $609.54 YES190020 $759.37 YES190025 $1,161.58 YES


Page 31

190026 $1,439.41 YES190027 $291.24 YES190034 $565.26 YES190036 $1,782.25 YES190039 $1,284.42 YES190040 $719.65 YES190041 $1,123.53 YES190044 $799.74 YES190045 $656.63 YES190046 $2,070.10 YES190050 $465.25 YES190053 $419.27 YES190054 $419.23 YES190060 $1,192.19 YES190064 $912.61 YES190065 $948.54 YES190079 $598.73 YES190081 $491.84 YES190086 $706.98 YES190088 $180.92 YES190090 $436.65 YES190098 $3,641.21 YES190099 $428.50 YES190102 $405.71 YES190106 $569.20 YES190111 $581.32 YES190114 $504.95 YES190116 $461.91 YES190118 $306.94 YES190125 $1,052.85 YES190128 $39,831.47 YES190133 $217.24 YES190140 $273.36 YES190144 $834.84 YES190145 $393.95 YES190146 $515.18 YES190151 $450.34 YES190160 $626.31 YES190164 $386.01 YES190167 $848.69 YES190175 $678.01 YES190176 $2,422.43 YES190177 $848.48 YES190183 $2,264.28 YES


Page 32

190184 $523.19 YES190190 $226.53 YES190199 $441.89 YES190201 $4,148.54 YES190202 $1,462.09 YES190204 $976.86 YES190205 $3,612.14 YES190208 $503.07 YES190218 $428.71 YES190236 $352.25 YES190241 n/a NO190242 $389.01 YES190245 n/a NO190246 n/a NO190250 n/a NO190251 n/a NO190255 n/a NO190256 $89.83 YES190257 n/a NO190259 n/a NO190261 n/a NO190263 n/a NO190266 n/a NO190267 n/a NO190268 n/a NO190270 n/a NO190274 $1,793.72 YES190278 n/a NO190297 $247.31 YES190298 n/a NO190300 n/a NO190303 $123.83 YES190304 n/a NO190307 $670.76 YES190308 $578.00 YES190310 n/a NO200001 $250.95 YES200008 $540.49 YES200009 $829.99 YES200018 $421.36 YES200019 $276.87 YES200020 n/a NO200021 $464.39 YES200024 $488.16 YES


Page 33

200025 n/a NO200031 $386.82 YES200032 n/a NO200033 $749.61 YES200034 $1,093.66 YES200037 $375.94 SCH200039 $622.93 YES200040 $239.82 YES200041 n/a NO200050 n/a NO200052 $338.45 SCH200063 $563.55 SCH220001 $682.96 YES220002 $324.68 YES220008 $346.63 YES220010 $915.82 YES220011 $1,221.40 YES220012 n/a NO220015 $292.97 YES220016 $894.04 YES220017 $964.42 YES220019 $549.71 YES220020 $575.77 YES220024 $689.18 YES220029 $308.78 YES220030 $237.90 YES220031 $2,039.47 YES220033 $574.85 YES220035 $556.77 YES220036 $778.13 YES220046 $519.74 YES220049 $609.48 YES220050 $184.24 YES220052 $758.39 YES220058 $231.84 YES220060 $292.30 YES220062 $993.38 YES220063 $951.20 YES220065 $222.18 YES220066 $1,250.48 YES220067 $342.05 YES220070 $273.71 YES220071 $657.32 YES220073 $405.17 YES


Page 34

220074 $647.93 YES220075 n/a NO220077 $1,193.05 YES220080 $875.42 YES220083 n/a NO220084 n/a NO220086 $741.45 YES220088 n/a NO220090 n/a NO220095 $696.46 YES220098 n/a NO220100 $350.31 YES220101 n/a NO220105 n/a NO220108 n/a NO220110 $794.88 YES220111 $862.74 YES220116 $1,194.46 YES220119 $290.84 YES220126 n/a NO220135 $215.92 YES220153 n/a NO220154 n/a NO220162 n/a NO220163 $978.15 YES220171 n/a NO220174 $252.84 YES220175 $396.42 YES220176 $699.57 YES220177 $578.82 YES230002 n/a NO230003 $61.98 YES230004 n/a NO230005 $502.25 YES230013 $506.34 YES230015 $335.36 YES230017 $1,176.03 YES230019 $432.87 YES230020 $834.93 YES230021 $543.23 YES230022 $286.73 YES230024 $1,211.90 YES230029 $523.19 YES230030 $424.22 YES


Page 35

230031 n/a NO230035 $480.49 YES230036 $267.10 SCH230037 $410.45 YES230038 $1,327.01 YES230040 n/a NO230041 $285.31 YES230046 $1,412.06 YES230047 $277.53 YES230053 $1,356.55 YES230054 $158.25 SCH230055 $267.68 SCH230058 $256.93 SCH230059 $675.47 YES230066 $1,273.78 YES230069 n/a NO230070 $737.82 YES230071 n/a NO230072 $782.24 YES230075 $413.83 YES230077 $330.22 YES230078 $216.60 YES230080 $408.01 YES230081 $318.27 SCH230085 $723.10 YES230089 $313.60 YES230092 $536.67 YES230093 $593.05 SCH230095 $141.62 SCH230096 $484.01 YES230097 $253.97 SCH230099 $394.71 YES230100 $281.16 SCH230101 n/a NO230104 $1,799.00 YES230105 n/a NO230106 $533.68 YES230108 $375.18 SCH230110 $354.77 SCH230117 $380.22 YES230118 $317.79 SCH230121 $437.48 YES230130 $470.70 YES230132 $2,570.02 YES


Page 36

230133 $361.98 SCH230141 $315.27 YES230142 $575.39 YES230144 n/a NO230146 $397.64 YES230151 $528.78 YES230156 $349.39 YES230165 $988.55 YES230167 $423.37 YES230174 $489.30 YES230176 n/a NO230180 $162.81 YES230193 $346.48 YES230195 $427.13 YES230197 $391.04 YES230207 $688.66 YES230208 $818.02 YES230212 n/a NO230216 $364.72 YES230217 $507.69 YES230222 n/a NO230227 $349.78 YES230230 $867.65 YES230236 $1,141.70 YES230239 $419.76 SCH230241 $369.59 YES230244 $490.69 YES230254 n/a NO230259 n/a NO230264 $229.90 YES230269 $276.26 YES230270 $415.56 YES230273 $1,478.77 YES230275 $19,509.33 YES230277 $366.70 YES230279 n/a NO230297 $1,259.78 YES230301 $247.60 YES230302 n/a NO240001 $758.23 YES240002 $653.05 YES240004 $2,548.46 YES240006 $1,441.62 YES240010 n/a NO


Page 37

240014 $394.38 YES240018 $373.45 YES240019 $1,963.03 YES240020 $708.34 YES240022 $844.39 SCH240030 $338.73 SCH240036 $517.92 SCH240038 $746.88 YES240040 $855.38 YES240043 $765.35 YES240044 $277.37 SCH240047 $531.20 YES240050 $362.84 YES240052 $359.81 YES240053 $325.54 YES240056 n/a NO240057 $570.92 YES240059 n/a NO240063 $925.79 YES240064 $347.37 SCH240066 n/a NO240069 $567.30 YES240071 $493.03 YES240075 $263.43 SCH240076 $540.68 YES240078 n/a NO240080 $1,903.36 YES240084 $384.97 YES240088 $736.41 SCH240093 $489.64 SCH240100 $684.50 YES240101 $513.13 SCH240104 $437.10 YES240106 $1,245.78 YES240115 $527.94 YES240132 $610.56 YES240141 $711.50 YES240166 n/a NO240187 $292.50 SCH240196 n/a NO240206 $1,416.09 YES240207 $668.21 YES240210 $574.65 YES240211 n/a NO


Page 38

240213 n/a NO240214 $1,338.96 YES250001 $3,320.22 YES250002 $179.12 YES250004 $558.69 YES250006 $1,074.81 YES250007 $1,097.35 YES250009 $400.49 YES250010 $207.50 SCH250012 $271.99 YES250017 $197.00 YES250018 $406.90 YES250019 $875.28 YES250020 $351.55 YES250023 n/a NO250025 $781.93 YES250027 n/a NO250031 $1,172.79 YES250034 $544.93 YES250036 $595.76 YES250038 $1,515.31 YES250040 $548.62 YES250042 $1,119.80 YES250043 $342.09 YES250044 $184.28 YES250048 $556.71 YES250049 $455.09 YES250050 $1,024.05 YES250051 $304.11 YES250057 $898.47 SCH250058 $816.56 SCH250060 $626.95 YES250061 $189.78 YES250067 $754.44 YES250069 $902.29 YES250072 $1,186.15 YES250077 $714.29 YES250078 $810.69 YES250079 $322.80 YES250081 $108.15 YES250082 $1,283.81 YES250084 $741.14 YES250085 $218.12 YES250093 $940.61 YES


Page 39

250094 $686.10 YES250095 $1,154.25 YES250096 $558.03 YES250097 $711.74 YES250099 $1,009.72 YES250100 $648.01 YES250102 $427.59 YES250104 $611.87 YES250117 $559.42 YES250122 $857.84 YES250123 $592.54 YES250124 $916.86 YES250126 $434.03 YES250127 $225.74 YES250128 $1,387.64 YES250134 $572.56 YES250136 $13,770.08 YES250138 $1,352.64 YES250141 $639.54 YES250151 $17,512.01 YES250152 $6,602.80 YES250162 $553.37 YES250163 n/a NO250164 n/a NO250165 n/a NO250166 n/a NO260001 $535.30 YES260004 n/a NO260005 $1,066.03 YES260006 $416.15 SCH260009 $303.01 SCH260011 $386.56 YES260015 $1,296.68 YES260017 $483.53 SCH260020 $1,126.34 YES260022 $432.55 SCH260023 $338.76 YES260024 $539.47 YES260025 $258.86 SCH260027 $1,226.43 YES260032 $914.78 YES260034 n/a NO260040 $916.63 YES260047 $260.97 YES


Page 40

260048 $3,749.44 YES260050 $428.04 SCH260052 $422.41 YES260057 $326.79 YES260059 $499.39 SCH260061 $752.13 YES260062 $548.68 YES260064 $182.51 SCH260065 $793.31 YES260068 n/a NO260070 $978.19 YES260074 $299.82 SCH260077 n/a NO260078 $819.62 YES260080 $310.29 YES260081 n/a NO260085 $292.51 YES260091 $3,202.95 YES260094 $333.82 SCH260095 $504.13 YES260096 n/a NO260097 $455.55 SCH260102 $3,874.87 YES260104 $1,022.59 YES260105 $933.75 YES260108 n/a NO260110 $381.55 YES260113 $779.31 SCH260115 n/a NO260116 $789.91 YES260119 $817.33 YES260137 $935.44 YES260138 $750.57 YES260141 $1,384.97 YES260142 $411.46 SCH260147 $163.69 SCH260160 $206.85 YES260162 n/a NO260163 $373.10 YES260175 $411.01 SCH260176 n/a NO260177 n/a NO260179 n/a NO260180 $603.01 YES


Page 41

260183 $627.14 YES260186 $281.25 SCH260190 n/a NO260191 n/a NO260193 n/a NO260195 $477.57 SCH260200 $451.19 YES260207 $379.87 YES260209 n/a NO260210 $1,839.12 YES260214 n/a NO260216 $323.94 YES260219 n/a NO260227 $145.45 YES260228 YES260229 n/a NO270003 $364.34 SCH270004 $601.34 YES270012 $532.54 SCH270014 n/a NO270017 $399.15 SCH270023 $1,021.25 YES270032 $792.86 YES270049 $645.32 YES270051 $598.13 YES270057 n/a NO270074 $1,045.91 YES270086 n/a NO270087 $76.79 YES280003 $494.21 YES280009 $377.67 SCH280013 $903.60 YES280020 $458.83 YES280023 $380.12 YES280030 $1,248.91 YES280032 $285.76 YES280040 n/a NO280060 $940.86 YES280061 $358.21 SCH280065 $255.03 SCH280077 $319.88 SCH280081 $1,201.00 YES280105 n/a NO280111 n/a NO


Page 42

280119 $1,473.55 YES280125 $270.02 SCH280127 n/a NO280128 n/a NO280129 n/a NO280130 n/a NO280131 n/a NO280132 n/a NO280133 n/a NO290001 $918.87 YES290002 n/a NO290003 $1,852.04 YES290005 $1,061.69 YES290006 n/a NO290007 $3,881.46 YES290008 $244.13 SCH290009 $460.70 YES290012 $337.66 YES290019 n/a NO290020 $231.08 SCH290021 $1,394.06 YES290022 $446.29 YES290027 n/a NO290032 n/a NO290039 $483.05 YES290041 $856.07 YES290042 n/a NO290045 $536.17 YES290046 $1,010.03 YES290047 $591.35 YES290049 n/a NO290051 n/a NO290053 n/a NO290054 n/a NO300001 n/a NO300003 $658.02 YES300005 $277.95 SCH300011 n/a NO300012 $566.92 YES300014 $352.84 YES300017 n/a NO300018 $272.84 YES300019 n/a NO300020 $466.47 YES


Page 43

300023 n/a NO300029 n/a NO300034 $292.77 YES310001 $764.05 YES310002 $2,812.81 YES310003 $856.14 YES310005 n/a NO310006 $633.60 YES310008 $319.58 YES310009 $800.13 YES310010 n/a NO310011 $272.19 YES310012 n/a NO310014 $1,764.42 YES310015 n/a NO310016 $1,328.19 YES310017 n/a NO310019 $1,566.92 YES310021 $646.62 YES310022 n/a NO310024 n/a NO310025 $318.85 YES310027 $1,520.99 YES310028 n/a NO310029 $717.60 YES310031 n/a NO310032 $738.97 YES310034 n/a NO310038 $871.99 YES310039 $664.01 YES310040 $1,180.72 YES310041 n/a NO310044 $675.05 YES310045 n/a NO310047 n/a NO310048 n/a NO310050 $311.27 YES310051 n/a NO310052 n/a NO310054 $321.96 YES310057 $438.92 YES310058 $6,901.85 YES310060 n/a NO310061 n/a NO


Page 44

310064 $733.27 YES310069 n/a NO310070 $1,212.65 YES310073 $586.14 YES310074 $2,268.18 YES310075 $1,202.99 YES310076 $776.93 YES310081 n/a NO310083 $893.82 YES310084 $818.88 YES310086 $430.98 YES310091 $306.77 YES310092 $711.15 YES310096 $939.19 YES310108 n/a NO310110 n/a NO310111 n/a NO310112 n/a NO310113 n/a NO310115 n/a NO310118 $943.15 YES310119 $3,974.28 YES310120 n/a NO310130 n/a NO320001 $4,454.96 YES320002 $649.45 SCH320003 n/a NO320004 $368.73 SCH320005 $692.58 SCH320006 $707.31 YES320009 $520.30 YES320011 $879.38 SCH320013 n/a NO320014 n/a NO320016 $455.56 SCH320017 $6,634.89 YES320018 $1,258.83 YES320021 $1,473.46 YES320022 $1,124.90 YES320030 $185.19 SCH320033 n/a NO320038 $832.88 SCH320057 $877.61 YES320058 $1,252.16 YES


Page 45

320059 $1,157.97 YES320060 $1,703.37 YES320061 $1,515.24 YES320062 $1,405.81 YES320063 $478.21 SCH320065 $940.70 SCH320067 $216.23 SCH320070 $368.16 YES320074 $530.61 YES320083 n/a NO320084 $245.47 YES320085 $550.36 YES320086 $501.21 YES320089 n/a NO330002 n/a NO330003 n/a NO330004 $378.87 YES330005 $1,786.51 YES330006 $1,960.43 YES330008 $345.05 SCH330009 $7,293.55 YES330011 $401.15 YES330013 $1,586.13 YES330014 $3,278.84 YES330019 $1,159.37 YES330023 $506.26 YES330024 $1,465.63 YES330027 $2,919.06 YES330028 $2,635.16 YES330029 n/a NO330030 $614.38 YES330033 $458.20 YES330037 n/a NO330043 $1,043.30 YES330044 $660.53 YES330045 $289.31 YES330046 $2,239.07 YES330047 $744.50 YES330049 n/a NO330053 $318.10 YES330055 $1,815.56 YES330056 $3,405.25 YES330057 $624.52 YES330058 $525.78 YES


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330059 $3,515.55 YES330061 $437.40 YES330065 $2,220.18 YES330073 $1,298.64 YES330074 n/a NO330078 $1,580.11 YES330079 $406.52 SCH330080 $6,726.44 YES330084 $371.07 SCH330085 $304.44 SCH330086 $991.49 YES330088 $1,420.91 YES330090 $730.51 YES330094 $446.15 YES330096 $488.00 YES330100 $2,187.97 YES330101 $1,827.44 YES330102 n/a NO330103 $531.56 YES330104 $766.79 YES330106 $700.38 YES330107 $326.05 YES330108 $915.45 YES330111 n/a NO330115 $623.56 YES330119 $617.98 YES330125 $1,037.92 YES330126 $427.80 YES330127 $5,969.84 YES330128 $5,872.78 YES330132 n/a NO330135 $989.99 YES330136 $457.86 SCH330140 $558.54 YES330141 $491.64 YES330144 $202.24 YES330151 $1,749.33 YES330153 $1,026.23 YES330154 n/a NO330157 $547.92 SCH330158 $893.00 YES330160 $1,212.78 YES330162 n/a NO330163 $1,094.44 YES


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330164 $1,222.98 YES330166 $196.78 YES330167 $661.06 YES330169 $1,720.89 YES330175 $444.89 SCH330177 n/a NO330180 $540.37 YES330181 n/a NO330182 n/a NO330184 $924.40 YES330185 n/a NO330188 $1,058.26 YES330191 $552.26 YES330193 $2,548.30 YES330194 $2,217.44 YES330195 $1,925.66 YES330196 $2,155.82 YES330197 $1,236.98 SCH330198 $485.19 YES330199 $7,658.16 YES330201 $1,470.68 YES330202 $8,417.28 YES330203 $1,635.40 YES330204 $5,813.72 YES330205 n/a NO330208 $2,165.87 YES330211 $516.68 SCH330214 $569.36 YES330215 $679.66 YES330218 $559.38 SCH330219 $2,428.31 YES330221 $3,010.63 YES330222 $547.95 YES330223 $477.54 SCH330224 $1,147.41 YES330226 $1,534.06 YES330229 $1,004.97 YES330231 $5,962.52 YES330232 $925.88 YES330233 $3,886.58 YES330234 $4,226.27 YES330235 n/a NO330236 $1,738.44 YES330238 $509.45 YES


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330239 $983.97 YES330240 $6,780.01 YES330241 $1,472.50 YES330245 $499.90 YES330246 $1,297.26 YES330249 n/a NO330250 $614.92 SCH330259 $738.46 YES330261 $1,124.02 YES330263 $497.33 SCH330264 $570.49 YES330265 $1,580.90 YES330267 $307.87 YES330268 $121.38 SCH330270 n/a NO330273 n/a NO330276 $585.05 YES330277 $335.94 YES330279 $918.22 YES330285 $2,646.11 YES330286 $792.97 YES330304 $398.94 YES330306 $2,013.77 YES330307 $442.35 YES330314 n/a NO330331 n/a NO330332 n/a NO330340 $282.76 YES330350 $3,285.41 YES330353 $1,527.51 YES330354 n/a NO330372 $931.69 YES330385 $7,201.15 YES330386 $727.65 YES330387 n/a NO330393 $1,120.13 YES330394 $763.58 YES330395 $2,280.38 YES330396 $9,028.84 YES330397 $4,973.23 YES330399 $6,099.50 YES330401 n/a NO330403 $0.00 YES330404 n/a NO


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330405 n/a NO330406 n/a NO330408 n/a NO330409 $524.03 YES340001 $602.35 YES340002 $642.80 YES340003 $431.53 YES340004 $617.82 YES340008 $658.02 YES340010 $507.86 SCH340011 $359.67 YES340013 $387.64 YES340014 $1,077.60 YES340015 $481.61 YES340016 $589.82 YES340017 $309.88 YES340020 $470.23 YES340021 $463.97 YES340023 $602.92 YES340024 $560.77 YES340027 $556.29 YES340028 $1,181.03 YES340030 $1,304.43 YES340032 $591.74 YES340036 $359.67 YES340037 $281.17 YES340038 n/a NO340039 $383.70 YES340040 $989.64 YES340041 $632.20 YES340042 $815.67 SCH340047 $1,169.46 YES340049 n/a NO340050 $860.30 SCH340051 $374.78 SCH340053 $1,403.24 YES340060 $429.38 YES340061 $1,899.08 YES340064 $471.46 YES340068 $553.90 YES340069 $979.46 YES340070 $574.89 YES340071 $639.46 YES340073 n/a NO


Page 50

340075 $866.92 YES340084 $232.93 YES340085 $962.69 YES340087 $411.77 YES340090 $630.39 YES340091 $932.11 YES340096 $673.59 YES340097 $436.33 YES340098 $450.05 YES340099 $590.70 SCH340106 $638.54 YES340107 $654.08 YES340109 $318.82 SCH340113 $1,738.44 YES340114 n/a NO340115 $382.81 YES340116 $357.51 YES340119 $382.33 YES340120 $722.04 YES340123 $608.17 YES340126 $491.17 YES340127 $462.15 YES340129 $389.47 YES340130 $641.50 YES340131 $322.00 SCH340132 $712.79 YES340133 $382.04 YES340141 $504.79 SCH340142 $277.45 SCH340143 $970.43 YES340144 $671.37 YES340145 $514.31 YES340147 $718.86 YES340148 n/a NO340151 $565.48 SCH340153 n/a NO340155 $641.72 YES340156 n/a NO340158 $331.71 YES340159 $255.55 YES340160 $368.71 YES340166 $803.05 YES340168 $207.35 YES340171 $341.31 YES


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340173 n/a NO340183 n/a NO340184 $305.79 YES340186 $759.09 YES350002 $347.61 YES350006 n/a NO350011 $582.58 YES350015 $508.10 YES350019 $620.16 SCH350063 $845.10 YES350064 n/a NO350070 $446.88 YES360001 $553.36 YES360002 $318.75 YES360003 $1,734.32 YES360006 $475.23 YES360008 $547.32 SCH360009 $464.13 YES360010 $399.89 YES360011 $456.81 YES360012 $873.59 YES360013 $586.67 YES360014 $673.72 SCH360016 n/a NO360017 $1,188.37 YES360019 $699.08 YES360020 $761.46 YES360025 $455.91 YES360026 n/a NO360027 $644.64 YES360029 $340.65 YES360032 n/a NO360035 $750.90 YES360036 $474.30 YES360037 $1,214.99 YES360039 $532.99 SCH360040 $342.85 SCH360041 n/a NO360044 $255.01 YES360046 $434.36 YES360048 $651.40 YES360051 $1,464.53 YES360052 $645.32 YES360054 $511.27 YES


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360055 $627.73 YES360056 $473.21 YES360058 $282.28 YES360059 $2,532.91 YES360064 $706.83 YES360065 $442.81 YES360066 $507.08 YES360068 $1,388.70 YES360070 $673.12 YES360071 $255.83 YES360072 $415.72 YES360074 $461.52 YES360075 $385.39 YES360076 $600.59 YES360077 $838.79 YES360078 $411.53 YES360079 n/a NO360080 $544.65 YES360081 $460.93 YES360082 $442.41 YES360084 $658.44 YES360085 $1,615.95 YES360086 $687.68 YES360087 $591.45 YES360089 $283.05 YES360090 n/a NO360091 n/a NO360092 $574.11 YES360095 $404.71 YES360096 $537.45 YES360098 n/a NO360101 n/a NO360107 $512.58 YES360109 $375.11 SCH360112 $1,175.92 YES360113 n/a NO360115 n/a NO360116 $335.55 YES360118 $505.23 YES360121 n/a NO360123 n/a NO360125 $403.20 SCH360130 n/a NO360131 $457.91 YES


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360132 $688.90 YES360133 $963.58 YES360134 $1,472.60 YES360137 $1,161.31 YES360141 $725.09 YES360143 n/a NO360144 $391.73 YES360145 $339.10 YES360147 $337.32 YES360148 n/a NO360150 n/a NO360151 n/a NO360152 $926.93 YES360153 $1,114.83 YES360155 n/a NO360156 $450.75 YES360159 $594.43 YES360161 $657.32 YES360163 $427.92 YES360170 $537.11 YES360172 $507.92 YES360174 $549.05 YES360175 $466.68 YES360179 $433.93 YES360180 $682.44 YES360185 $348.28 YES360189 $1,042.57 YES360192 $207.34 YES360195 n/a NO360197 $434.35 SCH360203 $328.98 SCH360210 $392.09 YES360211 $396.72 YES360212 $470.33 YES360218 $569.59 YES360230 n/a NO360234 $785.25 YES360236 $475.13 YES360239 $778.01 YES360241 n/a NO360242 n/a NO360245 $1,850.62 YES360247 $272.37 YES360258 n/a NO


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360259 $643.56 YES360261 $76.01 YES360262 $325.70 YES360263 n/a NO360266 n/a NO360269 n/a NO360270 n/a NO360271 n/a NO360274 n/a NO360276 n/a NO360347 n/a NO360348 n/a NO360350 n/a NO360351 n/a NO360352 $22.14 YES360354 n/a NO360355 n/a NO360356 n/a NO360358 n/a NO360359 n/a NO360360 $46.75 YES360361 n/a NO360362 n/a NO370001 $1,709.22 YES370002 $392.80 YES370004 $422.79 YES370006 $549.62 YES370007 $341.52 YES370008 $458.72 YES370011 $267.57 YES370013 $656.21 YES370014 $710.84 YES370015 n/a NO370016 $2,703.80 YES370018 $345.77 SCH370019 $852.60 YES370020 $550.06 YES370022 $373.25 SCH370023 $281.01 SCH370025 $492.65 YES370026 n/a NO370028 $1,640.22 YES370029 $562.05 YES370030 $212.87 YES


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370032 $709.43 YES370034 $457.49 SCH370036 $250.31 YES370037 $2,464.32 YES370039 $597.34 YES370040 $531.75 YES370041 n/a NO370047 $434.97 SCH370048 $618.31 YES370049 $463.27 SCH370051 $229.64 YES370054 $507.99 SCH370056 $488.12 YES370057 $205.03 YES370065 $283.83 YES370072 $223.40 YES370078 $1,520.01 YES370080 n/a NO370083 $137.10 YES370089 $430.10 SCH370091 $1,045.75 YES370093 $3,772.61 YES370094 $369.45 YES370097 $3,384.03 YES370099 $349.66 YES370100 $298.63 YES370103 $253.84 YES370106 $714.03 YES370112 $307.26 YES370113 $356.13 YES370114 $483.66 YES370138 $1,007.04 SCH370139 n/a NO370149 $658.85 YES370153 $208.11 YES370156 $218.68 YES370158 n/a NO370166 $1,144.78 YES370169 $181.25 YES370170 $1,724.68 YES370171 $1,599.40 YES370172 $1,521.49 YES370173 $825.80 YES370178 $435.80 YES


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370180 $1,427.29 YES370183 $478.64 YES370190 n/a NO370192 n/a NO370199 n/a NO370201 $210.76 YES370202 $1,038.31 YES370203 n/a NO370206 n/a NO370210 n/a NO370211 $912.58 YES370212 n/a NO370214 $24,731.66 YES370215 n/a NO370216 n/a NO370218 $808.31 YES370220 n/a NO370222 n/a NO370225 $246.17 YES370227 $321.80 YES370228 $566.55 YES370229 $208.59 YES370232 n/a NO370233 n/a NO370234 n/a NO370235 n/a NO370236 $408.10 YES380001 $391.03 SCH380002 $543.67 YES380004 $893.54 YES380005 $430.89 YES380007 $4,407.29 YES380009 $2,136.56 YES380014 $516.29 YES380017 $533.06 YES380018 $759.07 YES380020 $555.43 YES380021 $1,043.30 YES380022 $838.54 YES380025 $1,037.72 YES380027 $506.74 SCH380029 $3,628.53 YES380033 $628.22 YES380037 $569.79 YES


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380038 $853.84 YES380040 $573.82 SCH380047 $616.29 YES380050 $570.85 SCH380051 $1,090.70 YES380052 $572.83 SCH380056 $533.90 YES380060 $793.24 YES380061 $951.28 YES380071 $530.84 YES380075 $424.94 YES380082 $655.34 YES380089 n/a NO380090 $414.72 SCH380091 n/a NO380102 $871.02 YES390001 $305.54 YES390002 $1,286.41 YES390003 $345.83 YES390004 n/a NO390006 $1,065.20 YES390008 $431.22 YES390009 $779.27 YES390012 n/a NO390013 $342.36 YES390016 $779.98 YES390019 n/a NO390025 $20,820.12 YES390026 $265.46 YES390027 $4,281.50 YES390028 $1,651.07 YES390030 $942.95 YES390031 n/a NO390032 n/a NO390035 n/a NO390036 $564.83 YES390037 n/a NO390039 $814.48 SCH390041 $843.83 YES390042 $566.81 YES390043 $349.84 SCH390044 $699.09 YES390045 $392.09 YES390046 $619.74 YES


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390048 $376.98 SCH390049 $491.03 YES390050 $731.12 YES390052 $344.23 YES390056 $370.42 SCH390057 n/a NO390058 $241.45 YES390061 $663.41 YES390062 $823.78 YES390063 $845.60 YES390065 $284.91 YES390066 $372.65 YES390067 $769.65 YES390068 $665.21 YES390070 $900.50 YES390071 $461.48 YES390072 $252.95 YES390073 $561.05 YES390076 $519.17 YES390079 $497.34 YES390080 $691.16 YES390081 $852.90 YES390084 $584.48 YES390086 $1,063.50 YES390090 $4,435.36 YES390091 $377.89 YES390093 $242.95 SCH390095 n/a NO390096 $619.75 YES390097 $704.97 YES390100 $527.82 YES390101 $438.08 YES390102 n/a NO390104 n/a NO390107 n/a NO390108 n/a NO390110 $864.38 YES390111 $1,474.62 YES390112 $339.34 YES390113 $639.46 SCH390114 $6,603.97 YES390115 $714.21 YES390116 $400.44 YES390117 $469.80 YES


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390118 $1,181.99 YES390119 $555.13 YES390122 $375.88 SCH390123 n/a NO390125 $327.27 YES390127 n/a NO390130 n/a NO390132 $3,600.65 YES390133 $642.11 YES390137 $348.29 YES390138 $327.43 YES390139 n/a NO390142 $1,754.75 YES390145 $851.93 YES390146 n/a NO390147 $465.53 YES390150 $479.06 YES390151 $254.09 YES390153 n/a NO390154 n/a NO390156 $1,112.67 YES390157 n/a NO390160 n/a NO390162 $266.10 YES390163 $911.15 YES390164 $952.39 YES390168 $620.49 YES390173 $382.43 SCH390174 $957.77 YES390178 $494.99 YES390179 n/a NO390180 $768.69 YES390183 n/a NO390184 $861.90 YES390185 $291.00 YES390192 n/a NO390194 $541.03 YES390195 $462.75 YES390196 n/a NO390197 $1,479.04 YES390198 $727.40 YES390199 $364.81 YES390201 $346.75 SCH390203 n/a NO


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390204 $521.26 YES390211 $638.25 YES390217 $411.98 YES390219 $589.24 YES390220 $333.37 YES390222 n/a NO390223 $829.18 YES390225 $308.17 YES390226 $1,420.66 YES390228 n/a NO390231 n/a NO390233 n/a NO390236 $397.75 YES390237 n/a NO390256 $1,434.06 YES390258 n/a NO390263 n/a NO390265 n/a NO390266 $363.52 YES390267 n/a NO390268 n/a NO390270 $612.73 YES390272 $2,325.08 YES390278 $1,467.98 YES390290 $2,427.83 YES390302 n/a NO390304 $498.66 YES390307 n/a NO390312 n/a NO390313 n/a NO390314 n/a NO390316 n/a NO390318 n/a NO390321 n/a NO390322 n/a NO390323 n/a NO390324 n/a NO390325 n/a NO390326 n/a NO390327 n/a NO390328 n/a NO390329 n/a NO400001 n/a NO400003 n/a NO


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400004 n/a NO400005 n/a NO400006 $3,970.05 YES400007 $4,519.02 YES400009 $2,319.61 YES400010 $966.84 YES400011 $4,394.21 YES400012 $4,288.68 YES400013 $2,897.55 YES400014 n/a NO400015 $14,381.31 YES400016 n/a NO400018 $2,596.50 YES400019 n/a NO400021 $2,340.35 YES400022 $2,601.29 YES400024 n/a NO400026 n/a NO400032 $5,150.47 YES400044 $2,166.03 YES400048 $4,093.39 YES400061 $6,070.13 YES400079 $5,171.18 YES400087 $3,641.70 YES400098 $4,945.49 YES400102 $5,846.01 YES400103 n/a NO400104 $662.46 YES400105 $7,361.79 YES400106 n/a NO400109 n/a NO400110 $1,976.35 YES400111 $2,523.77 YES400112 $3,948.35 YES400113 $2,636.61 YES400114 $2,949.12 YES400115 $8,129.32 YES400117 $2,228.67 YES400118 $2,576.68 YES400120 $4,566.15 YES400121 n/a NO400122 n/a NO400123 $2,555.95 YES400124 n/a NO


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400125 n/a NO400126 $1,938.38 YES400127 $24,459.12 YES400128 $11,941.66 YES400130 n/a NO400131 n/a NO410001 $677.02 YES410004 $645.64 YES410005 n/a NO410006 $428.58 YES410007 $1,142.22 YES410008 n/a NO410009 $785.53 YES410010 $15,084.15 YES410011 $545.73 YES410012 n/a NO410013 n/a NO420002 $659.56 YES420004 $2,018.78 YES420005 $815.18 YES420007 $837.84 YES420009 $328.18 SCH420010 $719.59 YES420011 $329.99 YES420015 $585.22 YES420016 $193.86 SCH420018 $1,973.21 YES420019 $317.46 YES420020 $592.51 YES420023 $327.36 YES420026 n/a NO420027 $519.96 YES420030 $655.72 SCH420033 $507.23 YES420036 $595.27 YES420037 n/a NO420038 $597.79 SCH420039 $395.12 YES420043 $605.53 YES420048 $496.59 YES420049 $720.14 YES420051 $879.88 YES420053 $507.48 SCH420054 $618.61 YES


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420055 $667.12 YES420056 n/a NO420057 $401.62 YES420062 $399.92 YES420064 n/a NO420065 $614.43 YES420066 $304.11 YES420067 $637.99 SCH420068 $897.23 SCH420069 $1,024.42 YES420070 $812.54 YES420071 $669.65 SCH420072 $308.45 YES420073 $689.14 YES420078 $1,547.38 YES420079 $543.66 YES420080 $261.36 SCH420082 $752.26 YES420083 $511.40 YES420085 $333.70 YES420086 $1,482.30 YES420087 $269.22 YES420089 n/a NO420091 $597.17 YES420098 n/a NO420101 $211.47 YES420102 n/a NO420103 $39.30 YES420104 $329.15 YES420105 $550.72 YES430005 $215.50 YES430008 n/a NO430012 $371.54 SCH430013 $301.47 YES430014 n/a NO430015 $459.37 YES430016 $936.08 YES430027 $796.44 YES430048 $371.15 SCH430077 $1,024.10 SCH430081 $2,822.95 YES430082 $4,192.26 YES430083 $2,475.43 YES430084 $1,440.19 YES


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430089 n/a NO430090 n/a NO430091 n/a NO430092 n/a NO430093 n/a NO430094 n/a NO430095 n/a NO430096 n/a NO430097 $20.11 YES440001 n/a NO440002 $533.85 YES440003 $460.13 YES440006 $809.38 YES440007 $316.61 YES440008 $147.07 YES440009 $387.26 SCH440010 $145.16 YES440011 $396.22 YES440012 $431.34 YES440015 $1,266.20 YES440016 $197.90 YES440017 $600.81 YES440018 $398.43 YES440020 $367.40 YES440025 $420.99 YES440029 n/a NO440030 $560.48 YES440031 $310.09 YES440032 $396.80 YES440033 $375.42 YES440034 $429.28 YES440035 $540.65 YES440039 $1,612.54 YES440040 $237.55 YES440046 $414.14 YES440047 n/a NO440048 $691.27 YES440049 $1,205.45 YES440050 $792.91 YES440051 $464.04 YES440053 $573.19 YES440056 n/a NO440057 $366.62 YES440058 $401.68 YES


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440059 $446.33 YES440060 $267.45 YES440061 $385.53 YES440063 $928.57 YES440065 $685.85 YES440067 $602.64 YES440068 $781.95 YES440070 $148.89 YES440072 $318.54 YES440073 $414.35 YES440081 $704.78 YES440082 n/a NO440083 $335.91 YES440084 $499.83 YES440091 n/a NO440102 $431.98 YES440104 $1,617.48 YES440109 $644.15 YES440110 n/a NO440111 $3,740.82 YES440120 $451.45 YES440125 $923.60 YES440130 $367.77 YES440131 $1,074.24 YES440132 $268.56 YES440133 $1,078.10 YES440137 $225.17 YES440141 $347.99 YES440144 $425.27 YES440147 n/a NO440148 n/a NO440150 $491.80 YES440151 $463.41 YES440152 $10,895.99 YES440153 $489.67 YES440156 $1,632.05 YES440159 $816.21 YES440161 $973.49 YES440162 n/a NO440168 n/a NO440173 $587.85 YES440174 $279.12 YES440175 $384.44 YES440176 $718.23 YES


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440180 $708.51 YES440181 $182.83 YES440182 $674.74 YES440183 $1,172.89 YES440184 $792.81 YES440185 $546.27 YES440186 n/a NO440187 $437.86 YES440189 $440.09 YES440192 $245.58 YES440193 $754.84 YES440194 $587.07 YES440197 $443.14 YES440200 $144.51 YES440218 n/a NO440227 $793.81 YES440228 $592.58 YES440231 n/a NO440232 n/a NO450002 $2,212.56 YES450005 $649.26 YES450007 n/a NO450008 n/a NO450010 $475.21 SCH450011 $475.30 YES450015 $8,286.81 YES450018 $2,720.66 YES450021 $837.46 YES450023 $286.13 YES450024 $3,527.42 YES450028 $2,162.74 YES450029 $1,562.92 YES450032 $584.23 YES450033 $1,139.75 YES450034 $592.05 YES450035 $4,037.74 YES450037 $864.10 YES450039 $5,289.59 YES450040 $417.60 YES450042 $383.67 YES450044 $693.95 YES450046 $1,125.43 YES450051 $1,694.17 YES450052 $315.70 YES


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450054 $737.57 YES450055 $341.08 SCH450056 $557.15 YES450058 $1,168.90 YES450064 $687.15 YES450068 $3,093.60 YES450072 $331.71 YES450073 $738.97 SCH450076 n/a NO450078 $402.03 YES450079 $873.75 YES450080 $799.76 YES450082 $709.94 SCH450083 $572.58 YES450085 $419.98 YES450087 n/a NO450090 $692.23 YES450092 $1,253.82 YES450097 $1,895.95 YES450099 $145.28 SCH450101 $1,154.95 YES450102 $478.37 YES450104 $459.11 YES450107 $1,516.28 YES450108 n/a NO450119 $1,890.84 YES450123 n/a NO450124 $2,886.02 YES450128 $1,386.92 YES450130 $1,730.16 YES450132 $773.57 YES450133 $590.41 YES450135 $818.28 YES450137 $1,301.75 YES450143 n/a NO450144 $760.61 SCH450147 $741.26 YES450148 $494.64 YES450152 $811.29 YES450154 $675.95 SCH450155 $1,301.44 YES450162 $195.13 YES450163 $830.13 YES450165 $481.29 YES


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450176 $1,810.70 YES450177 $838.16 SCH450178 $203.61 SCH450184 $1,176.97 YES450187 $465.02 YES450188 $196.24 YES450192 $347.18 YES450193 $495.03 YES450194 $620.52 SCH450196 $305.22 YES450200 $847.84 YES450203 $303.96 YES450209 $1,529.36 YES450210 $296.34 SCH450211 $426.05 YES450213 $3,870.27 YES450214 $791.37 YES450219 $480.11 YES450221 $589.40 SCH450222 $685.61 YES450229 $547.04 YES450231 $395.97 YES450234 n/a NO450235 $488.03 YES450236 $645.38 YES450237 $816.28 YES450241 n/a NO450243 n/a NO450253 n/a NO450271 $369.20 YES450272 $652.93 YES450280 $553.71 YES450289 $11,921.04 YES450292 $456.41 YES450293 $1,228.75 YES450296 $561.26 YES450299 $687.15 YES450306 $212.48 YES450324 $624.69 YES450330 $1,256.61 YES450340 $606.60 YES450346 $783.42 YES450347 $369.88 YES450348 $290.65 SCH


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450351 $321.99 SCH450352 $610.08 YES450358 $342.86 YES450369 $140.56 SCH450370 $415.56 YES450372 n/a NO450373 $154.09 YES450379 $429.21 YES450388 $1,144.80 YES450389 $410.61 YES450395 $575.49 YES450399 $254.73 SCH450400 n/a NO450403 $650.16 YES450411 $209.47 YES450419 n/a NO450422 n/a NO450424 $708.47 YES450431 $1,186.22 YES450438 n/a NO450446 $4,121.24 YES450447 $403.54 YES450451 n/a NO450460 $125.57 SCH450462 $811.82 YES450465 $527.03 SCH450469 $269.55 YES450475 $425.36 YES450484 $432.41 YES450488 $138.51 YES450489 $249.72 SCH450497 n/a NO450498 n/a NO450508 $617.82 YES450518 $828.90 YES450530 n/a NO450537 n/a NO450539 $1,103.54 YES450558 $565.72 YES450563 n/a NO450565 $539.77 YES450571 $437.00 YES450573 $868.89 YES450578 n/a NO


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450580 $262.06 YES450584 n/a NO450586 n/a NO450587 $324.14 SCH450591 $1,275.11 YES450596 $266.38 YES450597 $385.97 YES450604 $248.29 YES450605 $470.54 YES450610 $554.23 YES450615 n/a NO450617 $878.22 YES450620 $1,997.71 YES450630 n/a NO450634 $306.17 YES450638 $1,399.79 YES450639 $545.98 YES450641 n/a NO450643 $1,910.30 YES450644 $1,659.59 YES450647 $1,380.13 YES450651 $722.70 YES450653 $386.08 SCH450654 $927.84 SCH450656 $366.34 YES450658 n/a NO450659 $1,325.61 YES450661 $3,296.94 YES450662 $1,867.67 YES450668 $989.49 YES450669 $916.65 YES450670 n/a NO450672 $343.11 YES450674 $87,460.20 YES450675 $1,698.51 YES450677 $565.47 YES450678 $745.27 YES450684 $1,011.48 YES450686 $1,339.28 YES450688 $552.03 YES450690 $226.58 YES450694 n/a NO450697 $2,702.94 YES450698 $286.32 SCH


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450702 $491.94 YES450709 n/a NO450711 $1,632.08 YES450713 $483.34 YES450716 $2,741.16 YES450718 $637.24 YES450723 $924.28 YES450730 $1,023.57 YES450742 $871.07 YES450743 $766.20 YES450746 n/a NO450747 $767.84 YES450749 $311.41 YES450754 n/a NO450755 $1,056.42 YES450766 n/a NO450770 $492.27 YES450771 $709.62 YES450774 n/a NO450775 $925.04 YES450779 $784.52 YES450780 n/a NO450788 $1,526.71 YES450795 $842.08 YES450796 n/a NO450797 n/a NO450801 $456.61 YES450803 $2,690.17 YES450804 n/a NO450808 n/a NO450809 $1,044.16 YES450820 $437.01 YES450822 n/a NO450825 $198.87 YES450827 n/a NO450828 $902.61 YES450831 $122.27 YES450832 $1,029.26 YES450833 $814.62 YES450834 n/a NO450840 $909.70 YES450841 $4,469.93 YES450844 $872.67 YES450845 n/a NO


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450847 $705.43 YES450848 $849.35 YES450851 n/a NO450853 n/a NO450855 $724.84 YES450856 n/a NO450860 n/a NO450862 $559.15 YES450864 n/a NO450865 $1,426.44 YES450867 $472.90 YES450869 $2,738.39 YES450871 n/a NO450872 n/a NO450874 n/a NO450875 n/a NO450876 n/a NO450877 $338.57 YES450878 n/a NO450880 n/a NO450883 n/a NO450884 $163.27 YES450885 n/a NO450886 n/a NO450888 n/a NO450889 n/a NO450890 n/a NO450891 n/a NO450893 n/a NO450894 n/a NO460001 $1,311.87 YES460003 $501.76 YES460004 $843.45 YES460005 $923.51 YES460006 $1,264.47 YES460007 $675.80 SCH460009 $1,689.14 YES460010 $769.91 YES460011 $519.43 YES460013 $579.68 YES460014 $543.52 YES460015 $1,328.18 YES460017 $932.67 YES460019 $686.93 SCH


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460021 $418.63 SCH460023 $1,025.74 YES460026 $363.18 YES460030 $552.24 SCH460033 n/a NO460035 $414.25 SCH460039 $489.10 YES460041 $714.98 YES460042 $404.07 YES460043 $62,118.31 YES460044 n/a NO460047 $680.98 YES460049 n/a NO460051 $1,366.17 YES460052 $1,346.62 YES460054 n/a NO460057 n/a NO460058 $1,833.00 YES460059 n/a NO470001 $446.61 SCH470003 $798.74 YES470005 $371.73 SCH470011 $455.22 YES470012 $295.01 YES470024 $382.28 SCH480001 n/a NO480002 n/a NO490001 $575.58 YES490002 $346.09 YES490004 $340.49 SCH490005 $409.06 YES490007 $1,060.16 YES490009 $1,203.89 YES490011 $472.84 YES490013 $388.11 YES490017 $742.89 YES490018 $282.74 SCH490019 $311.07 YES490020 $343.76 YES490021 $180.49 SCH490022 $482.28 YES490023 $318.34 YES490024 $842.57 YES490027 n/a NO


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490032 $1,783.14 YES490033 $432.74 YES490037 $479.22 SCH490038 $187.76 YES490040 $633.93 YES490041 $385.20 YES490042 $431.50 YES490043 $410.74 YES490044 $505.72 YES490045 $601.06 YES490046 $383.40 YES490048 n/a NO490050 $360.15 YES490052 $647.16 YES490053 $402.38 YES490057 n/a NO490059 $551.72 YES490060 $460.35 YES490063 $1,199.32 YES490066 n/a NO490067 $615.75 YES490069 $351.47 YES490075 $408.43 YES490077 n/a NO490079 $352.58 YES490084 n/a NO490088 n/a NO490089 $245.97 YES490090 $434.20 SCH490092 $357.09 SCH490093 $346.28 YES490094 $1,549.38 YES490097 $396.07 YES490098 $338.92 SCH490101 $521.87 YES490104 n/a NO490105 n/a NO490106 n/a NO490107 n/a NO490108 n/a NO490109 n/a NO490110 $285.72 YES490111 $292.63 SCH490112 $548.67 YES


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490113 $761.87 YES490114 $577.59 YES490115 $267.15 SCH490116 n/a NO490117 $180.53 YES490118 $608.61 YES490119 $732.86 YES490120 $591.88 YES490122 n/a NO490123 n/a NO490126 n/a NO490127 $271.56 SCH490129 n/a NO490130 n/a NO490134 $1,535.54 YES490135 $685.64 YES490136 $457.55 YES490140 n/a NO490141 $491.04 YES490143 n/a NO500001 $351.81 YES500002 $384.24 YES500003 $619.97 YES500005 n/a NO500007 $258.87 YES500008 $1,660.84 YES500011 $750.18 YES500012 $357.88 YES500014 $1,078.95 YES500015 $717.36 YES500016 $488.17 YES500019 $484.37 SCH500021 $497.70 YES500024 $718.40 YES500025 $342.52 YES500026 $697.89 YES500027 $1,165.80 YES500030 $526.82 SCH500031 $544.96 SCH500033 $1,092.94 SCH500036 $946.48 YES500037 $1,501.05 YES500039 $440.47 YES500041 $907.71 YES


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500044 $1,153.15 YES500049 $514.54 YES500050 $805.95 YES500051 n/a NO500052 $399,836.47 YES500053 $853.68 YES500054 $1,270.84 YES500058 $884.41 YES500060 $490.64 YES500064 $1,873.23 YES500072 $273.77 SCH500077 $635.09 YES500079 $546.73 YES500084 $345.94 YES500088 $978.67 YES500108 $921.20 YES500119 $444.73 YES500124 $597.26 YES500129 $1,157.36 YES500138 n/a NO500139 $345.07 YES500141 $633.26 YES500148 n/a NO500150 $1,211.92 YES500151 $171.31 YES500152 n/a NO510001 $1,463.60 YES510002 $484.48 YES510006 $594.60 SCH510007 $492.59 YES510008 $649.96 YES510012 $417.88 YES510013 $395.21 YES510018 n/a NO510022 $921.88 YES510023 $459.03 YES510024 n/a NO510029 $637.35 YES510030 $404.99 SCH510031 $449.78 YES510033 n/a NO510038 $593.55 YES510039 $572.24 YES510046 $470.02 YES


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510047 $372.77 YES510048 $634.01 SCH510050 $620.81 YES510055 $2,037.07 YES510058 $508.25 YES510059 n/a NO510062 $498.46 YES510070 $619.34 YES510071 $488.19 YES510072 n/a NO510077 $574.17 YES510082 $586.58 YES510086 $643.10 SCH520002 $389.28 YES520004 $583.36 YES520008 n/a NO520009 $1,539.26 YES520011 $466.24 YES520013 $647.81 YES520017 $968.50 YES520019 $323.55 SCH520021 $447.66 YES520027 n/a NO520028 n/a NO520030 $419.18 YES520033 $455.25 YES520034 $320.59 YES520035 $781.54 YES520037 $831.67 SCH520038 n/a NO520041 $235.56 YES520044 $322.38 YES520045 $616.90 YES520048 $604.25 YES520049 $429.80 YES520051 $1,467.54 YES520057 $395.78 YES520059 n/a NO520062 n/a NO520063 n/a NO520066 $357.49 YES520070 $385.04 YES520071 $252.90 YES520075 $912.37 YES


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520076 $319.73 YES520078 $1,031.06 YES520083 $434.46 YES520087 $850.56 YES520088 $453.72 SCH520089 $762.72 YES520091 $247.54 SCH520095 n/a NO520096 $891.45 YES520097 $445.25 YES520098 $609.20 YES520100 $431.81 YES520102 $320.28 YES520103 n/a NO520107 n/a NO520109 $350.36 SCH520113 $262.86 SCH520116 n/a NO520136 $1,528.24 YES520138 $789.45 YES520139 $738.27 YES520160 n/a NO520177 $919.37 YES520189 $423.97 YES520193 $1,029.14 YES520194 n/a NO520195 n/a NO520196 n/a NO520198 $395.63 YES520202 $327.20 YES520204 n/a NO520205 n/a NO520206 n/a NO520207 n/a NO520208 $335.54 YES530002 $552.54 SCH530006 $349.79 SCH530008 $549.80 SCH530010 $625.52 SCH530011 $504.19 SCH530012 $337.72 YES530014 $355.19 SCH530015 n/a NO530025 $380.23 SCH


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530032 $589.44 YES530033 n/a NO640001 n/a NO650001 n/a NO660001 n/a NO670002 $467.55 YES670004 $189.53 YES670005 n/a NO670006 n/a NO670007 n/a NO670008 n/a NO670010 n/a NO670012 n/a NO670018 $187.44 YES670019 $312.77 YES670021 n/a NO670023 n/a NO670024 n/a NO670025 n/a NO670029 n/a NO670031 n/a NO670034 n/a NO670041 $574.56 YES670043 $467.15 YES670044 $380.64 YES670045 n/a NO670046 n/a NO670047 $1,492.48 YES670049 n/a NO670050 n/a NO670053 $514.30 YES670054 n/a NO670055 n/a NO670056 $480.49 YES670057 n/a NO670058 n/a NO670059 n/a NO670060 $776.58 YES670061 n/a NO670062 n/a NO670063 n/a NO670066 $184.14 YES670067 n/a NO670068 n/a NO


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670069 n/a NO670071 n/a NO670072 $3,804.78 YES670073 n/a NO670074 n/a NO670075 $809.12 YES670076 n/a NO670077 $895.89 YES670078 n/a NO670079 n/a NO670080 $747.76 YES670081 n/a NO670082 n/a NO670083 $65.88 YES670085 n/a NO670087 n/a NO670088 n/a NO670089 n/a NO670899 n/a NO

Attachment 6County to CBSA Crosswalk Using New CBSA Delineations

County Stat

e

SSA State county code

FIPS State county code

"OLD CBSA" "OLD CBSA NAME" (Blanks are Rural) "N

ew C

BSA"

"New CBSA NAME" (Blanks are Rural)BALDWIN AL 01010 01003 01 19300Daphne-Fairhope-Foley, ALGREENE AL 01310 01063 46220 Tuscaloosa, AL 01PICKENS AL 01530 01107 01 46220Tuscaloosa, ALCOCHISE AZ 03010 04003 03 43420Sierra Vista-Douglas, AZFRANKLIN AR 04230 05047 22900 Fort Smith, AR-OK 04LITTLE RIVER AR 04400 05081 04 45500Texarkana, TX-ARMARIN CA 05310 06041 41884 San Francisco-San Mateo-Redwood City, CA 42034San Rafael, CAORANGE CA 05400 06059 42044 Santa Ana-Anaheim-Irvine, CA 11244Anaheim-Santa Ana-Irvine, CASANTA BARBARA CA 05520 06083 42060 Santa Barbara-Santa Maria-Goleta, CA 42200Santa Maria-Santa Barbara, CAWINDHAM CT 07070 09015 07 49340Worcester, MA-CTSUSSEX DE 08020 10005 08 41540Salisbury, MD-DECITRUS FL 10080 12017 10 26140Homosassa Springs, FLFLAGLER FL 10170 12035 37380 Palm Coast, FL 19660Deltona-Daytona Beach-Ormond Beach, FLGULF FL 10220 12045 10 37460Panama City, FLHIGHLANDS FL 10270 12055 10 42700Sebring, FLSUMTER FL 10590 12119 10 45540The Villages, FLWALTON FL 10650 12131 10 18880Crestview-Fort Walton Beach-Destin, FLLINCOLN GA 11690 13181 11 12260Augusta-Richmond County, GA-SCMORGAN GA 11771 13211 11 12060Atlanta-Sandy Springs-Roswell, GAPEACH GA 11811 13225 11 47580Warner Robins, GAPULASKI GA 11831 13235 11 47580Warner Robins, GAKALAWAO HI 12005 15005 12 27980Kahului-Wailuku-Lahaina, HIHONOLULU HI 12020 15003 26180 Honolulu, HI 46520Urban Honolulu, HIMAUI HI 12050 15009 12 27980Kahului-Wailuku-Lahaina, HIBUTTE ID 13110 16023 13 26820Idaho Falls, IDPOWER ID 13380 16077 38540 Pocatello, ID 13DE KALB IL 14170 17037 16974 Chicago-Joliet-Naperville, IL 20994Elgin, ILDE WITT IL 14180 17039 14 14010Bloomington, ILJACKSON IL 14470 17077 14 16060Carbondale-Marion, ILKANE IL 14530 17089 16974 Chicago-Joliet-Naperville, IL 20994Elgin, IL


MC LEAN IL 14650 17113 14060 Bloomington-Normal, IL 14010Bloomington, ILWILLIAMSON IL 14990 17199 14 16060Carbondale-Marion, ILBENTON IN 15030 18007 29140 Lafayette, IN 29200Lafayette-West Lafayette, INCARROLL IN 15070 18015 29140 Lafayette, IN 29200Lafayette-West Lafayette, INFRANKLIN IN 15230 18047 17140 Cincinnati-Middletown, OH-KY-IN 15GIBSON IN 15250 18051 21780 Evansville, IN-KY 15GREENE IN 15270 18055 14020 Bloomington, IN 15MADISON IN 15470 18095 11300 Anderson, IN 26900Indianapolis-Carmel-Anderson, INSCOTT IN 15710 18143 15 31140Louisville/Jefferson County, KY-INTIPPECANOE IN 15780 18157 29140 Lafayette, IN 29200Lafayette-West Lafayette, INTIPTON IN 15790 18159 29020 Kokomo, IN 15UNION IN 15800 18161 15 17140Cincinnati, OH-KY-INPLYMOUTH IA 16740 19149 16 43580Sioux City, IA-NE-SDFRANKLIN KS 17290 20059 28140 Kansas City, MO-KS 17GEARY KS 17300 20061 31740 Manhattan, KS 17KINGMAN KS 17470 20095 17 48620Wichita, KSALLEN KY 18010 21003 18 14540Bowling Green, KYBUTLER KY 18150 21031 18 14540Bowling Green, KYMEADE KY 18801 21163 31140 Louisville-Jefferson County, KY-IN 21060Elizabethtown-Fort Knox, KYNELSON KY 18890 21179 31140 Louisville-Jefferson County, KY-IN 18WEBSTER KY 18989 21233 21780 Evansville, IN-KY 18ACADIA LA 19000 22001 19 29180Lafayette, LAIBERIA LA 19220 22045 19 29180Lafayette, LAST. JAMES LA 19460 22093 19 35380New Orleans-Metairie, LATANGIPAHOA LA 19520 22105 19 25220Hammond, LAVERMILION LA 19560 22113 19 29180Lafayette, LAWEBSTER LA 19590 22119 19 43340Shreveport-Bossier City, LAFREDERICK MD 21100 24021 13644 Bethesda-Rockville-Frederick, MD 43524Silver Spring-Frederick-Rockville, MDMONTGOMERY MD 21150 24031 13644 Bethesda-Rockville-Frederick, MD 43524Silver Spring-Frederick-Rockville, MDST. MARYS MD 21180 24037 21 15680California-Lexington Park, MDWORCESTER MD 21230 24047 21 41540Salisbury, MD-DEESSEX MA 22040 25009 37764 Peabody, MA 15764Cambridge-Newton-Framingham, MAFRANKLIN MA 22060 25011 44140 Springfield, MA 22NORFOLK MA 22130 25021 14484 Boston-Quincy, MA 14454Boston, MA


PLYMOUTH MA 22150 25023 14484 Boston-Quincy, MA 14454Boston, MASUFFOLK MA 22160 25025 14484 Boston-Quincy, MA 14454Boston, MAIONIA MI 23330 26067 24340 Grand Rapids-Wyoming, MI 23LAPEER MI 23430 26087 47644 Warren-Troy-Farmington-Hills, MI 47664Warren-Troy-Farmington Hills, MILIVINGSTON MI 23460 26093 47644 Warren-Troy-Farmington-Hills, MI 47664Warren-Troy-Farmington Hills, MIMACOMB MI 23490 26099 47644 Warren-Troy-Farmington-Hills, MI 47664Warren-Troy-Farmington Hills, MIMIDLAND MI 23550 26111 23 33220Midland, MIMONTCALM MI 23580 26117 23 24340Grand Rapids-Wyoming, MINEWAYGO MI 23610 26123 24340 Grand Rapids-Wyoming, MI 23OAKLAND MI 23620 26125 47644 Warren-Troy-Farmington-Hills, MI 47664Warren-Troy-Farmington Hills, MIOTTAWA MI 23690 26139 26100 Holland-Grand Haven, MI 24340Grand Rapids-Wyoming, MIST. CLAIR MI 23730 26147 47644 Warren-Troy-Farmington-Hills, MI 47664Warren-Troy-Farmington Hills, MIFILLMORE MN 24220 27045 24 40340Rochester, MNLE SUEUR MN 24390 27079 24 33460Minneapolis-St. Paul-Bloomington, MN-WIMILLE LACS MN 24470 27095 24 33460Minneapolis-St. Paul-Bloomington, MN-WISIBLEY MN 24710 27143 24 33460Minneapolis-St. Paul-Bloomington, MN-WIBENTON MS 25040 28009 25 32820Memphis, TN-MS-ARGEORGE MS 25190 28039 37700 Pascagoula, MS 25JACKSON MS 25290 28059 37700 Pascagoula, MS 25060Gulfport-Biloxi-Pascagoula, MSSTONE MS 25650 28131 25060 Gulfport-Biloxi, MS 25YAZOO MS 25810 28163 25 27140Jackson, MSCRAWFORD MO 26270 29055 41180 St. Louis, MO-IL 26HOWARD MO 26440 29089 17860 Columbia, MO 26WASHINGTON MO 26992 29221 41180 St. Louis, MO-IL 26GOLDEN VALLEY MT 27180 30037 27 13740Billings, MTHALL NE 28390 31079 28 24260Grand Island, NEHAMILTON NE 28400 31081 28 24260Grand Island, NEHOWARD NE 28460 31093 28 24260Grand Island, NEMERRICK NE 28600 31121 28 24260Grand Island, NEBERGEN NJ 31100 34003 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJHUDSON NJ 31230 34017 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJMIDDLESEX NJ 31270 34023 20764 Edison-New Brunswick, NJ 35614New York-Jersey City-White Plains, NY-NJMONMOUTH NJ 31290 34025 20764 Edison-New Brunswick, NJ 35614New York-Jersey City-White Plains, NY-NJOCEAN NJ 31310 34029 20764 Edison-New Brunswick, NJ 35614New York-Jersey City-White Plains, NY-NJ


PASSAIC NJ 31320 34031 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJSOMERSET NJ 31350 34035 20764 Edison-New Brunswick, NJ 35084Newark, NJ-PABRONX NY 33020 36005 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJDUTCHESS NY 33230 36027 39100 Poughkeepsie-Newburgh-Middletown, NY 20524Dutchess County-Putnam County, NYJEFFERSON NY 33330 36045 33 48060Watertown-Fort Drum, NYKINGS NY 33331 36047 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJNEW YORK NY 33420 36061 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJORANGE NY 33540 36071 39100 Poughkeepsie-Newburgh-Middletown, NY 35614New York-Jersey City-White Plains, NY-NJPUTNAM NY 33580 36079 35644 New York-White Plains-Wayne, NY-NJ 20524Dutchess County-Putnam County, NYQUEENS NY 33590 36081 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJRICHMOND NY 33610 36085 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJROCKLAND NY 33620 36087 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJWESTCHESTER NY 33800 36119 35644 New York-White Plains-Wayne, NY-NJ 35614New York-Jersey City-White Plains, NY-NJYATES NY 33910 36123 33 40380Rochester, NYANSON NC 34030 37007 16740 Charlotte-Gastonia-Rock Hill, NC-SC 34BRUNSWICK NC 34090 37019 48900 Wilmington, NC 34820Myrtle Beach-Conway-North Myrtle Beach, SC-NCCRAVEN NC 34240 37049 34 35100New Bern, NCDAVIDSON NC 34280 37057 34 49180Winston-Salem, NCGATES NC 34360 37073 34 47260Virginia Beach-Norfolk-Newport News, VA-NCGREENE NC 34390 37079 24780 Greenville, NC 34IREDELL NC 34480 37097 34 16740Charlotte-Concord-Gastonia, NC-SCJONES NC 34510 37103 34 35100New Bern, NCLINCOLN NC 34540 37109 34 16740Charlotte-Concord-Gastonia, NC-SCPAMLICO NC 34680 37137 34 35100New Bern, NCROWAN NC 34790 37159 34 16740Charlotte-Concord-Gastonia, NC-SCOLIVER ND 35320 38065 35 13900Bismarck, NDSIOUX ND 35420 38085 35 13900Bismarck, NDERIE OH 36220 39043 41780 Sandusky, OH 36HOCKING OH 36380 39073 36 18140Columbus, OHJEFFERSON OH 36420 39081 44600 Steubenville-Weirton, OH-WV 48260Weirton-Steubenville, WV-OHOTTAWA OH 36630 39123 45780 Toledo, OH 36PERRY OH 36650 39127 36 18140Columbus, OHPREBLE OH 36690 39135 19380 Dayton, OH 36WASHINGTON OH 36850 39167 37620 Parkersburg-Marietta-Vienna, WV-OH 36


COTTON OK 37160 40033 37 30020Lawton, OKJOSEPHINE OR 38160 41033 38 24420Grants Pass, ORLINN OR 38210 41043 38 10540Albany, ORADAMS PA 39000 42001 39 23900Gettysburg, PABUCKS PA 39140 42017 37964 Philadelphia, PA 33874Montgomery County-Bucks County-Chester County, PACHESTER PA 39210 42029 37964 Philadelphia, PA 33874Montgomery County-Bucks County-Chester County, PACOLUMBIA PA 39250 42037 39 14100Bloomsburg-Berwick, PAFRANKLIN PA 39350 42055 39 16540Chambersburg-Waynesboro, PAMONROE PA 39550 42089 39 20700East Stroudsburg, PAMONTGOMERY PA 39560 42091 37964 Philadelphia, PA 33874Montgomery County-Bucks County-Chester County, PAMONTOUR PA 39580 42093 39 14100Bloomsburg-Berwick, PAARECIBO PR 40070 72013 41980 San Juan-Caguas-Guaynabo, PR 11640Arecibo, PRCAMUY PR 40140 72027 41980 San Juan-Caguas-Guaynabo, PR 11640Arecibo, PRCEIBA PR 40180 72037 21940 Fajardo, PR 41980San Juan-Carolina-Caguas, PRFAJARDO PR 40260 72053 21940 Fajardo, PR 41980San Juan-Carolina-Caguas, PRGUANICA PR 40270 72055 49500 Yauco, PR 38660Ponce, PRGUAYANILLA PR 40290 72059 49500 Yauco, PR 38660Ponce, PRHATILLO PR 40320 72065 41980 San Juan-Caguas-Guaynabo, PR 11640Arecibo, PRLUQUILLO PR 40440 72089 21940 Fajardo, PR 41980San Juan-Carolina-Caguas, PRPENUELAS PR 40550 72111 49500 Yauco, PR 38660Ponce, PRQUEBRADILLAS PR 40570 72115 41980 San Juan-Caguas-Guaynabo, PR 11640Arecibo, PRUTUADO PR 40710 72141 40 10380Aguadilla-Isabela, PRYAUCO PR 40770 72153 49500 Yauco, PR 38660Ponce, PRANDERSON SC 42030 45007 11340 Anderson, SC 24860Greenville-Anderson-Mauldin, SCBEAUFORT SC 42060 45013 42 25940Hilton Head Island-Bluffton-Beaufort, SCCHESTER SC 42110 45023 42 16740Charlotte-Concord-Gastonia, NC-SCJASPER SC 42260 45053 42 25940Hilton Head Island-Bluffton-Beaufort, SCLANCASTER SC 42280 45057 42 16740Charlotte-Concord-Gastonia, NC-SCUNION SC 42430 45087 42 43900Spartanburg, SCCUSTER SD 43160 46033 43 39660Rapid City, SDCAMPBELL TN 44060 47013 44 28940Knoxville, TNCROCKETT TN 44160 47033 44 27180Jackson, TNGRAINGER TN 44280 47057 34100 Morristown, TN 28940Knoxville, TNMAURY TN 44590 47119 44 34980Nashville-Davidson--Murfreesboro--Franklin, TN


MORGAN TN 44640 47129 44 28940Knoxville, TNROANE TN 44720 47145 44 28940Knoxville, TNSTEWART TN 44800 47161 17300 Clarksville, TN-KY 44CALHOUN TX 45224 48057 47020 Victoria, TX 45DELTA TX 45400 48119 19124 Dallas-Plano-Irving, TX 45FALLS TX 45500 48145 45 47380Waco, TXHOOD TX 45653 48221 45 23104Fort Worth-Arlington, TXHUDSPETH TX 45662 48229 45 21340El Paso, TXLYNN TX 45771 48305 45 31180Lubbock, TXMARTIN TX 45784 48317 45 33260Midland, TXNEWTON TX 45821 48351 45 13140Beaumont-Port Arthur, TXOLDHAM TX 45832 48359 45 11100Amarillo, TXSAN JACINTO TX 45884 48407 26420 Houston-Sugar Land-Baytown, TX 45SOMERVELL TX 45893 48425 45 23104Fort Worth-Arlington, TXBOX ELDER UT 46010 49003 46 36260Ogden-Clearfield, UTSUMMIT UT 46210 49043 41620 Salt Lake City, UT 46AUGUSTA VA 49070 51015 49 44420Staunton-Waynesboro, VABUCKINGHAM VA 49140 51029 49 16820Charlottesville, VACULPEPER VA 49230 51047 49 47894Washington-Arlington-Alexandria, DC-VA-MD-WVCUMBERLAND VA 49240 51049 40060 Richmond, VA 49DANVILLE CITY VA 49241 51590 19260 Danville, VA 49FLOYD VA 49310 51063 49 13980Blacksburg-Christiansburg-Radford, VAKING AND QUEENVA 49480 51097 40060 Richmond, VA 49LOUISA VA 49540 51109 40060 Richmond, VA 49PITTSYLVANIA VA 49710 51143 19260 Danville, VA 49RAPPAHANNOCK VA 49780 51157 49 47894Washington-Arlington-Alexandria, DC-VA-MD-WVSTAUNTON CITY VA 49891 51790 49 44420Staunton-Waynesboro, VASURRY VA 49900 51181 47260 Virginia Beach-Norfolk-Newport News, VA 49WAYNESBORO CITVA 49951 51820 49 44420Staunton-Waynesboro, VACOLUMBIA WA 50060 53013 50 47460Walla Walla, WAPEND OREILLE WA 50250 53051 50 44060Spokane-Spokane Valley, WASTEVENS WA 50320 53065 50 44060Spokane-Spokane Valley, WAWALLA WALLA WA 50350 53071 50 47460Walla Walla, WABROOKE WV 51040 54009 44600 Steubenville-Weirton, OH-WV 48260Weirton-Steubenville, WV-OH


FAYETTE WV 51090 54019 51 13220Beckley, WVHANCOCK WV 51140 54029 44600 Steubenville-Weirton, OH-WV 48260Weirton-Steubenville, WV-OHLINCOLN WV 51210 54043 16620 Charleston, WV 26580Huntington-Ashland, WV-KY-OHMORGAN WV 51320 54065 25180 Hagerstown-Martinsburg, MD-WV 51PLEASANTS WV 51360 54073 37620 Parkersburg-Marietta-Vienna, WV-OH 51PUTNAM WV 51390 54079 16620 Charleston, WV 26580Huntington-Ashland, WV-KY-OHRALEIGH WV 51400 54081 51 13220Beckley, WVGREEN WI 52220 55045 52 31540Madison, WI

Attachment 7Hospitals Waiving Lugar Redesignation for the Out-Migration Adjustment FY 2015

Medicare CCN

Provider Name

140167 IROQUOIS MEMORIAL HOSPITAL250117 HIGHLAND COMMUNITY HOSPITAL330047 ST MARY'S HOSPITAL AT AMSTERDAM390008 ELLWOOD CITY HOSPITAL390031 SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET390150 SOUTHWEST REGIONAL MEDICAL CENTER520116 UW HLTH PARTNERS WATERTOWN REGIONAL MEDICAL CTR

Attachment 8Hospitals Located in Lugar Counties FY 2015

NEWCounty Name State CBSA CBSA NameChambers County AL 12220 Auburn-Opelika, AL NewCherokee County AL 40660 Rome, GACleburne County AL 11500 Anniston-Oxford-Jacksonville, AL NewMacon County AL 12220 Auburn-Opelika, ALTalladega County AL 11500 Anniston-Oxford-Jacksonville, ALDenali Borough AK 21820 Fairbanks, AK NewHot Spring County AR 26300 Hot Springs, ARLitchfield County CT 35300 New Haven-Milford, CTBradford County FL 27260 Jacksonville, FLLevy County FL 23540 Gainesville, FLWashington County FL 37460 Panama City, FL NewChattooga County GA 40660 Rome, GAJackson County GA 12060 Atlanta-Sandy Springs-Roswell, GALumpkin County GA 12060 Atlanta-Sandy Springs-Roswell, GAPolk County GA 40660 Rome, GATalbot County GA 17980 Columbus, GA-ALOneida County ID 36260 Ogden-Clearfield, UT NewChristian County IL 44100 Springfield, ILIroquois County IL 28100 Kankakee, ILLogan County IL 44100 Springfield, ILMason County IL 37900 Peoria, ILOgle County IL 40420 Rockford, ILUnion County IL 16060 Carbondale-Marion, ILClinton County IN 29200 Lafayette-West Lafayette, INGreene County IN 14020 Bloomington, IN NewHenry County IN 26900 Indianapolis-Carmel-Anderson, INMarshall County IN 43780 South Bend-Mishawaka, IN-MI NewParke County IN 45460 Terre Haute, IN NewSpencer County IN 21780 Evansville, IN-KYStarke County IN 23844 Gary, INTipton County IN 26900 Indianapolis-Carmel-Anderson, IN NewWarren County IN 29200 Lafayette-West Lafayette, INBoone County IA 11180 Ames, IABuchanan County IA 47940 Waterloo-Cedar Falls, IACedar County IA 26980 Iowa City, IADelaware County IA 20220 Dubuque, IA NewIowa County IA 26980 Iowa City, IA NewJasper County IA 19780 Des Moines-West Des Moines, IA NewFranklin County KS 28140 Kansas City, MO-KS NewNelson County KY 31140 Louisville/Jefferson County, KY-IN NewAssumption Parish LA 12940 Baton Rouge, LAJefferson Davis Parish LA 29340 Lake Charles, LA NewSt. Landry Parish LA 29180 Lafayette, LA NewOxford County ME 30340 Lewiston-Auburn, ME NewCaroline County MD 12580 Baltimore-Columbia-Towson, MD New

RURAL COUNTY LUGAR DESIGNATED CBSA


Franklin County MA 44140 Springfield, MA NewAllegan County MI 24340 Grand Rapids-Wyoming, MIIonia County MI 24340 Grand Rapids-Wyoming, MI NewLenawee County MI 11460 Ann Arbor, MI NewNewaygo County MI 24340 Grand Rapids-Wyoming, MI NewShiawassee County MI 29620 Lansing-East Lansing, MITuscola County MI 40980 Saginaw, MIGoodhue County MN 33460 Minneapolis-St. Paul-Bloomington, MN-WI NewMeeker County MN 33460 Minneapolis-St. Paul-Bloomington, MN-WI NewRice County MN 33460 Minneapolis-St. Paul-Bloomington, MN-WI NewPearl River County MS 25060 Gulfport-Biloxi-Pascagoula, MSStone County MS 25060 Gulfport-Biloxi-Pascagoula, MS NewDade County MO 44180 Springfield, MOOtoe County NE 30700 Lincoln, NE NewDouglas County NV 16180 Carson City, NV NewLyon County NV 16180 Carson City, NVLos Alamos County NM 42140 Santa Fe, NMCayuga County NY 45060 Syracuse, NYCortland County NY 27060 Ithaca, NY NewGenesee County NY 40380 Rochester, NYGreene County NY 10580 Albany-Schenectady-Troy, NYLewis County NY 48060 Watertown-Fort Drum, NY NewMontgomery County NY 10580 Albany-Schenectady-Troy, NY NewSchuyler County NY 27060 Ithaca, NYSeneca County NY 40380 Rochester, NY NewCamden County NC 47260 Virginia Beach-Norfolk-Newport News, VA-NC NewCaswell County NC 15500 Burlington, NCGranville County NC 20500 Durham-Chapel Hill, NCGreene County NC 24780 Greenville, NC NewHarnett County NC 39580 Raleigh, NCPolk County NC 43900 Spartanburg, SCWilson County NC 40580 Rocky Mount, NC NewTraill County ND 24220 Grand Forks, ND-MN NewAshtabula County OH 17460 Cleveland-Elyria, OHChampaign County OH 44220 Springfield, OHColumbiana County OH 49660 Youngstown-Warren-Boardman, OH-PAHarrison County OH 48260 Weirton-Steubenville, WV-OH NewPreble County OH 19380 Dayton, OH NewClinton County PA 48700 Williamsport, PAFulton County PA 25180 Hagerstown-Martinsburg, MD-WV NewGreene County PA 38300 Pittsburgh, PALawrence County PA 38300 Pittsburgh, PA NewSchuylkill County PA 39740 Reading, PASusquehanna County PA 13780 Binghamton, NYAdjuntas Municipio PR 38660 Ponce, PR NewCoamo Municipio PR 41980 San Juan-Carolina-Caguas, PR NewLas Marías Municipio PR 32420 Mayagüez, PR New


Maricao Municipio PR 32420 Mayagüez, PR NewSalinas Municipio PR 25020 Guayama, PR NewClarendon County SC 44940 Sumter, SCColleton County SC 16700 Charleston-North Charleston, SC NewLee County SC 44940 Sumter, SCMarion County SC 22500 Florence, SC NewNewberry County SC 17900 Columbia, SC NewMeigs County TN 17420 Cleveland, TNBlanco County TX 12420 Austin-Round Rock, TX NewBosque County TX 47380 Waco, TXCalhoun County TX 47020 Victoria, TX NewFannin County TX 19124 Dallas-Plano-Irving, TXGrimes County TX 17780 College Station-Bryan, TXHarrison County TX 30980 Longview, TXHenderson County TX 46340 Tyler, TXHill County TX 23104 Fort Worth-Arlington, TX NewMilam County TX 12420 Austin-Round Rock, TXVan Zandt County TX 19124 Dallas-Plano-Irving, TXWillacy County TX 15180 Brownsville-Harlingen, TXKing and Queen Count VA 40060 Richmond, VA NewLouisa County VA 40060 Richmond, VA NewMadison County VA 16820 Charlottesville, VA NewOrange County VA 47900 Washington-Arlington-Alexandria, DC-VA-MD-WV NewPage County VA 25500 Harrisonburg, VAShenandoah County VA 49020 Winchester, VA-WVSouthampton County VA 47260 Virginia Beach-Norfolk-Newport News, VA-NC NewSurry County VA 47260 Virginia Beach-Norfolk-Newport News, VA-NC NewIsland County WA 42644 Seattle-Bellevue-Everett, WAMason County WA 36500 Olympia-Tumwater, WAJackson County WV 16620 Charleston, WVMorgan County WV 25180 Hagerstown-Martinsburg, MD-WV NewRoane County WV 16620 Charleston, WVGreen Lake County WI 22540 Fond du Lac, WIJefferson County WI 33340 Milwaukee-Waukesha-West Allis, WIWalworth County WI 33340 Milwaukee-Waukesha-West Allis, WI

Attachment 9Counties No Longer Lugar in FY15

County Name Lugar In FY 2014

No Longer Rural and Deemed

Lugar, Now Urban Under OMB

Delineations for FY 2015

Still Rural for FY 2015; No Longer Deemed Lugar in

FY 2015Adams County, PA x xAllen County, KY x xBanks County, GA x xBingham County, ID x xBuckingham County, VA x xColumbia County, NY x xCotton County, OK x xDavidson County, NC x xDe Witt County, IL x xFalls County, TX x xFillmore County, MN x xFlagler County, FL x xFloyd County, VA x xGreen County, WI x xHendry County, FL x xLincoln County, NC x xLinn County, OR x xMiddlesex County, VA x xMonroe County, PA x xMontcalm County, MI x xMorgan County, GA x xOceana County, MI x xOconee County, SC x xPeach County, GA x xSt. James Parrish, LA x xSullivan County, NY x xWahkiakum County, WA x xWalton County, FL x xWindham County, CT x xWyoming County, NY x x

CMS Certification

Number (CCN)

FY 2015 'Special Wage Index' under CBSA Transition Policy

CBSA under FY 2014

DesignationsCBSA under FY 2015

Delineations012012 0.8362 46220 46220092002 1.0415 47894 47894092003 1.0415 47894 47894142006 1.0356 16974 20994152007 1.0135 26900 26900152008 1.0135 26900 26900152013 1.0135 26900 26900152020 1.0135 26900 26900192006 0.8339 43340 43340192010 0.8339 43340 43340192011 0.8339 43340 43340192020 0.7948 29180 29180192022 0.7344 19 19192025 0.8339 43340 43340192028 0.7344 19 19192029 0.7948 29180 29180192032 0.7948 29180 29180192033 0.7948 29180 29180192034 0.7344 19 19192035 0.7344 19 19192052 0.7344 19 19222000 1.1245 15764 15764222003 1.1245 15764 15764222023 1.0249 44140 44140222046 1.0249 44140 44140222048 1.1509 49340 49340232026 0.8882 24340 24340232029 0.8882 24340 24340252004 0.758 25 25252005 0.8038 25060 25060252006 0.758 25 25252008 0.758 25 25252010 0.758 25 25252013 0.758 25 25312019 1.2974 35644 35614312020 1.1287 35084 35084312024 1.1287 35084 35084332006 1.2974 35644 35614332008 1.2974 35644 35614332014 1.2974 35644 35614332022 1.2974 35644 35614342015 0.9152 16740 16740

Attachment 10 - LTCH PPS Special Wage Index Table - FY 2015

342016 0.8721 49180 49180342019 0.7947 34 34392048 1.0497 37964 33874422004 0.8304 43900 43900422008 0.9214 24860 24860422009 0.9214 24860 24860442006 0.8988 34980 34980442011 0.8988 34980 34980442012 0.7026 28940 28940442015 0.7026 28940 28940452018 0.9393 23104 23104452019 0.9393 23104 23104452028 0.9393 23104 23104452031 0.7851 45 45452082 0.7851 45 45452088 0.9393 23104 23104452099 0.9393 23104 23104452110 0.9393 23104 23104462004 0.9507 41620 41620462006 0.9507 41620 41620512002 0.7985 16620 16620512003 0.8864 26580 26580522008 1.1235 31540 31540

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