CalPERS Report

COST EFFICIENCY AT HOSPITAL
FACILITIES IN CALIFORNIA
A REPORT BASED ON PUBLICLY

AVAILABLE DATA
Presented by:
Will Fox, FSA, MAAA
John Pickering, FSA, MAAA
October 17, 2007

TABLE OF CONTENTS
A) EXECUTIVE SUMMARY
B) OSHPD QUARTERLY FINANCIAL DATA
C) OSHPD DISCHARGE DATA
D) CREATING APR-DRG/SOI ALLOWED BENCHMARK AMOUNTS
E) CALCULATING THE BUYER COST INDEX
F) CONSIDERATIONS IN USING THE BUYER COST INDEX
G) CALCULATING THE HOSPITAL COST INDEX
H) GEOGRAPHIC AREAS
I) SORTING HIGH VOLUME FACILITIES
J) CAVEATS AND LIMITATIONS
ATTACHMENT A – HOSPITAL ALLOWED/BILLED AND COST/CHARGE RATIOS

ATTACHMENT B – EXPERIENCE BY APR-DRG/SOI AND BENCHMARK ALLOWED AMOUNTS
ATTACHMENT C – BUYER COST INDEX
ATTACHMENT D – HOSPITAL COST INDEX
ATTACHMENT E – MEDICARE GEOGRAPHIC FACTORS
ATTACHMENT F – COUNTY REFERENCE TABLE
ATTACHMENT G-1 – BUYER COST INDEX (BCI), HOSPITAL COST INDEX (HCI) AND RATIO -
SORT DESCENDING BY BCI
SORT DESCENDING BY HCI
SORT DESCENDING BY RATIO
SORT BY REGION AND NAME
Milliman
A) EXECUTIVE SUMMARY
At the request of the Pacific Business Group on Health (PBGH) Milliman, Inc. (Milliman) has
prepared this report to compare inpatient hospital costs using publicly available data. We
understand that PBGH will use this information to better understand the relative cost differences
among hospitals in California and will make this report available to CalPERS, other PBGH
members, and the public. We include in this report patient severity adjusted comparisons of
commercial buyer costs (i.e., what commercial insurers pay for hospital services) and
comparisons of hospital operating costs (i.e., what hospitals reported as their operating costs).
REPORT OVERVIEW
This report includes a detailed description of the methodology employed, examples and final
tables. Before using the results reported, the user should carefully review the methodology and
assumptions. The user should also review the Considerations in Using the Buyer Cost Index in
Section F.
METHODOLOGY OVERVIEW
Cost Efficiency was defined in the PBGH-sponsored Hospital Value Initiative (HVI) as the
contractually allowed amount divided by an APR-DRG/SOI (All Patient Refined Diagnosis
Related Group/Severity of Illness) based Allowed Benchmark. The Allowed Benchmarks are
the weighted average severity-adjusted commercial contractually allowed amount estimates for
all hospitals in our analysis. We call this result the Buyer Cost Index.
The Buyer Cost Index values present an estimate of the relative commercial reimbursement
levels (e.g. 1.03 is approximately 5% higher than 0.98). The Buyer Cost Index values reflect a
blend of negotiated commercial reimbursement levels and length of stay (LOS) efficiency since
the LOS is generally strongly correlated with commercial reimbursement. For example, under a
per diem contract, a higher LOS will yield a higher payment and a lower LOS will yield a lower
payment.
The initial hospital specific Buyer Cost Index is not adjusted for geographic cost differences.
However, we used Medicare inpatient geographic adjustment factors to estimate area adjusted
results. Attachment C shows the area adjusted index along with the unadjusted index. For many
purposes, it may be most appropriate to compare hospitals within a geographic area.
The major steps in creating the Buyer Cost Index were:
1. Use California Office of Statewide Health Planning and Development (OSHPD)

quarterly financial data, by hospital, to estimate the Third Party Managed Care
(Commercial) allowed/billed ratio for CY 2005.
2. Use the 2005 OSHPD discharge data as the claims data source. Limit to commercial
discharges, hospitals with reasonable financial data (as described on page B-3), and
hospitals with at least 100 commercial discharges.
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Page A-1
3. Estimate the commercial allowed amount for each discharge using the billed charges in
the discharge data and the hospital specific allowed/billed ratio for CY 2005.
4. Group the discharge data to APR-DRG/SOI.
5. Create Allowed Benchmark values by APR-DRG/SOI.
6. For a given hospital, sum the allowed and Allowed Benchmark values across all
discharges, and divide the total allowed by the total Allowed Benchmark to derive the
Buyer Cost Index.
7. Using the Medicare inpatient geographic adjustment factors show the area adjusted Buyer
Cost Index.
A similar process was followed to estimate a Hospital Cost Index, which measures the operating
cost for the hospital to deliver their services, rather than the commercial reimbursement amount.
This report relies on data and other information from OSHPD. We have not audited or verified
this data and other information. If the underlying data or information is inaccurate or
incomplete, the results of our review may likewise be inaccurate or incomplete. We have
attempted to identify and exclude incorrect data.
This report attempts only to measure the relative costs of services among different hospitals. It
does not evaluate the quality of care delivered. We understand that it is PBGH’s intention to
consider this or other relative cost information in the context of the hospital’s clinical and patient
experience performance. That analysis is beyond the scope of this project.
We understand that this report may be shared with other organizations outside PBGH. This work
is not intended to benefit any third party and is subject to the terms of our Consulting Services
Agreement with PBGH. The entire report should be made available to anyone using the results
of the analysis. Milliman makes no representations or warranties regarding the contents of this
report to third parties. Likewise, third parties are instructed that they are to place no reliance
upon this report prepared for PBGH by Milliman that would result in the creation of any duty or
liability under any theory of law by Milliman or its employees to third parties. Other parties
receiving this report must rely upon their own experts in drawing conclusions about relative
hospital costs in California. The estimates included in this report cannot and do not consider
every variation from the key assumptions and the effect of variations on the results.
Milliman
Page A-2
B) OSHPD QUARTERLY FINANCIAL DATA
The California OSHPD requires each hospital to submit financial results on a quarterly basis.
Milliman downloaded these files for the four quarters in CY 2005, and summarized the data
for each hospital.
Two ratios were calculated for each hospital:
• Other Third Parties - Managed Care (TPMC) Allowed/Billed Ratio

• Cost/Charge Ratio
Attachment A presents these ratios by hospital.
TPMC Allowed/Billed Ratio

The TPMC Allowed/Billed Ratio represents contractual allowed amounts divided by gross
billed charges for Other Third Parties – Managed Care payers. The formula using the
OSHPD data elements is:
(TPMC Gross IP Charges + TPMC Gross OP Charges

- TPMC Contractual Adjustments
TPMC Allowed/Billed Ratio = + TP Capitation)
(TPMC Gross IP Charges + TPMC Gross OP Charges)
As examples of the calculation, we detail the calculation for Torrance Memorial Medical
Center and Pomona Valley Hospital Medical Center.
Table B-1
Example of Calculation of Other Third Parties - Managed Care (Commercial) Allowed/Billed Ratio
Based on CY 2005 OSHPD Financial Data
(A) (B) (C) (D=A-B+C) (E=D/A)

Other Third Parties - Managed Care (Commercial)
Gross Allowed /
IP and OP Contractual Billed
OSHPD ID Hospital Charges Adjustments Capitation Allowed Ratio
106190422 Torrance Memorial $590,703,359 $448,121,853 $38,520,942 $181,102,448 30.7%
106190630 Pomona Valley $316,467,849 $219,148,393 $1,821,690 $99,141,146 31.3%
Notice that the Allowed/Billed Ratio is necessarily based on the combination of inpatient and
outpatient services because contractual adjustments and capitation are not reported separately
for inpatient and outpatient. We applied this all-services commercial allowed/billed ratio to
inpatient only services. This may impact our inpatient only results, but does produce findings
that are reasonable in terms of overall hospital cost.
Milliman
Page B-1
We used OSHPD’s category “Other Third Parties – Managed Care” for our commercial
Allowed/Billed ratios. The OSHPD definition of the Managed Care category in OSHPD
financials is:
“Managed care patients are patients enrolled in a managed care plan to receive health care
from providers on a pre-negotiated or per diem basis, usually involving utilization review
(includes Health Maintenance Organizations (HMO), Health Maintenance Organizations with
Point-of-Service option (POS) Preferred Provider Organizations (PPO), Exclusive Provider
Organizations (EPO), Exclusive Provider Organizations with Point-of-Service option, etc.).”
The OSHPD data is self reported and some hospitals report Other Third Party data only in the
“Traditional” sub-category. “Traditional” is defined as:
“The Other Third Parties – Traditional category includes all other forms of health coverage
excluding managed care plans. Examples include Short-Doyle, CHAMPUS, IRCA/SLIAG,
California Children's Services, indemnity plans, fee-for-service plans, and Workers’
Compensation.”
We used only the Other Third Parties – Managed Care (TPMC) data for our commercial
Buyer Cost Index analysis. Since this is self-reported data we are aware there is the potential
for inaccurate entries. We have outlined our reasonableness review and exclusions at the end
of this section.
Cost/Charge Ratio
The Cost/Charge Ratio represents total hospital operating costs divided by total gross billed
charges. We applied the OSHPD suggested formula:
Cost/Charge Ratio = (Total Operating Expenses – Other Operating Revenue)

(Gross IP Charges + Gross OP Charges)
Other Operating Revenue is subtracted from Total Operating Expenses to get to a patient
service cost basis.
The following table again uses Torrance Memorial Medical Center and Pomona Valley
Hospital Medical Center to provide examples of the calculation.
Table B-2
Example of Calculation of Cost / Charge Ratio
Based on CY 2005 OSHPD Financial Data
(A) (B) (C) (D=[B-C]/A)

All Payers
Gross Total Other Cost /
IP and OP Operating Operating Charge
OSHPD ID Hospital Charges Expenses Revenue Ratio
106190422 Torrance Memorial Medical Center $1,274,668,540 $313,842,450 $12,835,762 23.6%
106190630 Pomona Valley Hospital Medical Center $1,332,270,660 $280,263,941 $2,812,776 20.8%
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Page B-2
The Cost/Charge Ratio is based on an all patient average, rather than Other Third Parties –
Managed Care patients, because the operating expenses and other operating revenue are not
available at the payer category level. Actual cost/charge ratios for hospitals vary by
department and will vary by type of service and payer. A possible future refinement to this
report could use a more detailed cost estimate.
Attachment A presents the Allowed/Billed and Cost/Charge Ratios by hospital. We excluded

the following OSHPD defined hospital types: Kaiser, LTC emphasis, State hospitals,
Shriners, and Psych hospitals. We have excluded from consideration hospitals with likely
data problems in the OSHPD reported financial data. Our rules for exclusion were:
• Negative or Zero Allowed/Billed Ratio

• Negative or Zero Cost/Charge Ratio
• Allowed/Billed <0.05
• Allowed/Billed >1.00
• Commercial Discharges <100
Hospitals may differ in their reporting of the OSHPD financial data elements, although most
are consistent. The formula to calculate the allowed/billed ratio is based on typical reporting
practices and is consistent with OSHPD instructions. The tests outlined above help us to
identify and remove incorrect data.
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Page B-3
C) OSHPD DISCHARGE DATA
The OSHPD collects discharge level data from every hospital. Milliman purchased the
CY 2005 database and then identified commercial, non-skilled nursing facility, acute
discharges for hospitals where we had quarterly financial data. See Table C-1 for a summary
of the original records and the exclusions.
Table C-1
Scope of Analysis
CY 2005 OSHPD Discharge Data
Discharges Billed
Total Inpatient Discharges 3,604,621 $131,579,176,790
Inpatient Commercial, non-Kaiser, non-Shriners 1,122,359 $36,255,978,736
Ungroupable Discharges (1) 4,387 $222,371,618
Excluded Hospitals (2) 104,033 $2,747,121,727
Included in Analysis 1,013,939 $33,286,485,391
% of Inpatient Commercial Included 90.3% 91.8%
(1) Could not assign an APR DRG and SOI to these discharges.
(2) Credible Data not available for these providers. (see Section B)
Since the OSHPD Discharge Data only includes billed charges, the estimates for commercial
allowed and cost use the TPMC Allowed/Billed Ratio and Cost/Charge Ratio developed for
each hospital from the OSHPD Financial Data. This calculation is shown below using sample
Torrance Memorial Medical Center and Pomona Valley Hospital Medical Center discharges.
Table C-2
Illustrative Calculation of Estimated TPMC Allowed and Estimated Costs
(A) (B) (C=A*B) (D) (E=A*D)
Allowed / Cost /
Billed Estimated Charge Estimated
Discharge OSHPD ID Hospital Billed Ratio Allowed Ratio Cost
0948381 106190422 Torrance Memorial $10,999 30.7% $3,372 23.6% $2,597
0948382 106190422 Torrance Memorial $16,534 30.7% $5,069 23.6% $3,904
0948383 106190422 Torrance Memorial $1,206 30.7% $370 23.6% $285
1269399 106190630 Pomona Valley $16,467 31.3% $5,159 20.8% $3,429
1269404 106190630 Pomona Valley $59,854 31.3% $18,751 20.8% $12,465
1269407 106190630 Pomona Valley $42,608 31.3% $13,348 20.8% $8,873
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Page C-1
We applied the same Allowed/Billed Ratio to every discharge for a particular hospital. In
reality, the Allowed/Billed Ratio for a particular discharge will depend on the service specific
contract terms between the payer and the hospital. In general, the contract may provide for
payment for a particular discharge based on:
• A fixed dollar amount per day (per diem);

• A fixed dollar amount based on the patient's diagnosis and/or procedures (case rate);
and
• A percentage of the hospital's billed charges.
Under any of the above, contracts often include a stoploss provision where discharges with
billed charges in excess of a stated amount are paid on a different basis.
The use of a single allowed to billed ratio for all discharges at a particular hospital may cause
the allowed charges for particular discharges to be overstated or understated. However,
because all comparisons between hospitals are severity adjusted, and include all discharges,
both overstated and understated, we have no reason to believe that this approximation biases
the comparisons.
In some cases, the provider ID in the OSHPD Discharge Data is more detailed than the
provider IDs in the OSHPD Financials Data. For the following hospitals, we mapped the
more detailed ID in the OSHPD Discharge Data to the “master ID” shown below from the
OSHPD Financial Data:
Table C-3
Mapping of Detail OSHPD IDs to Master OSHPD IDs
Detail Master
OSHPD ID Hospital OSHPD ID Hospital
106010844 ALTA BATES SUMMIT MED CTR - HERRICK CAMPUS 106010739 ALTA BATES SUMMIT MED CTR-ALTA BATES
106154044 BAKERSFIELD MEMORIAL HOSPITAL - WHITE LANE 106150722 BAKERSFIELD MEMORIAL HOSPITAL
106190413 CITRUS VALLEY MEDICAL CENTER - IC CAMPUS 106190636 CITRUS VALLEY MEDICAL CENTER - QV CAMPUS
106190410 CITY OF ANGELS MEDICAL CENTER-INGLESIDE CAMPUS 917 106190661 CITY OF ANGELS
106510882 FREMONT MEDICAL CENTER 106580996 RIDEOUT MEMORIAL HOSPITAL
106190814 HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS 106190380 HOLLYWOOD COMMUNITY HOSP OF HOLLYWOOD
106190570 NORWALK COMMUNITY HOSPITAL 106190198 LOS ANGELES COMMUNITY HOSPITAL
106013619 SAN LEANDRO HOSPITAL 106010805 EDEN MEDICAL CENTER
106370658 SCRIPPS MERCY HOSPITAL - CHULA VISTA 106370744 SCRIPPS MERCY HOSPITAL
106370745 SHARP MEMORIAL HOSPITAL D/P APH 106370694 SHARP MEMORIAL HOSPITAL
106341052 SUTTER MEMORIAL HOSPITAL 106341051 SUTTER MEDICAL CENTER-SACRAMENTO
106100822 UNIVERSITY MEDICAL CENTER 106100717 COMMUNITY REGIONAL MEDICAL CENTER
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Page C-2
D) CREATING APR-DRG/SOI ALLOWED BENCHMARK AMOUNTS
APR-DRG/SOI based allowed benchmark amounts were created to reflect the relative
resources required to treat patients within each APR/SOI. Milliman performed the following
steps:
1. All OSHPD discharge records were grouped using 3M’s APR-DRG and Severity of
Illness Grouper (v24.0).
2. Discharges were summarized by APR/SOI and an average allowed per discharge and
average cost per discharge were calculated.
3. The cost per discharge amounts were increased pro-rata to balance with the actual
statewide allowed amounts. This results in Allowed Benchmarks by APR-DRG/SOI
that reflect allowed amounts in total while retaining the cost-based relativities by
APR/SOI.
Attachment B shows the data summarized by APR-DRG/SOI. We show the raw discharge
data, the estimated commercial allowed, the estimated cost per discharge, and the cost based
Allowed Benchmarks. Note that the averages by APR-DRG/SOI are not actual average
allowed or cost values. They are estimates using billed charges and the ratios developed in
Section B. While not indicative of the actual costs for services, we do believe that they
provide a reasonable measure of the relative patient severity differences.
There are several reasons that the cost-adjusted benchmarks were used, rather than the actual
allowed per discharge amounts:
• Cost-based relative charges are consistent with the way Medicare has moved in their
DRG relative weight updates.
• Allowed charges at each hospital reflect the hospital’s negotiating results in addition
to underlying patient severity. Cost-based benchmarks more closely approximate the
true resource differences among patients by APR-DRG/SOI.
A possible future enhancement to the Buyer Cost Index calculation would be to modify the
Allowed Benchmarks so that they more closely reflect true patient resource consumption
differences. The following are concerns that could be addressed by refining the Allowed
Benchmarks.
• The cost-based Allowed Benchmarks used in this report reflect a blend from a large
number of very different hospitals with different cost structures. This results in
benchmarks that will be higher for services that are done more frequently by higher
cost hospitals.
• The estimated costs that we have available using OSHPD data are not actual costs for
each discharge – they are estimated using actual billed charges and a hospital specific
cost/charge ratio.
• For many APR-DRGs the cost-based Allowed Benchmarks do not increase by severity
as should happen.
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Page D-1
E) CALCULATING THE BUYER COST INDEX
For each discharge, we assigned an Allowed Benchmark amount based on the APR-DRG/SOI
using the values in Attachment B. The table below illustrates the calculation of the Buyer
Cost Index for six discharges:
Table E-1
Illustrative Calculation of Estimated TPMC Allowed and Buyer Cost Index
(A) (B) (C=A*B) (D) (E=C/D)
Allowed / Buyer
Billed Estimated APR Benchmark Cost
Discharge OSHPD ID Hospital Billed Ratio Allowed DRG SOI Allowed Index
0948381 106190422 Torrance Memorial $10,999 30.7% $3,372 560 1 $3,824 0.882
0948382 106190422 Torrance Memorial $16,534 30.7% $5,069 134 2 $12,677 0.400
0948383 106190422 Torrance Memorial $1,206 30.7% $370 640 1 $1,075 0.344
1269399 106190630 Pomona Valley $16,467 31.3% $5,159 139 2 $8,138 0.634
1269404 106190630 Pomona Valley $59,854 31.3% $18,751 44 4 $37,740 0.497
1269407 106190630 Pomona Valley $42,608 31.3% $13,348 340 3 $12,541 1.064
For each hospital, we summarized all discharges and divided the total estimated allowed
amounts by the total Allowed Benchmark amounts to derive the Buyer Cost Index. Please
note that for the purposes of this report, only the hospital total Buyer Cost Index is a
reasonable data point. Individual discharge indices are based on estimated allowed amounts,
not the actual allowed amounts; therefore, subset Buyer Cost Index values (by APR or MDC,
etc.) are not valid for comparison purposes. However, the hospital total Buyer Cost Index is a
valid comparison, since the total estimate of allowed charges is reasonable and the total
estimate of benchmark allowed amounts is reasonable.
Attachment C shows the derivation of the Buyer Cost Index for each hospital. Notice that the
statewide average Buyer Cost Index is 1.00.
Given that hospital costs can vary significantly based on local labor and capital costs, we
generally recommend comparisons by geographic area. We have used Medicare’s inpatient
geographic adjustment factors to estimate a wage and capital adjustment for each hospital in
California. Attachment C shows the Medicare based geographic adjustment factor and the
area adjusted Buyer Cost Index. See Section H for a description of the geographic adjustment
factors.
We have added an identifier for major teaching hospitals based on the residents to beds ratio
and the percent Medicare inpatient add on for indirect medical education. At the request of
PBGH the last column on Attachment C shows the percentage of inpatient billed charges that
are for Indigent and Medi-Cal patients.
Milliman
Page E-1
F) CONSIDERATIONS IN USING THE BUYER COST INDEX
The Buyer Cost Index values for each hospital reflect the average commercial negotiated
payments on a patient severity adjusted basis. However, the Buyer Cost Index values are not
adjusted for a number of variables that affect hospitals’ commercial buyer costs. We have
identified several considerations when using the Buyer Cost Index:
• Payer Mix – Hospitals with more than average charity care, Medi-Cal, and Medicare
patients tend to cost shift to commercial payers, leading to a higher Buyer Cost Index
score. The Buyer Cost Index is not adjusted by payer mix. We show the percent
Indigent and Medi-Cal on Attachment C at the request of PBGH. A future
enhancement of this report could involve the development of a Payer Mix Index that
estimates the relative margins for each payer type and estimates the payer mix for each
hospital relative to the statewide average.
• Payer Variation – The Buyer Cost Index estimates are based on an average of all
commercial carriers. Each payer has a different contract with each hospital, and the
relative costs for a given payer may differ from these estimates, which are based on
the average.
• Service Variation – The Buyer Cost Index estimates are based on an average of all
commercial carriers for all services. Each payer has a different contract with each
hospital and the relative costs for a given service and payer may be very different from
these estimates, which are based on the average. For example, appendectomy cost
differences among hospitals may be very different from the total cost index values. If
detailed data was made available from the Payers or the Hospitals, then more detailed
comparisons could be made. This is one of the goals of the HVI.
• Patient Cost Sharing – The Buyer Cost Index estimates are based on insurance payer
negotiated allowed amounts and may not be relevant to patients, since benefit design
has a significant impact on patients’ out-of-pocket costs. If patient cost sharing is a
percentage coinsurance, then the index values are relevant. However, if there is an
out-of-pocket maximum or the cost sharing is a fixed dollar amount (per day or per
admission), then the patient relative costs will be very different from the index values.
• Geographic Cost Variation – The cost of labor and capital improvements varies within
California. The initial Buyer Cost Index does not adjust for this. We have used the
Medicare defined geographic area factors to produce an area adjusted Buyer Cost
Index.
• Changes over Time – The index values in this report are for CY 2005, since that is the
latest discharge dataset available at the time of this work. CY 2007 relative costs will
differ due to changes in negotiated contracts between 2005 and 2007.
• Self-Reported Data – The hospitals self-report their data to OSHPD and mistakes are
possible. As we describe in Section B, the instructions are straightforward and we
have reviewed the data for reasonableness; however, we have not audited the OSHPD
data.
Milliman
Page F-1
• Patient Severity Adjustment Based on Estimates using APR-DRG/SOI Averages – See
Section D for a discussion of the assumptions in developing the Benchmark Allowed
amounts. We believe that APR-DRG/SOI is the most refined patient grouping tool on
the market as was recently supported by the RAND March 2007 report to CMS
comparing Severity Adjusted DRG systems. However, an even more refined DRG
grouper could improve the results.
Milliman
Page F-2
G) CALCULATING THE HOSPITAL COST INDEX
Using the Cost/Charge ratios from the OSHPD financials, we estimated hospitals’ operating
costs for each discharge. Dividing estimated costs by the Allowed Benchmark amounts
results in a Hospital Cost Index. Attachment D presents the Hospital Cost Index.
The unadjusted statewide average Hospital Cost Index was 0.704, meaning that on average,
hospital costs were 70.4% of commercial allowed reimbursement. In order to more easily
interpret the cost relativities among hospitals in isolation, we show in Attachment D a
normalized Hospital Cost Index, in which the statewide average cost is normalized to 1.00.
Milliman
Page G-1
H) GEOGRAPHIC AREAS
The Medicare Inpatient Prospective Payment System (IPPS) geographically adjusts the
payment to each hospital for labor and capital costs. Due to a lag in the data CMS uses to
derive the Medicare factors, we used the factors effective 10/1/2006 to adjust the 2005
estimates in this report. Attachment E shows the Medicare factors as of 10/1/2006. Based on
the IPPS payment methodology we estimate that the Medicare payment for each hospital
reflects a blend of 64% based on the Wage Index, 8% based on the Capital Geographic
Adjustment Factor (GAF) and 28% unadjusted (1.00). We have assigned each county in
California to one of 15 areas using the Medicare county map and then consolidating counties
with limited numbers of hospitals. Attachment F shows the reference table used to assign
Counties to Cost Index Area. Each hospital is area adjusted using the actual Medicare factors
in Attachments C and D, but we use the consolidated categories for a review of results by
area. Based on our work with the HVI we separated Los Angeles County into four areas.
The table below shows area averages, the normalized Medicare factors, and area adjusted
averages. We normalized the Medicare area factors to 1.00 using hospital specific estimated
costs.
Table H-1
Cost Index Area Summary
(Allowed Based) (Cost Based) Area Adjusted

North / Buyer Hospital Normalized Buyer Hospital
South Estimated Cost Cost Medicare Cost Cost
Cost Index Area Area Facilities Allowed Index Index Adj. Factor Index Index
Alameda-Contra Costa-Solano North 21 $1,039,177,376 1.246 1.247 1.181 1.056 1.056
Central North 35 $962,365,751 0.897 0.842 0.932 0.962 0.903
North North 11 $192,805,859 1.038 0.920 0.932 1.113 0.987
Sacramento North 13 $963,489,934 1.322 1.061 1.028 1.286 1.032
San Francisco-San Mateo-Marin North 13 $998,348,646 1.184 1.244 1.171 1.011 1.062
Sonoma-Napa North 8 $190,975,097 1.193 1.121 1.085 1.100 1.033
South Bay North 13 $1,267,458,997 1.345 1.359 1.160 1.160 1.171
Central Coast South 17 $329,157,086 0.793 0.848 0.923 0.859 0.919
Los Angeles-NE South 25 $1,466,616,025 1.058 1.087 0.951 1.112 1.142
Los Angeles-NW South 13 $466,717,723 0.770 0.831 0.951 0.809 0.873
Los Angeles-SE South 15 $391,458,092 0.813 0.889 0.951 0.855 0.934
Los Angeles-SW South 15 $621,890,012 0.788 0.872 0.951 0.829 0.917
Orange South 26 $1,190,146,615 0.889 0.954 0.932 0.955 1.024
Riverside-San Bernardino South 28 $906,906,223 0.822 0.783 0.923 0.891 0.848
San Diego South 23 $1,120,163,643 0.917 0.895 0.923 0.994 0.970
Total 276 $12,107,677,080 1.000 1.000 1.000 1.000 1.000
North 114 $5,614,621,661 1.178 1.132 1.090 1.080 1.038

South 162 $6,493,055,419 0.885 0.914 0.938 0.943 0.975
Total 276 $12,107,677,080 1.000 1.000 1.000 1.000 1.000
Milliman
Page H-1
I) SORTING HIGH VOLUME FACILITIES
At the request of PBGH, Milliman has created four additional tables to highlight the low and
high performers for high volume facilities. We limited the additional tables to those facilities
with more than $10 million in commercial paid revenue and removed known specialty
hospitals. The tables are as follows:
• Attachment G-1 – Buyer Cost Index (BCI), Hospital Cost Index (HCI) and Ratio -
Sort Descending by BCI
Sort Descending by HCI
Sort Descending by Ratio
Sort by Region and Name
Milliman
Page I-1
J) CAVEATS AND LIMITATIONS
Milliman is not an advocate for any stakeholders in the California health insurance industry.
We are an independent consulting firm that was engaged by PBGH to develop a best estimate
of patient severity adjusted commercial hospital costs. Using the assumptions presented in
this report, we have objectively calculated hospital cost indices.
The Buyer Cost Index estimates reflect an average commercial payer and may not be
appropriate for individual health insurers. The Buyer Cost Index estimates reflect an average
across all service types and may not be appropriate for evaluating the relative cost of specific
services. These estimates are based on CY 2005 data and may not reflect current relative
costs. See Section F for other considerations.
This report relies on data and other information from OSHPD. We have not audited or
verified this data and other information. If the underlying data or information is inaccurate or
incomplete, the results of our review may likewise be inaccurate or incomplete. We have
attempted to identify and exclude incorrect data.
Milliman makes no representations or warranties regarding the contents of this report to third
parties. Likewise, third parties are instructed that they are to place no reliance upon this
report prepared for PBGH by Milliman that would result in the creation of any duty or
liability under any theory of law by Milliman or its employees to third parties. Other parties
receiving this report must rely upon their own experts in drawing conclusions about relative
hospital costs in California. The estimates included in this report cannot and do not consider
every variation from the key assumptions and the effect of variations on the results.
Milliman
Page J-1
Attachment A
Allowed / Billed and Cost / Charge Ratios
(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CY 2005 OSHPD Financials Database
Commercial TPMC Included:
IP Gross TPMC IP Contractual TP Gross IP and OP Total Operating Other Operating TPMC Allowed Cost / (1=yes, 0
OSHPD ID Hospital Cost Index Area Discharges and OP Charges Adjustments Capitation Charges Expenses Revenue / Billed Charge = no)
Total 1,117,972 $49,782,044,811 $32,510,589,514 $748,695,284 $185,175,015,379 $50,945,188,459 $1,846,911,954 NA NA 393
Included 1,013,939 $49,425,994,049 $32,157,474,595 $687,265,895 $164,120,846,306 $43,855,190,602 $1,542,013,503 0.363 0.258 276
Excluded 104,033 $356,050,762 $353,114,919 $61,429,389 $21,054,169,073 $7,089,997,857 $304,898,451 NA NA 117
106010846 ALAMEDA COUNTY MEDICAL CENTER Alameda-Contra Costa-Solano 394 $0 $0 $0 $563,119,446 $358,303,962 $113,258,675 - 0.435 0
106010735 ALAMEDA HOSPITAL Alameda-Contra Costa-Solano 799 $35,502,599 $23,740,691 $0 $235,839,591 $54,327,770 $1,237,201 0.331 0.225 1
106190017 ALHAMBRA HOSPITAL Los Angeles-NE 377 $11,589,284 $4,364,166 $287,558 $154,092,587 $55,971,911 $736,702 0.648 0.358 1
106010739 ALTA BATES SUMMIT MED CTR-ALTA BATES Alameda-Contra Costa-Solano 12,632 $92,484,541 $91,090,559 $23,380,664 $1,717,590,283 $464,828,611 $18,342,139 0.268 0.260 1
106370652 ALVARADO HOSPITAL MEDICAL CENTER San Diego 1,486 $168,801,426 $120,672,679 $3,116,412 $724,573,979 $132,481,522 $2,426,254 0.304 0.179 1
106370749 ALVARADO PARKWAY INSTITUTE BHS San Diego 381 $5,760,643 $3,140,559 $0 $39,430,876 $17,020,363 $189,028 0.455 0.427 1
106301097 ANAHEIM GENERAL HOSPITAL Orange 225 $0 $0 $0 $188,365,250 $36,027,033 $64,027 - 0.191 0
106301098 ANAHEIM MEMORIAL MEDICAL CENTER Orange 6,774 $234,705,438 $172,871,856 $0 $728,052,646 $166,480,196 $1,571,135 0.263 0.227 1
106190034 ANTELOPE VALLEY HOSPITAL MEDICAL CENTER Los Angeles-NW 8,331 $0 $0 $0 $785,538,956 $211,000,843 $4,413,791 - 0.263 0
106364231 ARROWHEAD REGIONAL MEDICAL CENTER Riverside-San Bernardino 1,516 $0 $0 $0 $943,118,770 $337,105,251 $4,467,394 - 0.353 0
106400466 ARROYO GRANDE COMMUNITY HOSPITAL Central Coast 547 $62,505,589 $56,589,485 $0 $197,333,631 $39,121,201 $925,667 0.095 0.194 1
106190163 AURORA CHARTER OAK Los Angeles-SE 1,550 $7,414,763 $2,705,511 $0 $24,754,217 $13,081,578 $752,124 0.635 0.498 1
106374024 AURORA SAN DIEGO San Diego 1,588 $12,066,259 $4,641,235 $0 $24,231,341 $11,710,890 $85,138 0.615 0.480 1
106560203 AURORA VISTA DEL MAR HOSPITAL Central Coast 1,500 $10,793,338 $4,544,978 $0 $25,875,001 $11,234,424 $60,241 0.579 0.432 1
106154101 BAKERSFIELD HEART HOSPITAL Central 722 $14,194,346 $33,670,144 $0 $169,819,912 $53,756,113 $689,375 (1.372) 0.312 0
106150722 BAKERSFIELD MEMORIAL HOSPITAL Central 7,154 $264,846,269 $155,542,127 $0 $726,643,975 $163,644,129 $1,308,489 0.413 0.223 1
106184008 BANNER LASSEN MEDICAL CENTER North 439 $0 $0 $0 $13,013,340 $5,652,334 $10,125 - 0.434 0
106190052 BARLOW HOSPITAL Los Angeles-NE 24 $8,081,871 $5,265,033 $0 $97,184,628 $30,841,401 $374,251 0.349 0.313 0
106361105 BARSTOW COMMUNITY HOSPITAL Riverside-San Bernardino 679 $26,012,054 $20,260,544 $0 $181,832,948 $25,872,816 $126,038 0.221 0.142 1
106090793 BARTON MEMORIAL HOSPITAL Sacramento 1,727 $3,818,623 $412,732 $0 $188,934,955 $93,746,486 $2,829,404 0.892 0.481 1
106361110 BEAR VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino 61 $252,405 $168,619 $0 $17,553,965 $13,467,122 $57,444 0.332 0.764 0
106190066 BELLFLOWER MEDICAL CENTER Los Angeles-SE 594 $6,673,259 $6,415,119 $120,155 $191,112,503 $36,472,758 $136,165 0.057 0.190 1
106330120 BETTY FORD CENTER OF EISENHOWER Riverside-San Bernardino 64 $0 $0 $0 $28,864,515 $28,805,359 $4,128,592 - 0.855 0
106190081 BEVERLY HOSPITAL Los Angeles-NE 2,574 $38,402,308 $21,107,293 $0 $213,725,216 $96,337,031 $196,330 0.450 0.450 1
106190020 BHC ALHAMBRA HOSPITAL Los Angeles-NE 2,024 $15,164,725 $6,789,880 $0 $32,139,657 $11,429,125 $195,042 0.552 0.350 1
106040802 BIGGS-GRIDLEY MEMORIAL HOSPITAL North 59 $0 $0 $0 $37,282,042 $15,276,271 $217,268 - 0.404 0
106190110 BROTMAN MEDICAL CENTER Los Angeles-SW 1,761 $110,476,035 $94,553,523 $0 $641,288,326 $99,947,189 $332,161 0.144 0.155 1
106044006 BUTTE COUNTY MENTAL HEALTH - PHF North 25 $0 $0 $0 $0 $0 $0 - - 0
106190125 CALIFORNIA HOSPITAL MEDICAL CENTER Los Angeles-NE 1,237 $50,430,629 $33,181,361 -$84,334 $683,098,408 $189,758,548 $5,933,583 0.340 0.269 1
106380929 CALIFORNIA PACIFIC MEDICAL CENTER San Francisco-San Mateo-Marin 21,195 $1,175,257,869 $632,918,730 $0 $2,493,889,000 $760,340,000 $55,411,000 0.461 0.283 1
106481015 CALIFORNIA SPECIALTY HOSPITAL Alameda-Contra Costa-Solano 1,174 $21,367,340 $12,477,313 $0 $44,567,304 $14,079,480 $252,131 0.416 0.310 1
106364050 CANYON RIDGE HOSPITAL Riverside-San Bernardino 1,150 $7,484,348 $3,133,402 $0 $18,390,733 $9,241,638 $69,724 0.581 0.499 1
106190137 CASA COLINA HOSPITAL FOR REHABILITATIVE Los Angeles-SE 233 $3,595,412 $1,340,354 $224,736 $42,036,679 $25,431,470 $1,378,739 0.690 0.572 1
106190045 CATALINA ISLAND MEDICAL CENTER Los Angeles-SW 6 $0 $0 $0 $5,224,889 $3,921,356 $61,001 - 0.739 0
106190555 CEDARS-SINAI MEDICAL CENTER Los Angeles-NE 25,283 $1,768,368,871 $995,211,602 $0 $4,957,022,000 $1,375,342,000 $155,912,000 0.437 0.246 1
106190230 CENTINELA FREEMAN M.C-MEMORIAL Los Angeles-SW 2,943 $108,092,862 $90,439,582 $0 $799,945,927 $133,504,105 $216,616 0.163 0.167 1
106190148 CENTINELA FREEMAN MED CTR-CENTINELA Los Angeles-SW 3,856 $352,530,585 $271,197,097 $0 $1,585,999,344 $210,747,857 $4,905,624 0.231 0.130 1
106190500 CENTINELA FREEMAN MED CTR-MARINA Los Angeles-SW 1,025 $50,046,452 $39,377,503 $0 $223,797,200 $44,035,833 $1,068,827 0.213 0.192 1
106160787 CENTRAL VALLEY GENERAL HOSPITAL Central 1,593 $34,173,501 $24,957,651 $0 $153,695,323 $47,558,883 $925,782 0.270 0.303 1
106190155 CENTURY CITY DOCTORS HOSPITAL Los Angeles-NE 72 $3,921,770 $2,051,600 $0 $21,735,871 $19,526,276 $0 0.477 0.898 0
106301140 CHAPMAN MEDICAL CENTER Orange 1,007 $61,845,498 $49,306,401 $0 $188,397,234 $41,196,083 $194,689 0.203 0.218 1
106010776 CHILDRENS HOSP & RESEARCH CTR OAKLAND Alameda-Contra Costa-Solano 3,088 $278,140,314 $161,763,307 $0 $524,609,788 $300,840,528 $56,827,317 0.418 0.465 1
106204019 CHILDRENS HOSP CENTRAL CALIF Central 3,245 $161,086,819 $75,096,807 $0 $609,519,942 $260,792,060 $8,307,453 0.534 0.414 1
106304113 CHILDRENS HOSPITAL AT MISSION Orange 1,659 $67,877,321 $38,859,265 $0 $91,980,434 $33,547,434 $707,872 0.428 0.357 1
106190170 CHILDRENS HOSPITAL OF LOS ANGELES Los Angeles-NE 3,255 $243,561,093 $149,189,114 $0 $830,244,174 $445,161,286 $21,534,080 0.387 0.510 1
106300032 CHILDRENS HOSPITAL OF ORANGE COUNTY Orange 4,627 $322,970,801 $191,258,924 $0 $735,528,348 $298,175,901 $45,670,281 0.408 0.343 1
106370673 CHILDRENS HOSPITAL-SAN DIEGO San Diego 6,123 $347,210,774 $224,473,038 $22,726,401 $815,425,731 $338,658,747 $31,509,448 0.419 0.377 1
106382715 CHINESE HOSPITAL San Francisco-San Mateo-Marin 163 $3,257,182 $3,257,182 $3,243,354 $109,536,143 $54,352,518 $1,727,651 0.996 0.480 1
106361144 CHINO VALLEY MEDICAL CENTER Riverside-San Bernardino 1,929 $43,586,121 $13,473,266 $0 $232,559,949 $54,404,751 $584,244 0.691 0.231 1
106190636 CITRUS VALLEY MEDICAL CENTER - QV CAMPUS Los Angeles-SE 7,052 $247,521,671 $172,439,587 $636,410 $1,065,858,114 $239,385,862 $2,391,879 0.306 0.222 1
106190661 CITY OF ANGELS Los Angeles-NE 199 $0 $0 $0 $203,370,896 $58,892,465 $0 - 0.290 0
106190176 CITY OF HOPE NATIONAL MEDICAL CENTER Los Angeles-SE 2,447 $445,850,829 $235,758,295 $0 $777,226,959 $317,658,914 $16,042,742 0.471 0.388 1
106100005 CLOVIS COMMUNITY HOSPITAL Central 7,506 $160,142,780 $89,153,377 $0 $274,698,019 $93,303,715 $923,081 0.443 0.336 1
106100697 COALINGA REGIONAL MEDICAL CENTER Central 294 $5,408,409 $2,189,486 $0 $19,201,121 $11,215,905 $53,633 0.595 0.581 1
106190766 COAST PLAZA DOCTORS HOSPITAL Los Angeles-SE 680 $0 $0 $0 $189,388,135 $57,249,134 $32,904 - 0.302 0
106301258 COASTAL COMMUNITIES HOSPITAL Orange 729 $21,881,467 $12,048,061 $0 $304,818,636 $56,257,758 $159,169 0.449 0.184 1
106190184 COLLEGE HOSPITAL Los Angeles-SE 3,546 $43,506,957 $27,228,209 $0 $92,862,291 $31,544,087 $114,453 0.374 0.338 1
106301155 COLLEGE HOSPITAL COSTA MESA Orange 1,241 $16,885,867 $11,052,376 $0 $81,830,151 $29,564,171 $614,115 0.345 0.354 1
CMM 10/12/2007 11:24 AM

Milliman
Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [Att A] Page 1 of 7
Attachment A

106361458 COLORADO RIVER MEDICAL CENTER Riverside-San Bernardino 633 $14,443,642 $8,746,040 $0 $54,582,949 $19,366,685 $342,860 0.394 0.349 1
106060870 COLUSA REGIONAL MEDICAL CENTER North 177 $6,353,119 $2,439,012 $0 $35,799,214 $14,613,043 $152,579 0.616 0.404 1
106190197 COMMUNITY & MISSION HOSP-HTG PARK Los Angeles-SW 370 $12,096,436 $9,457,972 $17,340 $225,121,189 $47,911,250 $38,378 0.220 0.213 1
106190196 COMMUNITY HOSPITAL OF GARDENA Los Angeles-SW 54 $285,799 $121,371 $0 $16,616,073 $6,595,264 $23,980 0.575 0.395 0
106190475 COMMUNITY HOSPITAL OF LONG BEACH Los Angeles-SW 654 $0 $0 $0 $162,917,565 $39,204,344 $226,078 - 0.239 0
106430743 COMMUNITY HOSPITAL OF LOS GATOS South Bay 2,950 $204,988,546 $153,974,011 $0 $461,051,468 $102,269,052 $141,659 0.249 0.222 1
106270744 COMMUNITY HOSPITAL OF MONTEREY PENINSULA South Bay 4,862 $0 $0 $0 $658,514,358 $293,809,652 $9,237,105 - 0.432 0
106361323 COMMUNITY HOSPITAL OF SAN BERNARDINO Riverside-San Bernardino 973 $33,303,505 $25,677,287 $0 $553,266,979 $119,508,635 $2,054,780 0.229 0.212 1
106560473 COMMUNITY MEM HOSP-SAN BUENAVENTURA Central Coast 8,204 $376,663,491 $333,077,399 $0 $932,371,663 $176,962,133 $3,265,641 0.116 0.186 1
106100717 COMMUNITY REGIONAL MEDICAL CENTER Central 5,118 $211,572,112 $106,102,060 $1,568,777 $1,247,772,784 $492,751,441 $24,062,097 0.506 0.376 1
106374094 CONTINENTAL REHAB HOSP FOR SAN DIEGO San Diego 18 $8,904,498 $4,721,342 $0 $52,207,026 $29,334,079 $90,730 0.470 0.560 0
106070924 CONTRA COSTA REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano 686 $30,993,197 $15,377,962 $0 $427,430,225 $293,138,004 $10,727,464 0.504 0.661 1
106160702 CORCORAN DISTRICT HOSPITAL Central 55 $0 $0 $0 $16,136,020 $9,441,942 $60,850 - 0.581 0
106331152 CORONA REGIONAL MEDICAL CENTER Riverside-San Bernardino 5,527 $123,984,158 $81,861,441 $0 $389,553,220 $91,945,712 $714,203 0.340 0.234 1
106390846 DAMERON HOSPITAL Central 6,990 $217,219,356 $162,473,473 $0 $591,288,163 $126,509,831 $1,331,001 0.252 0.212 1
106190232 DEL AMO HOSPITAL Los Angeles-SW 1,316 $16,672,875 $9,925,189 $0 $57,327,117 $18,183,945 $74,275 0.405 0.316 1
106150706 DELANO REGIONAL MEDICAL CENTER Central 563 $2,689,947 $1,409,223 $0 $133,507,291 $47,992,895 $761,099 0.476 0.354 1
106331164 DESERT REGIONAL MEDICAL CENTER Riverside-San Bernardino 6,356 $371,241,281 $260,329,128 $0 $1,545,022,674 $250,658,878 $411,253 0.299 0.162 1
106364144 DESERT VALLEY HOSPITAL Riverside-San Bernardino 3,140 $64,044,461 $41,403,087 $0 $328,720,505 $74,500,694 $239,272 0.354 0.226 1
106392287 DOCTORS HOSPITAL OF MANTECA Central 2,476 $258,396,163 $211,346,244 $0 $530,412,376 $51,306,982 $70,845 0.182 0.097 1
106190857 DOCTORS HOSPITAL OF WEST COVINA Los Angeles-SE 73 $4,110,154 $3,626,722 $0 $34,977,166 $10,276,909 $55,516 0.118 0.292 0
106361166 DOCTORS HSP MED CTR OF MONTCLAIR Riverside-San Bernardino 2,374 $52,796,234 $35,208,572 $5,606,469 $195,431,698 $52,779,312 $613,978 0.439 0.267 1
106500852 DOCTORS MEDICAL CENTER Central 5,869 $603,765,716 $466,116,129 $0 $2,642,018,141 $272,364,247 $2,611,885 0.228 0.102 1
106440755 DOMINICAN SANTA CRUZ HOSPITAL - SOQUEL South Bay 5,377 $0 $0 $0 $865,207,518 $209,574,107 $2,440,408 - 0.239 0
106190243 DOWNEY COMMUNITY HOSPITAL Los Angeles-SE 4,143 $23,393,488 $29,067,884 $5,674,397 $558,113,692 $123,493,127 $572,974 0.000 0.220 0
106070904 DRS MEDICAL CENTER - SAN PABLO-PINOLE Alameda-Contra Costa-Solano 1,707 $157,564,668 $125,866,670 $0 $837,006,596 $145,086,906 $1,230,048 0.201 0.172 1
106196168 E & L MILLER CHILDRENS HOSPITAL Los Angeles-SW 9,090 $202,847,519 $94,440,944 $382,081 $519,086,471 $232,954,787 $9,888,204 0.536 0.430 1
106190256 EAST LOS ANGELES DOCTORS HOSPITAL Los Angeles-NE 300 $5,011,673 $15,756,126 $0 $160,150,086 $39,847,714 $96,965 (2.144) 0.248 0
106190328 EAST VALLEY HOSPITAL MED CTR Los Angeles-SE 264 $14,564,602 $11,083,597 $0 $100,436,839 $27,198,359 $511,157 0.239 0.266 1
106320859 EASTERN PLUMAS HEALTH CARE North 57 $2,141,490 $0 $0 $32,847,823 $20,047,935 $61,788 1.000 0.608 0
106010805 EDEN MEDICAL CENTER Alameda-Contra Costa-Solano 4,197 $195,659,486 $89,426,289 $0 $866,539,189 $241,437,559 $3,766,608 0.543 0.274 1
106331168 EISENHOWER MEDICAL CENTER Riverside-San Bernardino 4,075 $269,616,057 $185,764,990 $0 $1,237,566,703 $276,322,899 $17,470,291 0.311 0.209 1
106430763 EL CAMINO HOSPITAL South Bay 12,820 $142,987,908 $91,061,979 $0 $1,123,329,956 $282,468,319 $12,646,473 0.363 0.240 1
106130699 EL CENTRO REGIONAL MEDICAL CENTER San Diego 1,905 $30,176,084 $16,513,801 $0 $212,264,667 $71,150,952 $1,402,495 0.453 0.329 1
106094002 EL DORADO COUNTY MENTAL HEALTH - PHF Sacramento 38 $0 $0 $0 $0 $0 $0 - - 0
106500867 EMANUEL MEDICAL CENTER Central 5,991 $180,141,845 $122,339,987 $0 $553,502,324 $114,117,839 $2,804,105 0.321 0.201 1
106190280 ENCINO TARZANA REGIONAL MEDICAL CENTER Los Angeles-NW 661 $84,900,360 $67,511,065 $0 $419,243,038 $67,735,118 $321,940 0.205 0.161 1
106190517 ENCINO TARZANA REGIONAL MEDICAL CENTER Los Angeles-NW 7,004 $355,631,559 $276,736,292 $0 $1,065,201,937 $167,255,070 $1,088,177 0.222 0.156 1
106040962 ENLOE MEDICAL CENTER - ESPLANADE CAMPUS North 4,713 $210,109,248 $129,612,597 $0 $921,617,068 $231,686,435 $2,246,047 0.383 0.249 1
106474007 FAIRCHILD MEDICAL CENTER North 419 $0 $0 $0 $62,431,410 $29,579,023 $346,233 - 0.468 0
106370705 FALLBROOK HOSPITAL DISTRICT San Diego 1,155 $72,257,869 $52,352,254 $0 $139,815,591 $31,942,317 $317,168 0.275 0.226 1
106040875 FEATHER RIVER HOSPITAL North 1,222 $0 $0 $0 $433,885,265 $83,325,807 $3,229,128 - 0.185 0
106190298 FOOTHILL PRESBYTERIAN HOSPITAL Los Angeles-SE 2,375 $74,388,007 $52,928,740 $0 $217,672,398 $47,187,666 $509,982 0.288 0.214 1
106301175 FOUNTAIN VALLEY RGNL HOSP & MC-EUCLID Orange 7,215 $379,756,854 $285,444,121 $0 $1,144,583,279 $213,952,040 $287,957 0.248 0.187 1
106230949 FRANK R HOWARD MEMORIAL HOSPITAL North 243 $0 $0 $0 $70,582,793 $24,784,072 $354,229 - 0.346 0
106014034 FREMONT HOSPITAL Alameda-Contra Costa-Solano 1,951 $25,724,122 $16,354,510 $0 $54,513,235 $14,996,824 $31,778 0.364 0.275 1
106400480 FRENCH HOSPITAL MEDICAL CENTER Central Coast 1,747 $141,304,931 $128,430,732 $0 $348,794,840 $58,336,700 $1,099,951 0.091 0.164 1
106104089 FRESNO COUNTY - PHF Central 2 $0 $0 $0 $0 $0 $0 - - 0
106105029 FRESNO HEART HOSPITAL Central 932 $0 $0 $0 $27,079,707 $11,583,485 $63,557 - 0.425 0
106104047 FRESNO SURGERY CENTER Central 979 $0 $0 $0 $65,171,483 $24,123,271 $0 - 0.370 0
106301283 GARDEN GROVE HOSPITAL & MEDICAL CENTER Orange 1,861 $61,363,524 $44,840,700 $139,766 $343,611,576 $64,752,045 $171,828 0.272 0.188 1
106190315 GARFIELD MEDICAL CENTER Los Angeles-NE 2,860 $144,043,368 $163,734,164 $23,963,794 $910,377,715 $122,902,585 $691,454 0.030 0.134 0
106270777 GEORGE L. MEE MEMORIAL HOSPITAL South Bay 486 $9,371 $145 $0 $86,185,495 $42,440,801 $417,548 0.985 0.488 1
106190323 GLENDALE ADVENTIST MEDICAL CENTER Los Angeles-NW 6,786 $235,897,715 $168,345,160 $0 $1,082,789,940 $222,769,769 $4,131,367 0.286 0.202 1
106190522 GLENDALE MEMORIAL HOSPITAL & HEALTH CTR Los Angeles-NW 2,996 $156,545,989 $117,045,413 $413,587 $875,625,063 $175,760,697 $1,565,257 0.255 0.199 1
106110889 GLENN MEDICAL CENTER North 21 $0 $0 $338,602 $15,836,469 $9,011,190 $110,635 - 0.562 0
106420483 GOLETA VALLEY COTTAGE HOSPITAL Central Coast 996 $0 $0 $0 $118,898,330 $33,745,401 $817,686 - 0.277 0
106150775 GOOD SAMARITAN HOSPITAL - BAKERSFIELD Central 181 $294,549 $176,664 $0 $42,586,875 $17,985,540 $21,641 0.400 0.422 1
106190392 GOOD SAMARITAN HOSPITAL - LA Los Angeles-NE 7,330 $248,425,675 $184,438,440 $1,121,223 $910,020,910 $222,837,371 $2,390,891 0.262 0.242 1
106430779 GOOD SAMARITAN HOSPITAL - SAN JOSE South Bay 14,755 $708,424,855 $490,989,710 $0 $1,172,910,049 $289,481,315 $1,564,963 0.307 0.245 1
106190352 GREATER EL MONTE COMMUNITY HOSPITAL Los Angeles-SE 596 $11,560,639 $9,497,348 $0 $219,934,238 $45,071,863 $284,142 0.178 0.204 1
106370714 GROSSMONT HOSPITAL San Diego 7,349 $379,735,857 $252,052,550 $31,663,252 $1,408,331,751 $335,443,256 $855,393 0.420 0.238 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment A

106160725 HANFORD COMMUNITY HOSPITAL Central 1,010 $113,145,301 $76,392,366 $636,613 $342,010,456 $77,319,996 $498,905 0.330 0.225 1
106350784 HAZEL HAWKINS MEMORIAL HOSPITAL South Bay 1,102 $31,438,589 $13,225,592 $0 $123,965,595 $57,530,378 $288,561 0.579 0.462 1
106490964 HEALDSBURG DISTRICT HOSPITAL Sonoma-Napa 108 $4,127,324 $1,480,283 $0 $37,457,780 $18,571,758 $115,373 0.641 0.493 1
106304159 HEALTHBRIDGE CHILDRENS REHAB Orange 43 $11,898,823 $8,661,936 $0 $46,211,832 $6,520,206 $16,180 0.272 0.141 0
106154022 HEALTHSOUTH BAKERSFIELD REG REHAB HOSP Central 265 $3,567,508 $1,718,315 $0 $24,293,073 $12,896,483 $105,442 0.518 0.527 1
106380842 HEBREW HOME FOR THE AGED DISABLED San Francisco-San Mateo-Marin 1 $0 $0 $0 $0 $0 $0 - - 0
106331194 HEMET VALLEY MEDICAL CENTER Riverside-San Bernardino 2,167 $39,965,039 $27,394,379 $0 $437,044,307 $106,879,886 $1,277,815 0.315 0.242 1
106190949 HENRY MAYO NEWHALL MEMORIAL HOSPITAL Los Angeles-NW 6,465 $0 $0 $0 $621,767,611 $108,165,025 $919,026 - 0.172 0
106344021 HERITAGE OAKS HOSPITAL Sacramento 1,109 $0 $0 $0 $40,605,639 $13,528,365 $17,485 - 0.333 0
106362041 HI-DESERT MEDICAL CENTER Riverside-San Bernardino 972 $20,834,430 $15,901,685 $0 $152,870,899 $47,737,990 $348,244 0.237 0.310 1
106301205 HOAG MEMORIAL HOSPITAL PRESBYTERIAN Orange 17,028 $535,171,938 $246,759,235 $28,200,620 $1,152,051,866 $487,688,387 $24,006,091 0.592 0.402 1
106190380 HOLLYWOOD COMMUNITY HOSP OF HOLLYWOOD Los Angeles-NE 70 $533,152 $955,032 $0 $117,578,266 $23,468,854 $555,507 (0.791) 0.195 0
106190382 HOLLYWOOD PRESBYTERIAN MEDICAL CTR Los Angeles-NE 1,034 $72,342,148 $56,914,417 $0 $949,058,623 $154,845,593 $1,037,682 0.213 0.162 1
106301209 HUNTINGTON BEACH HOSPITAL Orange 1,168 $31,197,932 $29,567,670 $0 $220,819,999 $51,537,322 $280,026 0.052 0.232 1
106190400 HUNTINGTON MEMORIAL HOSPITAL Los Angeles-NE 12,000 $420,567,983 $260,050,107 $0 $1,264,159,554 $354,267,604 $8,778,467 0.382 0.273 1
106320874 INDIAN VALLEY HOSPITAL North 9 $0 $0 $0 $4,807,944 $4,156,369 $7,392 - 0.863 0
106304045 IRVINE MEDICAL CENTER Orange 7,095 $311,956,950 $251,100,317 $0 $561,128,459 $95,218,654 $180,148 0.195 0.169 1
106121031 JEROLD PHELPS COMMUNITY HOSPITAL North 6 $0 $0 $0 $5,040,947 $4,740,456 $27,316 - 0.935 0
106220733 JOHN C FREMONT HEALTHCARE DISTRICT Central 13 $0 $0 $0 $18,138,630 $13,871,048 $396,678 - 0.743 0
106331216 JOHN F. KENNEDY MEMORIAL HOSPITAL Riverside-San Bernardino 1,980 $93,833,663 $72,733,303 $0 $470,792,376 $78,967,535 $82,341 0.225 0.168 1
106070988 JOHN MUIR MEDICAL CENTER Alameda-Contra Costa-Solano 11,704 $834,738,536 $512,252,218 $2,196,269 $1,726,835,711 $480,392,450 $55,424,428 0.389 0.246 1
106540734 KAWEAH DELTA DISTRICT HOSPITAL Central 7,273 $242,450,119 $152,425,116 $21,746 $1,036,673,790 $293,697,795 $24,139,992 0.371 0.260 1
106210993 KENTFIELD REHABILITATION CENTER San Francisco-San Mateo-Marin 101 $9,082,366 $1,623,470 $0 $35,342,642 $19,661,571 $255,365 0.821 0.549 1
106150736 KERN MEDICAL CENTER Central 1,160 $10,705,867 $4,105,960 $0 $370,827,142 $191,657,886 $6,875,587 0.616 0.498 1
106150737 KERN VALLEY HEALTHCARE DISTRICT Central 92 $3,232,879 $864,759 $0 $55,128,851 $21,564,034 $150,492 0.733 0.388 0
106190449 KINDRED HOSPITAL - LA MIRADA Los Angeles-SE 126 $0 $0 $0 $181,594,154 $57,584,126 $84,081 - 0.317 0
106190305 KINDRED HOSPITAL - LOS ANGELES Los Angeles-NE 54 $12,936,048 $3,538,910 $0 $135,220,253 $28,056,653 $107,552 0.726 0.207 0
106500954 KINDRED HOSPITAL - MODESTO Central 35 $0 $0 $0 $35,667,603 $16,926,557 $29,597 - 0.474 0
106370721 KINDRED HOSPITAL - SAN DIEGO San Diego 46 $0 $0 $0 $46,366,634 $15,879,997 $37,212 - 0.342 0
106301127 KINDRED HOSPITAL BREA Orange 17 $1,964,648 $1,671,722 $0 $63,477,508 $19,458,941 $42,920 0.149 0.306 0
106361274 KINDRED HOSPITAL ONTARIO Riverside-San Bernardino 56 $0 $0 $0 $143,153,649 $28,630,877 $102,427 - 0.199 0
106010887 KINDRED HOSPITAL SAN FRANCISCO BAY AREA Alameda-Contra Costa-Solano 110 $0 $0 $0 $100,645,806 $25,264,086 $68,984 - 0.250 0
106301380 KINDRED HOSPITAL WESTMINSTER Orange 92 $41,441,929 $12,521,558 $0 $193,404,174 $45,549,519 $129,782 0.698 0.235 0
106344035 KINDRED HOSPITAL-SACRAMENTO Sacramento 58 $13,371,938 $8,148,722 $0 $39,817,268 $13,446,392 $0 0.391 0.338 0
106100745 KINGSBURG MEDICAL HOSPITAL Central 112 $254,167 $156,475 $0 $16,559,461 $7,100,386 $81,417 0.384 0.424 1
106301234 LA PALMA INTERCOMMUNITY HOSPITAL Orange 2,074 $79,092,708 $67,017,200 $3,822,129 $150,888,370 $41,994,942 $1,021,202 0.201 0.272 1
106191227 LAC/HARBOR+UCLA MEDICAL CENTER Los Angeles-SW 675 $4,896,784 $3,653,721 $5,293,483 $1,102,251,750 $432,206,833 $25,723,500 1.335 0.369 0
106191230 LAC/MARTIN LUTHER KING JR. DREW MED CTR Los Angeles-NE 209 $4,185,945 $0 $2,700,662 $834,689,361 $441,944,023 $7,872,724 1.645 0.520 0
106191231 LAC/OLIVE VIEW -UCLA MED CTR Los Angeles-NW 150 $17,124,031 $15,428,907 $6,707,330 $559,853,217 $298,874,247 $2,812,341 0.491 0.529 1
106191306 LAC/RANCHO LOS AMIGOS NATIONAL REHAB CTR Los Angeles-SE 46 $6,234,384 $5,389,678 $0 $310,741,560 $166,583,250 $1,609,880 0.135 0.531 0
106191228 LAC/USC MEDICAL CENTER Los Angeles-NE 789 $20,100,951 $20,100,951 $13,574,720 $1,916,316,083 $931,480,270 $19,295,616 0.675 0.476 1
106190240 LAKEWOOD REGIONAL MEDICAL CENTER - SOUTH Los Angeles-SW 2,092 $146,781,271 $113,149,532 $0 $613,837,256 $98,733,606 $57,263 0.229 0.161 1
106190455 LANCASTER COMMUNITY HOSPITAL Los Angeles-NW 3,031 $112,853,032 $89,666,391 $0 $345,536,419 $66,425,000 $446,389 0.205 0.191 1
106380868 LANGLEY PORTER PSYCHIATRIC INSTITUTE San Francisco-San Mateo-Marin 515 $8,243,948 $3,534,734 $0 $15,292,243 $14,126,892 $1,334,061 0.571 0.837 1
106190462 LAS ENCINAS HOSPITAL Los Angeles-NE 1,668 $15,738,750 $4,127,752 $0 $28,141,913 $16,800,980 $467,430 0.738 0.580 1
106190680 LITTLE CO OF MARY-SAN PEDRO HOSPITAL Los Angeles-SW 1,733 $82,749,455 $51,700,703 $0 $430,740,666 $106,423,379 $920,241 0.375 0.245 1
106190470 LITTLE COMPANY OF MARY HOSPITAL Los Angeles-SW 7,461 $275,994,890 $184,277,891 $0 $835,516,952 $207,854,988 $5,210,713 0.332 0.243 1
106390923 LODI MEMORIAL HOSPITAL Central 2,649 $135,891,807 $90,212,453 $238,796 $600,194,349 $95,421,626 $916,087 0.338 0.157 1
106364014 LOMA LINDA UNIVERSITY BEHAVIORAL MEDICIN Riverside-San Bernardino 2,615 $27,644,366 $13,675,108 $0 $44,755,645 $20,449,425 $682,981 0.505 0.442 1
106361246 LOMA LINDA UNIVERSITY MEDICAL CENTER Riverside-San Bernardino 10,904 $626,424,282 $371,238,574 $0 $2,434,125,845 $722,845,353 $63,139,145 0.407 0.271 1
106420491 LOMPOC HEALTHCARE DISTRICT Central Coast 746 $7,895,380 $4,264,863 $0 $76,011,966 $35,625,067 $580,624 0.460 0.461 1
106190525 LONG BEACH MEMORIAL MEDICAL CENTER Los Angeles-SW 6,024 $361,726,835 $221,876,684 $411,756 $1,145,627,518 $323,775,113 $15,515,278 0.388 0.269 1
106301248 LOS ALAMITOS MEDICAL CENTER Orange 3,851 $228,815,032 $178,771,352 $0 $711,158,580 $103,300,821 $239,471 0.219 0.145 1
106190198 LOS ANGELES COMMUNITY HOSPITAL Los Angeles-NE 774 $9,105,679 $8,431,606 $0 $233,548,824 $41,633,828 $232,642 0.074 0.177 1
106190854 LOS ANGELES METROPOLITAN MEDICAL CENTER Los Angeles-NE 234 $681,679 $590,632 $871,920 $178,328,355 $45,083,236 $100,768 1.413 0.252 0
106560492 LOS ROBLES REGIONAL MEDICAL CENTER Central Coast 7,570 $279,683,449 $145,592,820 $0 $665,553,731 $177,011,360 $749,553 0.479 0.265 1
106434040 LUCILE S PACKARD CHILDRENS HOSPITAL South Bay 10,371 $702,424,100 $337,415,011 $0 $1,157,443,791 $435,798,343 $22,444,240 0.520 0.357 1
106201281 MADERA COMMUNITY HOSPITAL Central 999 $18,271,629 $3,310,528 $0 $138,200,937 $59,019,696 $947,798 0.819 0.420 1
106260011 MAMMOTH HOSPITAL Central 415 $2,486,756 $248,678 $0 $50,595,285 $34,278,204 $194,250 0.900 0.674 1
106420493 MARIAN MEDICAL CENTER Central Coast 3,326 $132,814,731 $76,609,072 $0 $516,392,774 $140,534,734 $1,650,101 0.423 0.269 1
106244027 MARIE GREEN PSYCHIATRIC CENTER Central 20 $0 $0 $0 $0 $0 $0 - - 0
106211006 MARIN GENERAL HOSPITAL San Francisco-San Mateo-Marin 5,016 $258,951,112 $142,719,247 $257,437 $780,118,463 $232,070,794 $4,834,424 0.450 0.291 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment A

106050932 MARK TWAIN ST. JOSEPHS HOSPITAL Central 456 $14,714,912 $6,545,085 $0 $82,804,271 $37,593,931 $610,840 0.555 0.447 1
106090933 MARSHALL MEDICAL CENTER Sacramento 1,739 $0 $0 $0 $368,588,922 $110,487,905 $999,646 - 0.297 0
106450936 MAYERS MEMORIAL HOSPITAL North 103 $0 $0 $0 $22,791,681 $17,154,807 $359,519 - 0.737 0
106240924 MEMORIAL HOSPITAL LOS BANOS Central 577 $0 $0 $0 $120,632,273 $34,024,035 $96,336 - 0.281 0
106500939 MEMORIAL HOSPITAL MODESTO Central 7,958 $110,129,428 $102,987,826 $23,773,139 $1,534,142,389 $310,510,555 $5,838,742 0.281 0.199 1
106190521 MEMORIAL HOSPITAL OF GARDENA Los Angeles-SW 1,330 $8,995,340 $14,681,414 $0 $244,814,765 $68,141,180 $1,762,261 (0.632) 0.271 0
106231013 MENDOCINO COAST DISTRICT HOSPTIAL North 359 $0 $0 $0 $78,276,125 $34,188,736 $548,355 - 0.430 0
106334018 MENIFEE VALLEY MEDICAL CENTER Riverside-San Bernardino 653 $22,575,688 $17,041,200 $0 $184,352,927 $41,098,082 $409,142 0.245 0.221 1
106414018 MENLO PARK SURGICAL HOSPITAL San Francisco-San Mateo-Marin 100 $0 $0 $0 $16,948,276 $6,962,089 $5,617 - 0.410 0
106340947 MERCY GENERAL HOSPITAL Sacramento 6,811 $601,460,935 $452,129,669 $25,198,928 $1,433,234,000 $309,853,000 $9,589,000 0.290 0.210 1
106150761 MERCY HOSPITAL - BAKERSFIELD Central 10,825 $345,641,347 $233,176,494 $0 $704,149,073 $175,139,681 $1,320,820 0.325 0.247 1
106344029 MERCY HOSPITAL - FOLSOM Sacramento 3,530 $131,201,101 $69,512,748 $3,576,895 $223,951,000 $64,539,000 $504,000 0.497 0.286 1
106470871 MERCY HOSPITAL OF MT. SHASTA North 402 $0 $0 $0 $82,197,483 $37,450,909 $425,452 - 0.450 0
106450949 MERCY MEDICAL CENTER North 4,113 $0 $0 $0 $745,073,188 $205,716,077 $3,770,198 - 0.271 0
106240942 MERCY MERCED MED CTR-COMMUNITY CAMPUS Central 3,122 $99,444,115 $54,601,506 $0 $453,542,982 $115,773,139 $317,334 0.451 0.255 1
106340950 MERCY SAN JUAN HOSPITAL Sacramento 6,297 $359,390,514 $214,657,027 $23,113,978 $1,064,666,000 $249,489,000 $2,757,000 0.467 0.232 1
106013687 MERRITT PERALTA INSTITUTE CDRH Alameda-Contra Costa-Solano 562 $5,333,168 $3,979,487 $0 $5,661,201 $2,702,476 $0 0.254 0.477 1
106340951 METHODIST HOSPITAL OF SACRAMENTO Sacramento 2,942 $126,048,558 $75,870,748 $6,967,279 $405,360,000 $116,775,000 $1,675,000 0.453 0.284 1
106190529 METHODIST HOSPITAL OF SOUTHERN CAL Los Angeles-NE 6,567 $0 $0 $0 $605,558,077 $173,460,488 $1,770,136 - 0.284 0
106190681 MIRACLE MILE MEDICAL CENTER Los Angeles-NE 9 $0 $0 $0 $20,242,814 $6,269,564 $0 - 0.310 0
106190524 MISSION COMMUNITY HOSPITAL - PANORAMA Los Angeles-NW 597 $0 $0 $0 $142,886,469 $51,019,543 $472,992 - 0.354 0
106301262 MISSION HOSPITAL REGIONAL MEDICAL CENTER Orange 8,927 $358,346,293 $194,533,139 $0 $865,061,125 $244,296,881 $8,955,787 0.457 0.272 1
106250956 MODOC MEDICAL CENTER North 24 $0 $0 $0 $11,481,953 $9,038,381 $114,643 - 0.777 0
106190547 MONTEREY PARK HOSPITAL Los Angeles-NE 631 $25,758,811 $21,617,693 $0 $320,490,334 $43,986,759 $180,598 0.161 0.137 1
106334048 MORENO VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino 1,555 $27,284,825 $19,157,125 $0 $170,190,630 $44,626,131 $556,359 0.298 0.259 1
106361266 MOUNTAINS COMMUNITY HOSPITAL Riverside-San Bernardino 238 $2,382,655 $35,799 $0 $21,174,409 $13,258,353 $109,668 0.985 0.621 1
106071018 MT DIABLO MEDICAL CENTER Alameda-Contra Costa-Solano 3,202 $431,497,832 $301,211,617 $1,204,224 $1,070,751,799 $238,436,425 $3,661,761 0.305 0.219 1
106074039 MT DIABLO MEDICAL PAVILION Alameda-Contra Costa-Solano 1,583 $23,139,118 $10,959,414 $0 $36,939,428 $22,172,394 $313,494 0.526 0.592 1
106274043 NATIVIDAD MEDICAL CENTER South Bay 1,169 $0 $0 $0 $299,017,458 $117,955,016 $13,501,371 - 0.349 0
106281297 NELSON M HOLDERMAN MEMORIAL HOSPITAL Sonoma-Napa 3 $0 $0 $0 $0 $0 $0 - - 0
106301304 NEWPORT BAY HOSPITAL Orange 19 $0 $0 $0 $12,621,224 $8,439,928 $0 - 0.669 0
106481357 NORTH BAY MEDICAL CENTER Alameda-Contra Costa-Solano 1,868 $93,397,413 $42,387,563 $5,106,129 $553,429,802 $132,718,791 $1,848,008 0.601 0.236 1
106454012 NORTHERN CALIF REHABILITATION HOSPITAL North 35 $1,461,540 $860,510 $0 $28,076,989 $12,053,522 $23,208 0.411 0.428 0
106141273 NORTHERN INYO HOSPITAL Central 409 $16,844,366 $708,198 $0 $63,044,470 $33,352,408 $233,747 0.958 0.525 1
106190568 NORTHRIDGE HOSPITAL MEDICAL CENTER Los Angeles-NW 7,426 $361,232,863 $248,139,973 $43,386 $1,060,690,990 $230,012,845 $2,997,732 0.313 0.214 1
106214034 NOVATO COMMUNITY HOSPITAL - CURRENT LOC San Francisco-San Mateo-Marin 516 $62,668,106 $32,761,037 $50,148 $176,898,184 $57,178,403 $2,211,603 0.478 0.311 1
106430837 O CONNOR HOSPITAL South Bay 7,005 $317,184,798 $209,070,015 $0 $993,476,859 $226,283,743 $1,877,202 0.341 0.226 1
106500967 OAK VALLEY DISTRICT HOSPITAL Central 547 $21,529,387 $16,595,243 $265,071 $128,379,151 $41,620,600 $561,787 0.241 0.320 1
106560501 OJAI VALLEY COMMUNITY HOSPITAL Central Coast 431 $16,577,572 $10,978,364 $94,720 $50,564,723 $19,684,520 $530,547 0.343 0.379 1
106190534 OLYMPIA MEDICAL CENTER Los Angeles-NE 1,012 $180,272,188 $154,795,084 $0 $778,868,778 $85,871,441 $294,951 0.141 0.110 1
106300225 ORANGE COAST MEMORIAL MEDICAL CENTER Orange 7,474 $268,669,701 $184,271,629 $0 $436,225,051 $133,800,864 $942,555 0.314 0.305 1
106040937 OROVILLE HOSPITAL North 1,242 $15,498,148 $8,142,120 $0 $273,896,395 $90,120,039 $799,791 0.475 0.326 1
106190581 ORTHOPAEDIC HOSPITAL Los Angeles-NE 144 $10,903,011 $6,683,317 $0 $52,097,796 $37,665,458 $5,385,820 0.387 0.620 1
106190307 PACIFIC ALLIANCE MEDICAL CENTER Los Angeles-NE 221 $2,995,241 $2,116,359 $0 $86,842,058 $56,460,597 $4,427,057 0.293 0.599 1
106190587 PACIFIC HOSPITAL OF LONG BEACH Los Angeles-SW 194 $0 $0 $0 $366,982,064 $107,561,945 $1,277,549 - 0.290 0
106560838 PACIFIC SHORES Central Coast 343 $2,117,514 $577,428 $0 $19,711,315 $5,433,319 $0 0.727 0.276 1
106190696 PACIFICA HOSPITAL OF THE VALLEY Los Angeles-NW 1,330 $352 $820,019 $425,050 $161,096,297 $62,617,501 $809,851 (1,121.071) 0.384 0
106491338 PALM DRIVE HOSPITAL Sonoma-Napa 280 $18,419,614 $0 $0 $61,575,355 $21,229,822 $353,878 1.000 0.339 1
106331288 PALO VERDE HOSPITAL Riverside-San Bernardino 438 $16,874,596 $7,984,456 $0 $59,137,618 $20,568,351 $461,778 0.527 0.340 1
106370755 PALOMAR MEDICAL CENTER San Diego 7,673 $180,456,890 $110,029,243 $14,813,379 $761,239,896 $247,994,183 $4,838,165 0.472 0.319 1
106370759 PARADISE VALLEY HOSPITAL San Diego 1,553 $60,430,887 $42,085,479 $0 $550,585,247 $141,089,541 $2,997,566 0.304 0.251 1
106331293 PARKVIEW COMMUNITY HOSPITAL Riverside-San Bernardino 2,627 $69,194,545 $43,102,342 $0 $328,134,869 $87,822,884 $713,441 0.377 0.265 1
106454013 PATIENTS HOSPITAL OF REDDING North 194 $13,809,514 $10,765,580 $0 $26,941,582 $4,555,237 $19,545 0.220 0.168 1
106410852 PENINSULA MEDICAL CENTER San Francisco-San Mateo-Marin 7,343 $97,285,276 $96,487,412 $22,542,461 $1,168,494,352 $307,921,893 $7,815,519 0.240 0.257 1
106491001 PETALUMA VALLEY HOSPITAL Sonoma-Napa 916 $66,391,981 $39,280,553 $0 $242,495,217 $65,539,196 $2,280,098 0.408 0.261 1
106130760 PIONEERS MEMORIAL HOSPITAL San Diego 1,628 $35,452,828 $16,877,914 $0 $154,454,705 $56,660,108 $814,133 0.524 0.362 1
106301297 PLACENTIA-LINDA COMMUNITY HOSPITAL Orange 2,562 $107,670,284 $81,223,631 $0 $263,674,481 $47,276,295 $106,965 0.246 0.179 1
106320986 PLUMAS DISTRICT HOSPITAL North 214 $0 $0 $0 $31,122,835 $17,511,921 $116,881 - 0.559 0
106370977 POMERADO HOSPITAL San Diego 3,515 $86,166,928 $52,354,294 $3,686,090 $275,955,077 $97,650,997 $1,061,608 0.435 0.350 1
106190630 POMONA VALLEY HOSPITAL MEDICAL CENTER Los Angeles-SE 6,484 $316,467,849 $219,148,393 $1,821,690 $1,332,270,660 $280,263,941 $2,812,776 0.313 0.208 1
106190631 PRESBYTERIAN INTERCOMMUNITY HOSPITAL Los Angeles-SE 8,600 $398,258,154 $263,621,040 $0 $1,159,899,503 $233,651,434 $10,704,365 0.338 0.192 1
106190468 PROMISE HOSPITAL OF EAST LOS ANGELES Los Angeles-NE 421 $16,423,694 $12,009,008 $0 $228,376,812 $77,976,484 $257,839 0.269 0.340 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment A

106190385 PROVIDENCE HOLY CROSS MEDICAL CENTER Los Angeles-NW 6,690 $267,120,426 $233,066,098 $15,025,434 $1,010,441,289 $170,338,024 $2,454,979 0.184 0.166 1
106190758 PROVIDENCE SAINT JOSEPH MEDICAL CENTER Los Angeles-NW 7,926 $453,798,659 $335,843,766 $3,787,952 $1,383,339,106 $285,537,569 $4,693,697 0.268 0.203 1
106281047 QUEEN OF THE VALLEY HOSPITAL Sonoma-Napa 2,181 $207,096,352 $118,066,827 $0 $651,358,937 $186,089,817 $2,472,236 0.430 0.282 1
106171049 REDBUD COMMUNITY HOSPITAL North 235 $0 $0 $0 $134,157,764 $47,647,991 $222,309 - 0.354 0
106361308 REDLANDS COMMUNITY HOSPITAL Riverside-San Bernardino 6,689 $145,125,190 $77,899,017 $12,631,785 $418,536,313 $155,879,711 $687,554 0.550 0.371 1
106121051 REDWOOD MEMORIAL HOSPITAL North 495 $19,733,338 $9,442,926 $0 $82,705,277 $25,111,321 $210,103 0.521 0.301 1
106430705 REGIONAL MEDICAL CENTER OF SAN JOSE South Bay 3,998 $207,388,957 $132,623,591 $0 $895,817,249 $215,579,258 $555,042 0.361 0.240 1
106424047 REHABILITATION INST AT SANTA BARBARA Central Coast 153 $6,111,225 $2,281,219 $0 $18,861,511 $15,836,958 $1,162,605 0.627 0.778 1
106580996 RIDEOUT MEMORIAL HOSPITAL North 3,784 $3,119,312 $533,009 $0 $448,357,682 $172,268,698 $929,116 0.829 0.382 1
106150782 RIDGECREST REGIONAL HOSPITAL Central 967 $0 $0 $0 $85,839,267 $35,817,604 $162,161 - 0.415 0
106331226 RIVERSIDE CENTER FOR BEHAVIORAL MEDICINE Riverside-San Bernardino 129 $10,047,804 $6,190,370 $0 $17,809,451 $6,867,324 $20,139 0.384 0.384 1
106331312 RIVERSIDE COMMUNITY HOSPITAL Riverside-San Bernardino 7,820 $265,631,181 $145,992,078 $0 $842,723,471 $207,305,959 $2,314,845 0.450 0.243 1
106334487 RIVERSIDE COUNTY REGIONAL MEDICAL CENTER Riverside-San Bernardino 3,949 $8,887,795 $5,947,060 $0 $757,569,170 $267,772,163 $53,465,199 0.331 0.283 1
106344011 SACRAMENTO COUNTY MENTAL HEALTH TRMT CTR Sacramento 8 $0 $0 $0 $0 $0 $0 - - 0
106301317 SADDLEBACK MEMORIAL MEDICAL CENTER Orange 9,286 $314,186,763 $193,784,834 $0 $821,570,674 $242,453,716 $3,772,645 0.383 0.291 1
106270875 SALINAS VALLEY MEMORIAL HOSPITAL South Bay 6,272 $169,579,520 $42,210,153 $0 $598,741,663 $266,134,547 $1,847,086 0.751 0.441 1
106361318 SAN ANTONIO COMMUNITY HOSPITAL Riverside-San Bernardino 9,329 $376,727,773 $269,840,807 $0 $826,101,924 $199,525,123 $1,427,860 0.284 0.240 1
106301325 SAN CLEMENTE HOSPITAL AND MEDICAL CENTER Orange 1,133 $3,047,369 $3,732,645 $0 $8,827,650 $2,976,563 $24,422 (0.225) 0.334 0
106374055 SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL San Diego 13 $0 $0 $0 $0 $0 $0 - - 0
106374084 SAN DIEGO HOSPICE ACUTE CARE CENTER San Diego 106 $1,180,314 $575,562 $0 $8,687,691 $7,275,316 $0 0.512 0.837 1
106190673 SAN DIMAS COMMUNITY HOSPITAL Los Angeles-SE 2,522 $131,892,793 $107,597,061 $0 $340,249,840 $47,058,858 $110,126 0.184 0.138 1
106380939 SAN FRANCISCO GENERAL HOSP MED CTR San Francisco-San Mateo-Marin 1,722 $7,786,847 $2,519,503 $17,624,644 $943,584,073 $445,502,123 $8,814,421 2.940 0.463 0
106190200 SAN GABRIEL VALLEY MEDICAL CENTER Los Angeles-NE 3,358 $120,808,033 $91,222,327 $782,363 $489,157,390 $105,526,553 $395,280 0.251 0.215 1
106331326 SAN GORGONIO MEMORIAL HOSPITAL Riverside-San Bernardino 356 $0 $0 $0 $80,519,826 $33,583,133 $970,432 - 0.405 0
106150788 SAN JOAQUIN COMMUNITY HOSPITAL Central 4,139 $0 $0 $0 $546,485,946 $110,105,221 $1,583,233 - 0.199 0
106394003 SAN JOAQUIN COUNTY MENTAL HEALTH SERVICE Central 45 $0 $0 $0 $0 $0 $0 - - 0
106391010 SAN JOAQUIN GENERAL HOSPITAL Central 632 $0 $0 $0 $283,396,726 $182,240,422 $11,024,934 - 0.604 0
106104023 SAN JOAQUIN VALLEY REHAB HOSPITAL Central 143 $5,016,532 $1,717,183 $0 $33,190,624 $17,508,531 $43,833 0.658 0.526 1
106404046 SAN LUIS OBISPO CO - PHF Central Coast 207 $0 $0 $0 $0 $0 $0 - - 0
106410782 SAN MATEO MEDICAL CENTER San Francisco-San Mateo-Marin 123 $0 $0 $0 $280,945,693 $192,831,119 $47,608,903 - 0.517 0
106074017 SAN RAMON REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano 4,163 $316,699,662 $238,397,833 $0 $523,048,876 $106,569,858 $968,899 0.247 0.202 1
106420514 SANTA BARBARA COTTAGE HOSPITAL Central Coast 7,984 $0 $0 $0 $946,698,121 $254,662,647 $9,451,904 - 0.259 0
106424002 SANTA BARBARA COUNTY - PHF Central Coast 20 $0 $0 $0 $0 $0 $0 - - 0
106430883 SANTA CLARA VALLEY MEDICAL CENTER South Bay 2,345 $129,219,910 $73,034,621 $18,281,292 $1,418,240,094 $696,508,437 $8,578,119 0.576 0.485 1
106190687 SANTA MONICA - UCLA MEDICAL CENTER Los Angeles-SW 5,467 $208,738,195 $166,208,567 $19,639,438 $489,648,281 $154,454,409 $4,120,573 0.298 0.307 1
106491064 SANTA ROSA MEMORIAL HOSPITAL Sonoma-Napa 5,209 $343,781,383 $211,000,899 $0 $1,053,996,486 $268,903,026 $2,668,769 0.386 0.253 1
106420522 SANTA YNEZ VALLEY COTTAGE HOSPITAL Central Coast 56 $0 $0 $0 $23,388,755 $7,882,070 $146,362 - 0.331 0
106371256 SCRIPPS GREEN HOSPITAL San Diego 4,393 $288,667,060 $165,326,881 $0 $640,711,343 $181,107,392 $8,995,389 0.427 0.269 1
106371394 SCRIPPS MEMORIAL HOSPITAL - ENCINITAS San Diego 3,422 $124,898,574 $64,917,012 $0 $356,023,178 $111,128,023 $1,620,695 0.480 0.308 1
106370771 SCRIPPS MEMORIAL HOSPITAL-LA JOLLA San Diego 13,622 $524,340,641 $312,299,050 $376,279 $1,050,186,682 $307,606,111 $11,529,275 0.405 0.282 1
106370744 SCRIPPS MERCY HOSPITAL San Diego 8,720 $320,966,018 $198,811,461 $13,466,297 $1,320,084,090 $366,276,431 $10,904,295 0.423 0.269 1
106100793 SELMA DISTRICT HOSPITAL Central 507 $30,773,076 $22,337,790 $259,710 $116,972,378 $28,178,480 $515,300 0.283 0.236 1
106124004 SEMPERVIRENS PSYCHIATRIC HEALTH FACILITY North 29 $0 $0 $0 $0 $0 $0 - - 0
106321016 SENECA HEALTHCARE DISTRICT North 47 $0 $0 $0 $15,021,410 $10,749,440 $36,355 - 0.713 0
106410891 SEQUOIA HOSPITAL San Francisco-San Mateo-Marin 4,988 $309,077,686 $196,520,199 $0 $740,150,807 $164,645,991 $2,234,741 0.364 0.219 1
106410817 SETON MEDICAL CENTER San Francisco-San Mateo-Marin 2,359 $242,031,229 $140,358,113 $0 $1,148,852,577 $245,133,755 $2,394,054 0.420 0.211 1
106370875 SHARP CHULA VISTA MEDICAL CENTER San Diego 4,150 $173,199,261 $118,766,425 $17,284,221 $843,252,741 $180,685,200 $1,527,962 0.414 0.212 1
106370689 SHARP CORONADO HOSPITAL & HEALTHCARE CTR San Diego 560 $32,072,630 $20,091,342 $1,599,977 $147,024,353 $48,326,081 $409,106 0.423 0.326 1
106370695 SHARP MARY BIRCH HOSPITAL FOR WOMEN San Diego 11,626 $217,385,903 $136,452,667 $479,717 $336,597,083 $80,313,497 $655,481 0.375 0.237 1
106370694 SHARP MEMORIAL HOSPITAL San Diego 8,494 $556,017,556 $391,376,813 $76,125,472 $1,466,716,811 $411,914,667 $12,310,132 0.433 0.272 1
106374049 SHARP VISTA PACIFICA San Diego 168 $3,689,457 $1,843,640 $1,683 $4,790,278 $2,055,607 $243 0.501 0.429 1
106450940 SHASTA REGIONAL MEDICAL CENTER North 1,357 $174,050,163 $152,078,592 $0 $924,174,707 $114,397,357 $305,940 0.126 0.123 1
106190708 SHERMAN OAKS HOSPITAL & HEALTH CENTER Los Angeles-NW 783 $41,512,085 $29,992,897 $0 $298,037,466 $69,926,266 $1,281,351 0.277 0.230 1
106100797 SIERRA KINGS DISTRICT HOSPITAL Central 615 $5,027,148 $2,415,454 $0 $54,314,913 $23,193,939 $578,970 0.520 0.416 1
106291023 SIERRA NEVADA MEMORIAL HOSPITAL North 2,164 $2,109,466 $1,004,472 $1,008,323 $268,019,259 $85,925,685 $1,499,717 1.002 0.315 0
106540798 SIERRA VIEW DISTRICT HOSPITAL Central 1,683 $65,381,418 $29,948,386 $0 $371,286,119 $87,718,550 $1,170,427 0.542 0.233 1
106342392 SIERRA VISTA HOSPITAL Sacramento 1,404 $15,728,130 $8,041,764 $0 $37,978,414 $13,202,123 $56,272 0.489 0.346 1
106400524 SIERRA VISTA REGIONAL MEDICAL CENTER Central Coast 3,130 $263,573,837 $193,008,985 $0 $631,677,619 $104,704,246 $910,735 0.268 0.164 1
106560525 SIMI VALLEY HOSP & HLTH SVCS-SYCAMORE Central Coast 2,825 $123,834,643 $77,281,996 $0 $309,822,440 $80,134,490 $466,643 0.376 0.257 1
106491076 SONOMA VALLEY HOSPITAL Sonoma-Napa 511 $2,362,864 $2,362,864 $1,161,794 $112,653,009 $36,649,233 $108,753 0.492 0.324 1
106551034 SONORA COMMUNITY HOSPITAL - FOREST Central 1,349 $0 $0 $0 $339,276,003 $102,168,427 $4,624,190 - 0.288 0
106301337 SOUTH COAST MEDICAL CENTER Orange 3,062 $109,688,393 $72,231,890 $0 $244,633,309 $71,452,548 $1,708,647 0.341 0.285 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment A

106141338 SOUTHERN INYO HOSPITAL Central 6 $0 $0 $0 $7,833,911 $5,001,577 $83,664 - 0.628 0
106334068 SOUTHWEST HEALTHCARE SYSTEM-MURRIETA Riverside-San Bernardino 13,491 $218,828,575 $129,565,138 $0 $565,222,005 $148,387,634 $1,687,351 0.408 0.260 1
106100899 ST. AGNES MEDICAL CENTER Central 8,060 $354,924,260 $212,380,289 $0 $1,020,301,688 $319,926,503 $5,917,220 0.402 0.308 1
106361339 ST. BERNARDINE MEDICAL CENTER Riverside-San Bernardino 5,324 $239,265,812 $169,216,495 $0 $824,061,368 $187,739,017 $2,855,262 0.293 0.224 1
106521041 ST. ELIZABETH COMMUNITY HOSPITAL North 1,188 $0 $0 $0 $190,990,764 $59,025,707 $1,085,676 - 0.303 0
106190754 ST. FRANCIS MEDICAL CENTER Los Angeles-SE 2,636 $95,123,244 $89,164,736 $4,548,820 $813,781,631 $201,732,126 $4,663,172 0.110 0.242 1
106380960 ST. FRANCIS MEMORIAL HOSPITAL San Francisco-San Mateo-Marin 1,585 $150,838,556 $135,576,663 $0 $550,053,226 $135,391,263 $1,536,863 0.101 0.243 1
106281078 ST. HELENA HOSPITAL Sonoma-Napa 1,504 $94,700,075 $63,892,531 $493,645 $322,535,492 $87,492,378 $3,860,869 0.331 0.259 1
106190756 ST. JOHNS HOSPITAL AND HEALTH CENTER Los Angeles-SW 7,983 $369,158,926 $265,061,838 $0 $847,205,412 $224,497,120 $27,122,319 0.282 0.233 1
106560508 ST. JOHNS PLEASANT VALLEY HOSPITAL Central Coast 1,353 $75,514,314 $46,074,083 $0 $260,138,562 $62,014,301 $291,251 0.390 0.237 1
106560529 ST. JOHNS REGIONAL MEDICAL CENTER Central Coast 3,778 $202,267,505 $125,771,931 $0 $695,346,708 $186,363,842 $861,916 0.378 0.267 1
106121080 ST. JOSEPH HOSPITAL - EUREKA North 1,834 $110,115,382 $53,349,970 $0 $424,048,920 $126,667,547 $665,611 0.516 0.297 1
106301340 ST. JOSEPH HOSPITAL - ORANGE Orange 14,866 $352,576,938 $237,799,867 $728,912 $1,315,078,045 $403,068,306 $54,252,386 0.328 0.265 1
106392232 ST. JOSEPHS BEHAVIORAL HEALTH CENTER Central 875 $11,124,290 $6,146,567 $0 $23,903,330 $8,350,810 $25,432 0.447 0.348 1
106391042 ST. JOSEPHS MEDICAL CENTER OF STOCKTON Central 5,659 $316,169,554 $199,625,659 $1,371,538 $1,100,946,647 $236,630,761 $7,579,021 0.373 0.208 1
106301342 ST. JUDE MEDICAL CENTER Orange 8,108 $430,822,300 $209,370,751 $0 $1,022,150,986 $279,233,904 $5,177,751 0.514 0.268 1
106434138 ST. LOUISE REGIONAL HOSPITAL South Bay 1,632 $83,072,651 $51,386,185 $0 $253,046,783 $60,626,325 $287,452 0.381 0.238 1
106380964 ST. LUKES HOSPITAL San Francisco-San Mateo-Marin 1,330 $66,845,290 $32,349,001 $0 $401,086,965 $130,495,266 $8,209,932 0.516 0.305 1
106361343 ST. MARY MEDICAL CENTER Riverside-San Bernardino 6,796 $8,377,576 $14,395,284 $3,528,514 $471,574,414 $132,489,581 $1,667,537 (0.297) 0.277 0
106190053 ST. MARY MEDICAL CENTER Los Angeles-SW 1,742 $82,955,025 $61,809,244 $1,835,635 $784,497,656 $168,128,849 $931,311 0.277 0.213 1
106380965 ST. MARYS MEDICAL CENTER San Francisco-San Mateo-Marin 1,961 $260,597,776 $176,866,940 $0 $670,821,032 $153,768,733 $4,426,217 0.321 0.223 1
106010967 ST. ROSE HOSPITAL Alameda-Contra Costa-Solano 1,310 $55,268,850 $32,698,704 $0 $322,659,575 $96,980,983 $526,296 0.408 0.299 1
106190762 ST. VINCENT MEDICAL CENTER Los Angeles-NE 2,659 $115,902,796 $59,560,766 $1,408,548 $525,667,492 $144,847,946 $3,257,823 0.498 0.269 1
106430905 STANFORD UNIVERSITY HOSPITAL South Bay 9,710 $1,776,551,950 $1,043,549,539 $864,000 $3,811,842,074 $1,189,884,698 $49,932,000 0.413 0.299 1
106501016 STANISLAUS BEHAVIORAL HEALTH CENTER Central 812 $0 $0 $0 $28,151,723 $17,041,374 $6,996 - 0.605 0
106504038 STANISLAUS SURG CENTER Central 990 $0 $0 $0 $190,042,844 $23,810,831 $608,852 - 0.122 0
106190599 SUBURBAN MEDICAL CENTER Los Angeles-SE 87 $6,435,499 $9,894,480 $0 $78,694,482 $16,701,131 $104,587 (0.537) 0.211 0
106010937 SUMMIT MEDICAL CENTER Alameda-Contra Costa-Solano 4,499 $501,642,158 $333,312,082 $0 $1,368,216,140 $333,949,215 $39,551,383 0.336 0.215 1
106364121 SUN HEALTH ROBERT H BALLARD REHAB HSP Riverside-San Bernardino 110 $0 $0 $0 $15,352,460 $19,509,425 $38,416 - 1.268 0
106250955 SURPRISE VALLEY COMMUNITY HOSPITAL North 3 $0 $0 $0 $3,152,667 $3,290,631 $226,865 - 0.972 0
106034002 SUTTER AMADOR HOSPITAL Central 757 $0 $0 $0 $130,725,637 $54,531,453 $198,909 - 0.416 0
106310791 SUTTER AUBURN FAITH HOSPITAL Sacramento 1,337 $76,313,952 $38,872,548 $2,847,659 $260,937,677 $73,753,804 $2,263,069 0.528 0.274 1
106344017 SUTTER CENTER FOR PSYCHIATRY Sacramento 1,421 $20,977,933 $9,382,327 $0 $38,485,805 $18,300,119 $917,841 0.553 0.452 1
106084001 SUTTER COAST HOSPITAL North 620 $0 $0 $0 $98,306,840 $39,950,910 $776,916 - 0.398 0
106574010 SUTTER DAVIS HOSPITAL Sacramento 1,797 $78,121,872 $48,842,052 $7,803,099 $195,296,773 $57,178,808 $1,074,285 0.475 0.287 1
106070934 SUTTER DELTA MEDICAL CENTER Alameda-Contra Costa-Solano 2,614 $102,158,856 $57,569,608 $0 $327,760,540 $102,895,678 $1,391,912 0.436 0.310 1
106171395 SUTTER LAKESIDE HOSPITAL North 645 $8,605,331 $2,568,896 $0 $163,042,984 $59,385,640 $1,119,214 0.701 0.357 1
106444012 SUTTER MATERNITY & SURGERY CENTER South Bay 1,948 $0 $0 $0 $75,188,278 $26,725,246 $547,130 - 0.348 0
106490919 SUTTER MEDICAL CENTER OF SANTA ROSA Sonoma-Napa 2,633 $113,390,399 $51,111,977 $233,689 $407,827,337 $164,327,202 $4,821,086 0.551 0.391 1
106341051 SUTTER MEDICAL CENTER-SACRAMENTO Sacramento 11,338 $755,986,702 $441,277,356 $31,762,870 $2,466,322,352 $552,394,253 $19,184,529 0.458 0.216 1
106311000 SUTTER ROSEVILLE MEDICAL CENTER Sacramento 7,160 $307,099,574 $168,969,930 $11,853,014 $828,731,355 $209,342,243 $5,755,402 0.488 0.246 1
106481094 SUTTER SOLANO MEDICAL CENTER Alameda-Contra Costa-Solano 1,510 $0 $0 $0 $310,002,845 $87,133,393 $581,896 - 0.279 0
106391056 SUTTER TRACY COMMUNITY HOSPITAL Central 2,168 $0 $0 $0 $235,943,452 $64,166,379 $857,932 - 0.268 0
106514001 SUTTER-YUBA - PHF North 6 $0 $0 $0 $0 $0 $0 - - 0
106291053 TAHOE FOREST HOSPITAL North 1,230 $31,775,318 $6,123,438 $0 $87,779,853 $56,957,478 $2,175,033 0.807 0.624 1
106190782 TARZANA TREATMENT CENTER Los Angeles-NW 501 $0 $0 $0 $14,373,340 $11,043,417 $0 - 0.768 0
106150808 TEHACHAPI HOSPITAL Central 29 $1,905,429 $910,627 $0 $17,858,988 $10,673,886 $286,969 0.522 0.582 0
106014207 TELECARE HERITAGE - PHF Alameda-Contra Costa-Solano 329 $0 $0 $0 $0 $0 $0 - - 0
106314029 TELECARE PLACER CO - P.H.F. Sacramento 1 $0 $0 $0 $0 $0 $0 - - 0
106484028 TELECARE SOLANO - PHF Alameda-Contra Costa-Solano 262 $0 $0 $0 $0 $0 $0 - - 0
106190784 TEMPLE COMMUNITY HOSPITAL Los Angeles-NE 235 $1,492,371 $446,124 $0 $116,700,414 $36,187,929 $24,101 0.701 0.310 1
106564121 THOUSAND OAKS SURGICAL HOSPITAL Central Coast 327 $7,286,722 $5,274,309 $0 $10,757,303 $3,584,863 $90,484 0.276 0.325 1
106010782 THUNDER ROAD CHEMICAL DEPENDCY RCVRY HSP Alameda-Contra Costa-Solano 123 $1,777,369 $626,987 $0 $3,708,628 $4,954,244 $2,600,194 0.647 0.635 1
106190422 TORRANCE MEMORIAL MEDICAL CENTER Los Angeles-SW 16,275 $590,703,359 $448,121,853 $38,520,942 $1,274,668,540 $313,842,450 $12,835,762 0.307 0.236 1
106370780 TRI-CITY MEDICAL CENTER San Diego 6,405 $207,359,789 $134,295,259 $9,839,181 $714,859,048 $231,503,376 $2,963,122 0.400 0.320 1
106190159 TRI-CITY REGIONAL MEDICAL CENTER Los Angeles-SE 261 $8,384,110 $313,527 $0 $140,622,721 $36,010,490 $237,285 0.963 0.254 1
106531059 TRINITY GENERAL HOSPITAL North 55 $0 $0 $0 $18,122,460 $12,053,108 $336,222 - 0.647 0
106540816 TULARE DISTRICT HOSPITAL Central 1,321 $707,698 $361,584 $0 $137,739,474 $59,397,685 $2,249,255 0.489 0.415 1
106551061 TUOLUMNE GENERAL HOSPITAL Central 327 $9,729,454 $6,329,597 $0 $76,276,582 $32,744,374 $461,827 0.349 0.423 1
106301357 TUSTIN HOSPITAL MEDICAL CENTER Orange 102 $9,731,125 $8,187,788 $0 $128,589,989 $24,346,406 $379,047 0.159 0.186 1
106304079 TUSTIN REHABILITATION HOSPITAL Orange 227 $5,735,551 $3,000,678 $0 $30,061,486 $16,801,927 $58,126 0.477 0.557 1
106400548 TWIN CITIES COMMUNITY HOSPITAL Central Coast 1,696 $151,330,009 $111,349,955 $0 $426,765,207 $60,451,660 $163,986 0.264 0.141 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment A

106190796 UCLA MEDICAL CENTER Los Angeles-NE 12,265 $1,141,872,227 $727,081,457 $5,299,826 $2,409,010,604 $796,329,282 $49,947,854 0.368 0.310 1
106190930 UCLA NEUROPSYCHIATRIC HOSPITAL Los Angeles-NE 1,028 $27,450,012 $15,408,611 $0 $51,443,460 $33,311,372 $0 0.439 0.648 1
106381154 UCSF MEDICAL CENTER San Francisco-San Mateo-Marin 13,061 $1,814,534,937 $1,280,040,862 $3,733,152 $3,747,206,450 $1,092,780,837 $53,048,446 0.297 0.277 1
106231396 UKIAH VALLEY MEDICAL CENTER North 1,198 $51,224,172 $30,451,603 $0 $185,830,693 $49,435,957 $862,281 0.406 0.261 1
106370787 UNIVERSITY COMMUNITY MEDICAL CENTER San Diego 34 $212,273 $116,290 $0 $53,115,673 $31,570,142 $1,012,860 0.452 0.575 0
106370782 UNIVERSITY OF CALIF - SAN DIEGO MED CTR San Diego 6,102 $452,127,080 $237,245,387 $0 $1,336,934,805 $534,743,933 $23,269,022 0.475 0.383 1
106341006 UNIVERSITY OF CALIFORNIA DAVIS MED CTR Sacramento 9,263 $1,036,106,663 $701,757,327 $83,223,326 $3,272,979,610 $810,781,039 $6,282,460 0.403 0.246 1
106301279 UNIVERSITY OF CALIFORNIA IRVINE MED CTR Orange 4,627 $533,068,188 $385,756,036 $389,796 $1,835,632,539 $412,189,172 $10,446,571 0.277 0.219 1
106191216 USC KENNETH NORRIS JR. CANCER HOSPITAL Los Angeles-NE 1,499 $163,214,817 $98,678,559 $0 $286,714,730 $99,159,533 $933,987 0.395 0.343 1
106194219 USC UNIVERSITY HOSPITAL Los Angeles-NE 3,465 $575,669,718 $424,149,329 $0 $1,469,611,705 $267,188,014 $1,644,363 0.263 0.181 1
106484001 VACA VALLEY HOSPITAL Alameda-Contra Costa-Solano 571 $44,559,731 $27,688,771 $3,882,169 $295,717,066 $56,693,280 $247,596 0.466 0.191 1
106010983 VALLEY MEMORIAL HOSPITAL Alameda-Contra Costa-Solano 4,696 $306,312,962 $206,946,886 $0 $716,162,918 $177,750,021 $8,299,773 0.324 0.237 1
106190812 VALLEY PRESBYTERIAN HOSPITAL Los Angeles-NW 4,157 $74,317,565 $43,835,256 $0 $463,575,127 $128,908,813 $2,705,244 0.410 0.272 1
106560481 VENTURA COUNTY MEDICAL CENTER Central Coast 1,175 $32,813,989 $23,698,512 $403,712 $411,795,496 $209,892,449 $5,956,178 0.290 0.495 1
106190818 VERDUGO HILLS HOSPITAL Los Angeles-NW 3,528 $104,521,562 $82,757,335 $0 $253,766,845 $68,485,285 $530,498 0.208 0.268 1
106361370 VICTOR VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino 2,245 $45,944,034 $34,060,805 $0 $189,796,334 $47,823,635 $1,271,926 0.259 0.245 1
106010987 WASHINGTON HOSPITAL - FREMONT Alameda-Contra Costa-Solano 7,791 $222,282,524 $88,838,320 $0 $782,312,953 $253,992,783 $3,015,751 0.600 0.321 1
106444013 WATSONVILLE COMMUNITY HOSPITAL South Bay 1,693 $139,068,053 $102,203,500 $0 $550,377,553 $96,370,811 $200,223 0.265 0.175 1
106301379 WEST ANAHEIM MEDICAL CENTER Orange 2,455 $78,641,757 $62,162,793 $0 $269,605,695 $61,539,450 $274,060 0.210 0.227 1
106190859 WEST HILLS HOSPITAL & MEDICAL CENTER Los Angeles-NW 4,742 $220,075,156 $152,257,555 $0 $538,064,577 $116,996,624 $1,529,600 0.308 0.215 1
106301188 WESTERN MEDICAL CENTER-ANAHEIM Orange 821 $46,654,064 $37,202,309 $0 $310,168,055 $67,241,488 $254,112 0.203 0.216 1
106301566 WESTERN MEDICAL CENTER-SANTA ANA Orange 3,162 $266,479,313 $211,093,116 $0 $864,556,009 $150,007,927 $852,981 0.208 0.173 1
106190878 WHITE MEMORIAL MEDICAL CENTER Los Angeles-NE 2,304 $101,928,700 $72,204,099 $0 $819,113,055 $212,964,519 $5,613,598 0.292 0.253 1
106190883 WHITTIER HOSPITAL MEDICAL CENTER Los Angeles-SE 2,715 $110,978,299 $104,624,075 $0 $494,092,464 $75,519,796 $176,639 0.057 0.152 1
106571086 WOODLAND MEMORIAL HOSPITAL Sacramento 1,715 $93,096,757 $84,050,920 $12,430,164 $227,125,000 $71,244,000 $6,543,000 0.231 0.285 1
CMM 10/12/2007 11:24 AM

Milliman
Attachment B
Experience by APR-DRG/SOI and Benchmark Allowed Amounts
2005 OSHPD Discharge Data

Estimated Estimated Allowed to Benchmark
APR Severity Average Average Average Cost TPMC
DRG Level Description Discharges LOS Days Billed Allowed* Cost* Multiplier Allowed
Total 1,013,939 3.77 3,818,375 $32,829 $11,941 $8,407 1.420 $11,941
001 1 Liver Transplant 13 8.31 108 $214,529 $76,665 $61,198 1.420 $86,926
001 2 Liver Transplant 108 11.10 1,199 $280,269 $108,778 $79,738 1.420 $113,261
002 1 Heart &/Or Lung Transplant 16 12.44 199 $365,719 $129,770 $96,913 1.420 $137,657
002 2 Heart &/Or Lung Transplant 46 13.26 610 $336,998 $125,390 $96,159 1.420 $136,586
002 3 Heart &/Or Lung Transplant 72 23.67 1,704 $501,498 $194,687 $146,052 1.420 $207,454
002 4 Heart &/Or Lung Transplant 104 47.02 4,890 $1,037,189 $389,965 $298,298 1.420 $423,705
003 1 Bone Marrow Transplant 591 20.81 12,298 $195,459 $82,578 $64,310 1.420 $91,347
003 4 Bone Marrow Transplant 91 67.40 6,133 $1,004,503 $428,865 $355,020 1.420 $504,275
004 1 Trach W/Dmv W Exten Proc 2 10.00 20 $289,249 $77,717 $56,854 1.420 $80,755
004 2 Trach W/Dmv W Exten Proc 22 22.73 500 $385,526 $141,641 $102,584 1.420 $145,712
004 3 Trach W/Dmv W Exten Proc 123 32.90 4,047 $546,600 $210,434 $146,038 1.420 $207,434
004 4 Trach W/Dmv W Exten Proc 571 45.91 26,215 $811,644 $300,226 $214,694 1.420 $304,954
005 1 Trach W/Dmv W/O Enten Proc 3 8.33 25 $114,567 $43,218 $30,773 1.420 $43,711
005 2 Trach W/Dmv W/O Enten Proc 17 32.47 552 $402,277 $135,152 $98,957 1.420 $140,559
005 3 Trach W/Dmv W/O Enten Proc 121 26.96 3,262 $351,277 $122,263 $90,081 1.420 $127,952
005 4 Trach W/Dmv W/O Enten Proc 357 39.72 14,180 $603,038 $208,173 $150,329 1.420 $213,529
006 1 Pancreas Transplant 0 0.00 0 $0 $0 $0 1.420 $0
006 2 Pancreas Transplant 35 9.86 345 $265,559 $99,397 $73,508 1.420 $104,411
020 1 Craniotomy For Trauma 190 4.44 844 $65,446 $23,725 $16,544 1.420 $23,499
020 4 Craniotomy For Trauma 116 16.79 1,948 $294,906 $115,169 $80,973 1.420 $115,015
021 1 Craniotomy Exc For Trauma 1,769 3.93 6,953 $74,654 $29,047 $19,943 1.420 $28,328
021 2 Craniotomy Exc For Trauma 1,753 6.38 11,177 $102,109 $39,134 $28,129 1.420 $39,955
021 3 Craniotomy Exc For Trauma 641 12.53 8,034 $183,988 $69,338 $50,224 1.420 $71,338
021 4 Craniotomy Exc For Trauma 353 22.20 7,836 $323,399 $117,452 $85,080 1.420 $120,849
022 1 Ventricular Shunt Proc 284 2.99 849 $40,810 $15,340 $11,561 1.420 $16,422
022 2 Ventricular Shunt Proc 254 5.89 1,495 $63,496 $24,022 $17,963 1.420 $25,515
023 1 Spinal Procedures 567 3.97 2,249 $49,581 $18,336 $12,929 1.420 $18,365
023 4 Spinal Procedures 30 26.83 805 $381,233 $149,368 $105,243 1.420 $149,488
024 1 Extracranial Vascular Proc 1,067 1.73 1,850 $43,213 $15,242 $10,808 1.420 $15,352
024 2 Extracranial Vascular Proc 503 3.22 1,620 $61,907 $21,884 $15,576 1.420 $22,124
024 3 Extracranial Vascular Proc 154 7.84 1,207 $125,873 $44,424 $31,462 1.420 $44,689
024 4 Extracranial Vascular Proc 37 13.19 488 $261,244 $87,131 $61,154 1.420 $86,864
026 1 Other Nervous System Proc 510 2.08 1,063 $38,518 $14,586 $10,292 1.420 $14,619
026 2 Other Nervous System Proc 234 3.58 838 $53,486 $19,890 $14,185 1.420 $20,148
040 1 Spinal Disorders & Injuries 82 2.84 233 $33,007 $13,068 $8,717 1.420 $12,382
040 2 Spinal Disorders & Injuries 115 4.48 515 $42,121 $16,193 $11,096 1.420 $15,761
040 3 Spinal Disorders & Injuries 81 21.60 1,750 $92,171 $50,587 $42,802 1.420 $60,796
040 4 Spinal Disorders & Injuries 23 49.35 1,135 $213,421 $123,296 $101,055 1.420 $143,540
041 1 Nervous System Neoplasms 194 2.73 529 $26,232 $9,754 $7,034 1.420 $9,991
041 2 Nervous System Neoplasms 615 4.11 2,529 $28,807 $10,672 $7,531 1.420 $10,697
041 3 Nervous System Neoplasms 421 7.03 2,958 $50,723 $19,024 $13,260 1.420 $18,835
041 4 Nervous System Neoplasms 57 14.09 803 $134,787 $50,592 $34,583 1.420 $49,121
042 1 Degenerative Nerv Syst Dis 132 3.77 497 $21,427 $7,686 $5,864 1.420 $8,330
042 2 Degenerative Nerv Syst Dis 305 5.53 1,688 $25,042 $8,964 $6,627 1.420 $9,413
043 1 Mult Sclerosis & Other 364 3.29 1,198 $24,272 $7,998 $5,968 1.420 $8,477
043 2 Mult Sclerosis & Other 201 5.27 1,059 $36,855 $12,709 $9,381 1.420 $13,325
043 3 Mult Sclerosis & Other 42 8.19 344 $62,120 $21,971 $16,417 1.420 $23,319
043 4 Mult Sclerosis & Other 7 19.14 134 $253,351 $96,703 $60,883 1.420 $86,478
044 1 Intracranial Hemorrhage 263 3.40 894 $30,954 $10,831 $7,524 1.420 $10,687
044 2 Intracranial Hemorrhage 412 6.02 2,481 $45,367 $16,502 $11,595 1.420 $16,470
045 1 Cva W Infarct 842 2.72 2,290 $24,582 $8,660 $6,001 1.420 $8,524
045 2 Cva W Infarct 2,784 4.02 11,204 $30,321 $10,714 $7,576 1.420 $10,761
045 3 Cva W Infarct 947 6.71 6,357 $49,665 $17,788 $12,786 1.420 $18,161
045 4 Cva W Infarct 197 10.90 2,147 $108,681 $38,284 $26,802 1.420 $38,069
046 1 Nonspec Cva & Precereb Occl 69 2.55 176 $26,012 $8,879 $6,024 1.420 $8,556
047 1 Transient Ischemia 993 1.62 1,606 $17,432 $6,004 $4,193 1.420 $5,956
*Estimates are based on hospital specific ratios from Attachment A and do not reflect actual allowed or costs by APR-DRG/SOI
Milliman Page 1 of 16
Attachment B

047 2 Transient Ischemia 1,202 2.08 2,497 $20,243 $6,830 $4,805 1.420 $6,825
047 3 Transient Ischemia 159 3.08 489 $30,424 $10,240 $7,057 1.420 $10,023
047 4 Transient Ischemia 4 7.25 29 $75,477 $27,599 $16,765 1.420 $23,814
048 1 Peripheral & Cranial Nerv 569 2.62 1,491 $20,125 $7,090 $4,918 1.420 $6,986
048 4 Peripheral & Cranial Nerv 25 16.40 410 $104,688 $37,617 $29,441 1.420 $41,819
049 1 Bact & Tuberculous Infec 62 6.11 379 $36,435 $13,489 $9,001 1.420 $12,785
049 2 Bact & Tuberculous Infec 267 6.25 1,670 $60,223 $21,379 $14,967 1.420 $21,260
050 1 Non-Bacterial Infections 92 4.12 379 $24,838 $9,045 $6,319 1.420 $8,975
050 2 Non-Bacterial Infections 322 5.75 1,850 $41,410 $15,126 $10,997 1.420 $15,621
050 3 Non-Bacterial Infections 140 9.84 1,378 $73,421 $27,443 $19,744 1.420 $28,045
050 4 Non-Bacterial Infections 39 15.87 619 $200,331 $73,781 $51,045 1.420 $72,505
051 1 Viral Meningitis 978 2.71 2,652 $17,910 $6,566 $4,510 1.420 $6,406
051 2 Viral Meningitis 412 3.93 1,618 $28,125 $10,138 $7,002 1.420 $9,945
051 3 Viral Meningitis 52 5.96 310 $44,217 $16,597 $11,620 1.420 $16,505
051 4 Viral Meningitis 12 10.83 130 $145,930 $48,554 $34,674 1.420 $49,251
052 1 Nontrauma Stupor & Coma 293 1.79 525 $16,692 $5,877 $4,141 1.420 $5,882
052 2 Nontrauma Stupor & Coma 395 2.58 1,021 $20,510 $7,024 $5,080 1.420 $7,215
053 1 Seizure 2,087 2.35 4,898 $17,412 $6,592 $4,766 1.420 $6,770
053 2 Seizure 1,604 2.73 4,384 $21,639 $8,005 $5,610 1.420 $7,968
053 3 Seizure 805 4.41 3,552 $32,881 $12,549 $9,042 1.420 $12,844
053 4 Seizure 103 10.33 1,064 $114,699 $43,624 $30,931 1.420 $43,935
054 1 Migraine & Other Headache 1,329 2.30 3,057 $16,806 $5,994 $4,120 1.420 $5,852
054 2 Migraine & Other Headache 799 2.93 2,338 $21,370 $7,910 $5,366 1.420 $7,622
054 3 Migraine & Other Headache 93 4.18 389 $33,625 $12,313 $8,423 1.420 $11,964
054 4 Migraine & Other Headache 8 8.50 68 $76,396 $25,923 $17,941 1.420 $25,484
055 1 Head Trauma W Coma >1 Hr 614 2.08 1,280 $24,161 $9,713 $6,836 1.420 $9,710
055 4 Head Trauma W Coma >1 Hr 76 12.43 945 $137,486 $54,540 $37,934 1.420 $53,882
056 1 Brain Contusion/Laceration 253 2.08 525 $25,266 $10,110 $6,958 1.420 $9,883
057 1 Concussion, Closed Skull 1,343 1.35 1,808 $25,608 $10,417 $6,961 1.420 $9,887
057 2 Concussion, Closed Skull 905 2.01 1,822 $34,627 $13,849 $8,976 1.420 $12,750
057 3 Concussion, Closed Skull 113 4.91 555 $61,002 $23,581 $14,964 1.420 $21,256
057 4 Concussion, Closed Skull 20 7.70 154 $78,446 $26,608 $21,020 1.420 $29,857
058 1 Oth Disorders Nervous Sys 1,052 2.46 2,584 $19,823 $7,184 $5,050 1.420 $7,173
058 2 Oth Disorders Nervous Sys 733 4.46 3,269 $29,789 $11,482 $8,277 1.420 $11,757
058 3 Oth Disorders Nervous Sys 248 8.36 2,074 $48,254 $20,061 $14,881 1.420 $21,136
058 4 Oth Disorders Nervous Sys 40 14.35 574 $90,962 $37,743 $27,483 1.420 $39,037
070 1 Orbital Procedures 59 2.05 121 $30,766 $11,863 $8,755 1.420 $12,436
073 1 Eye Procedures Except Orbit 213 1.36 290 $23,175 $8,739 $6,539 1.420 $9,288
080 1 Acute Major Eye Infections 135 3.05 412 $15,075 $5,368 $3,772 1.420 $5,358
082 1 Eye Disorders Exc Major Inf 331 2.22 735 $16,524 $6,190 $4,307 1.420 $6,118
089 1 Maj Cranial/Facial Bone Proc 415 2.16 896 $46,472 $18,137 $13,324 1.420 $18,926
089 3 Maj Cranial/Facial Bone Proc 121 8.27 1,001 $133,644 $52,391 $38,624 1.420 $54,862
090 1 Maj Larynx & Trachea Proc 13 2.15 28 $33,961 $13,999 $11,278 1.420 $16,019
091 1 Oth Maj Head & Neck Proc 167 3.53 589 $55,813 $19,928 $14,078 1.420 $19,997
092 1 Facial Bone Proc Exc Major 938 1.53 1,431 $30,941 $11,322 $8,271 1.420 $11,748
092 2 Facial Bone Proc Exc Major 630 2.45 1,544 $52,088 $19,819 $14,271 1.420 $20,271
092 3 Facial Bone Proc Exc Major 109 3.90 425 $75,799 $29,594 $20,601 1.420 $29,262
092 4 Facial Bone Proc Exc Major 10 25.10 251 $268,412 $120,263 $85,228 1.420 $121,059
Attachment B

093 1 Sinus & Mastoid Proc 248 1.73 430 $27,329 $10,135 $7,167 1.420 $10,180
095 1 Cleft Lip & Palate Repair 890 1.37 1,220 $22,486 $8,885 $6,392 1.420 $9,080
095 2 Cleft Lip & Palate Repair 126 1.71 215 $26,847 $10,756 $7,661 1.420 $10,882
097 1 Tonsil & Adenoid Proc 730 1.44 1,051 $14,755 $5,718 $4,270 1.420 $6,065
097 2 Tonsil & Adenoid Proc 247 2.60 642 $23,507 $9,009 $6,785 1.420 $9,638
098 1 Oth Ear,Nose,Mouth,Throat 1,052 1.62 1,705 $25,505 $9,459 $6,769 1.420 $9,615
098 2 Oth Ear,Nose,Mouth,Throat 372 2.80 1,040 $37,324 $14,114 $10,099 1.420 $14,345
098 3 Oth Ear,Nose,Mouth,Throat 52 6.35 330 $73,141 $29,543 $20,741 1.420 $29,461
110 1 Ear,Nose,Mouth,Throat Malig 38 1.87 71 $20,148 $7,568 $5,438 1.420 $7,725
111 1 Vertigo & Other Labyrinth 572 1.73 989 $14,628 $5,177 $3,578 1.420 $5,082
111 4 Vertigo & Other Labyrinth 0 0.00 0 $0 $0 $0 1.420 $0
113 1 Infections Of Up Resp Tract 1,625 1.70 2,766 $9,319 $3,446 $2,489 1.420 $3,535
113 2 Infections Of Up Resp Tract 1,141 2.41 2,749 $15,625 $5,918 $4,170 1.420 $5,924
113 3 Infections Of Up Resp Tract 185 4.09 757 $32,581 $12,901 $8,812 1.420 $12,516
113 4 Infections Of Up Resp Tract 15 6.93 104 $97,811 $41,369 $29,606 1.420 $42,052
114 1 Dental & Oral Disease 405 2.24 908 $17,388 $6,336 $4,704 1.420 $6,682
120 1 Maj Respiratory & Chest Proc 589 5.00 2,944 $63,379 $23,389 $16,805 1.420 $23,871
121 1 Oth Respiratory & Chest Proc 748 3.87 2,895 $47,606 $17,337 $12,322 1.420 $17,502
130 1 Respiratory System Diag 18 11.22 202 $127,916 $50,785 $35,512 1.420 $50,442
130 2 Respiratory System Diag 126 11.21 1,412 $135,149 $50,071 $34,862 1.420 $49,518
131 1 Cystic Fibrosis 31 5.26 163 $42,849 $14,865 $12,386 1.420 $17,593
131 2 Cystic Fibrosis 151 7.57 1,143 $59,380 $21,670 $16,601 1.420 $23,581
131 3 Cystic Fibrosis 165 10.25 1,692 $75,373 $29,110 $24,266 1.420 $34,468
131 4 Cystic Fibrosis 57 11.21 639 $85,594 $35,461 $26,653 1.420 $37,858
132 1 Bpd & Oth Chronic Resp Dis 7 4.00 28 $17,654 $6,535 $5,867 1.420 $8,334
133 1 Pulmonary Edema & Resp Fail 42 2.21 93 $23,585 $8,992 $5,986 1.420 $8,502
133 2 Pulmonary Edema & Resp Fail 321 3.70 1,188 $35,749 $12,576 $8,523 1.420 $12,107
133 3 Pulmonary Edema & Resp Fail 691 4.87 3,364 $50,073 $17,626 $12,062 1.420 $17,133
133 4 Pulmonary Edema & Resp Fail 1,120 5.75 6,438 $75,650 $25,568 $17,793 1.420 $25,274
134 1 Pulmonary Embolism 820 3.96 3,247 $29,199 $10,123 $7,073 1.420 $10,046
134 2 Pulmonary Embolism 1,008 4.60 4,639 $36,901 $13,162 $8,925 1.420 $12,677
134 3 Pulmonary Embolism 385 6.76 2,604 $58,696 $21,068 $14,514 1.420 $20,616
134 4 Pulmonary Embolism 81 9.00 729 $102,443 $38,507 $25,769 1.420 $36,603
135 1 Major Chest & Resp Trauma 521 2.56 1,333 $27,654 $10,559 $7,177 1.420 $10,194
135 4 Major Chest & Resp Trauma 47 7.17 337 $103,033 $36,587 $24,653 1.420 $35,017
136 1 Respiratory Malignancy 144 3.36 484 $27,196 $9,634 $6,658 1.420 $9,457
136 2 Respiratory Malignancy 773 4.34 3,351 $32,221 $11,405 $8,019 1.420 $11,390
137 1 Major Respiratory Infections 272 5.79 1,575 $28,389 $10,282 $7,428 1.420 $10,550
138 1 Bronchiolitis & Rsv Pneum 2,078 2.49 5,171 $12,273 $4,574 $3,305 1.420 $4,695
138 2 Bronchiolitis & Rsv Pneum 1,018 3.22 3,275 $17,421 $6,432 $4,757 1.420 $6,756
138 3 Bronchiolitis & Rsv Pneum 84 5.05 424 $33,985 $13,623 $10,281 1.420 $14,604
Attachment B

138 4 Bronchiolitis & Rsv Pneum 24 8.75 210 $78,591 $31,990 $24,548 1.420 $34,868
139 1 Other Pneumonia 4,110 2.66 10,935 $15,469 $5,451 $3,833 1.420 $5,445
139 2 Other Pneumonia 6,723 3.44 23,156 $23,399 $8,110 $5,730 1.420 $8,138
139 3 Other Pneumonia 2,551 5.11 13,023 $39,941 $13,847 $9,800 1.420 $13,920
139 4 Other Pneumonia 404 7.99 3,228 $81,815 $29,463 $20,671 1.420 $29,362
140 1 Chronic Obstructive Pulm Dis 1,401 3.01 4,218 $20,255 $6,728 $4,740 1.420 $6,732
140 2 Chronic Obstructive Pulm Dis 1,764 3.61 6,363 $26,433 $9,022 $6,199 1.420 $8,805
140 3 Chronic Obstructive Pulm Dis 727 4.90 3,560 $39,136 $13,381 $9,307 1.420 $13,220
140 4 Chronic Obstructive Pulm Dis 123 7.07 869 $75,774 $25,244 $17,556 1.420 $24,936
141 1 Asthma 3,934 2.11 8,305 $12,755 $4,621 $3,341 1.420 $4,746
141 2 Asthma 1,887 2.92 5,519 $19,359 $6,915 $4,981 1.420 $7,075
141 3 Asthma 232 4.25 985 $32,081 $11,853 $8,452 1.420 $12,005
141 4 Asthma 53 4.87 258 $53,885 $20,350 $15,458 1.420 $21,956
142 1 Interstitial Lung Disease 89 3.51 312 $27,137 $9,210 $6,787 1.420 $9,640
142 2 Interstitial Lung Disease 233 4.44 1,035 $33,384 $12,247 $8,450 1.420 $12,002
143 1 Other Respiratory Diagnoses 708 2.75 1,947 $16,704 $6,345 $4,441 1.420 $6,307
144 1 Resp Signs & Symptons 1,463 1.73 2,537 $16,627 $6,121 $4,157 1.420 $5,904
144 2 Resp Signs & Symptons 1,132 2.80 3,170 $22,316 $8,382 $5,663 1.420 $8,043
144 3 Resp Signs & Symptons 305 4.01 1,223 $31,985 $12,230 $8,658 1.420 $12,298
144 4 Resp Signs & Symptons 31 7.13 221 $61,682 $22,196 $16,418 1.420 $23,320
160 1 Maj Cardiothoracic Repair 19 5.32 101 $128,093 $50,898 $42,401 1.420 $60,227
160 2 Maj Cardiothoracic Repair 83 7.54 626 $158,856 $64,132 $54,671 1.420 $77,656
160 3 Maj Cardiothoracic Repair 181 11.55 2,090 $237,123 $105,133 $83,549 1.420 $118,674
160 4 Maj Cardiothoracic Repair 80 29.09 2,327 $518,885 $239,322 $190,080 1.420 $269,992
161 1 Cardiac Defib & Heart Assist 338 1.96 664 $112,335 $40,158 $27,892 1.420 $39,618
161 2 Cardiac Defib & Heart Assist 651 2.69 1,748 $127,934 $45,993 $31,816 1.420 $45,191
162 1 Cardiac Valve Proc W/Cath 59 6.80 401 $181,441 $60,852 $40,759 1.420 $57,895
162 2 Cardiac Valve Proc W/Cath 178 8.16 1,453 $196,985 $68,505 $46,339 1.420 $65,820
163 1 Cardiac Valve Proc W/0 Cath 449 5.28 2,370 $139,077 $52,779 $36,016 1.420 $51,158
165 1 Coronary Bypass W/Card Cath 309 6.51 2,013 $150,872 $52,650 $35,029 1.420 $49,755
165 2 Coronary Bypass W/Card Cath 1,520 7.35 11,177 $169,708 $58,731 $38,676 1.420 $54,936
166 1 Cor Bypass W/O Card Cath 334 4.77 1,592 $127,220 $44,620 $29,685 1.420 $42,164
166 2 Cor Bypass W/O Card Cath 1,150 5.72 6,579 $141,348 $49,085 $32,822 1.420 $46,621
167 1 Other Cardiothoracic Proc 232 3.67 851 $96,562 $37,028 $26,847 1.420 $38,133
167 2 Other Cardiothoracic Proc 139 5.58 776 $128,044 $49,638 $36,381 1.420 $51,675
167 3 Other Cardiothoracic Proc 193 10.05 1,940 $169,660 $71,424 $53,316 1.420 $75,731
167 4 Other Cardiothoracic Proc 91 20.41 1,857 $339,258 $134,893 $104,224 1.420 $148,040
169 1 Maj Thoracic & Abdomen Proc 147 4.23 622 $70,945 $24,898 $16,954 1.420 $24,082
169 2 Maj Thoracic & Abdomen Proc 400 5.74 2,294 $103,994 $37,769 $26,451 1.420 $37,571
170 1 Perm Cardiac Pacemak W Ami 9 2.78 25 $100,350 $37,446 $26,304 1.420 $37,363
171 1 Perm Card Pacemak W/O Ami 772 1.96 1,516 $50,566 $18,000 $12,408 1.420 $17,624
171 2 Perm Card Pacemak W/O Ami 602 3.25 1,959 $63,108 $22,892 $15,704 1.420 $22,307
171 3 Perm Card Pacemak W/O Ami 119 5.62 669 $93,945 $33,296 $23,284 1.420 $33,073
171 4 Perm Card Pacemak W/O Ami 26 11.54 300 $169,501 $61,651 $41,018 1.420 $58,263
173 1 Other Vascular Procedures 1,018 2.52 2,569 $54,429 $19,206 $13,304 1.420 $18,897
173 2 Other Vascular Procedures 946 3.91 3,703 $74,449 $26,055 $18,240 1.420 $25,909
174 1 Percut Cardiovasc Proc W/Ami 3,774 2.31 8,722 $79,127 $26,990 $18,711 1.420 $26,577
174 2 Percut Cardiovasc Proc W/Ami 2,044 2.80 5,730 $84,082 $28,636 $20,001 1.420 $28,410
174 3 Percut Cardiovasc Proc W/Ami 538 4.27 2,296 $107,002 $35,784 $24,638 1.420 $34,995
174 4 Percut Cardiovasc Proc W/Ami 432 7.55 3,261 $170,400 $58,647 $40,500 1.420 $57,526
175 1 Percut Cardiovasc W/O Ami 10,207 1.33 13,598 $64,613 $22,824 $15,568 1.420 $22,113
175 2 Percut Cardiovasc W/O Ami 3,488 1.75 6,103 $70,109 $24,599 $16,788 1.420 $23,845
175 3 Percut Cardiovasc W/O Ami 726 3.62 2,630 $94,620 $33,153 $23,158 1.420 $32,894
175 4 Percut Cardiovasc W/O Ami 147 9.68 1,423 $193,746 $71,658 $49,092 1.420 $69,730
176 1 Card Pacemak & Defib Repl 99 1.54 152 $40,098 $13,672 $10,093 1.420 $14,336
Attachment B

177 1 Card Pacemak & Defib Revis 80 2.09 167 $29,767 $10,494 $7,408 1.420 $10,523
180 1 Other Circulatory System 120 2.88 346 $34,527 $12,119 $8,720 1.420 $12,386
180 3 Other Circulatory System 145 9.12 1,323 $97,620 $33,322 $23,761 1.420 $33,750
190 1 Acute Myocardial Infarct 1,163 1.90 2,209 $26,328 $9,045 $6,264 1.420 $8,897
190 2 Acute Myocardial Infarct 1,909 2.48 4,731 $31,842 $11,029 $7,592 1.420 $10,783
190 3 Acute Myocardial Infarct 737 4.01 2,958 $45,815 $15,112 $10,614 1.420 $15,076
190 4 Acute Myocardial Infarct 497 5.98 2,974 $82,975 $28,383 $19,814 1.420 $28,145
191 1 Card Cathet Exc Ischemia 693 2.01 1,390 $34,842 $12,598 $8,473 1.420 $12,035
192 1 Card Cathet W/Ischemia 3,584 1.73 6,205 $30,133 $10,740 $7,150 1.420 $10,156
192 2 Card Cathet W/Ischemia 1,627 2.23 3,627 $35,268 $12,284 $8,213 1.420 $11,666
192 3 Card Cathet W/Ischemia 239 3.72 890 $49,433 $16,872 $11,388 1.420 $16,176
192 4 Card Cathet W/Ischemia 18 4.94 89 $64,806 $23,196 $15,424 1.420 $21,909
193 1 Acute & Subacute Endocard 25 5.72 143 $38,322 $14,185 $9,741 1.420 $13,837
194 1 Heart Failure 1,115 2.42 2,696 $19,653 $6,531 $4,627 1.420 $6,572
194 2 Heart Failure 3,507 3.32 11,631 $26,577 $8,929 $6,288 1.420 $8,931
194 3 Heart Failure 1,533 5.25 8,048 $45,115 $15,131 $10,577 1.420 $15,024
194 4 Heart Failure 322 9.46 3,046 $108,317 $36,198 $25,035 1.420 $35,560
196 1 Ventricular Fibrillation 15 1.33 20 $13,082 $4,470 $3,172 1.420 $4,506
197 1 Peripheral & Oth Vasc Dis 1,058 3.20 3,383 $18,184 $6,559 $4,456 1.420 $6,329
197 2 Peripheral & Oth Vasc Dis 1,197 4.13 4,945 $26,572 $9,343 $6,440 1.420 $9,148
197 3 Peripheral & Oth Vasc Dis 613 5.41 3,314 $41,038 $14,947 $10,271 1.420 $14,589
197 4 Peripheral & Oth Vasc Dis 65 8.48 551 $95,780 $35,389 $22,261 1.420 $31,620
198 1 Angina Pect & Coronary Ath 3,842 1.48 5,699 $14,316 $5,005 $3,423 1.420 $4,862
198 2 Angina Pect & Coronary Ath 2,286 1.89 4,324 $17,720 $6,295 $4,232 1.420 $6,011
198 3 Angina Pect & Coronary Ath 347 2.77 961 $23,927 $8,514 $5,826 1.420 $8,275
198 4 Angina Pect & Coronary Ath 15 4.00 60 $47,108 $15,829 $11,716 1.420 $16,642
199 1 Hypertension 586 1.85 1,082 $15,945 $5,511 $3,857 1.420 $5,479
199 2 Hypertension 410 2.35 962 $19,568 $6,842 $4,769 1.420 $6,774
199 3 Hypertension 98 3.76 368 $28,763 $11,345 $7,810 1.420 $11,093
199 4 Hypertension 6 7.83 47 $77,700 $29,682 $19,359 1.420 $27,498
200 1 Card Struct & Valve Dis 95 1.72 163 $15,330 $5,573 $3,995 1.420 $5,674
201 1 Card Arrhythmia & Conduction 3,420 1.63 5,568 $14,848 $5,196 $3,593 1.420 $5,103
201 2 Card Arrhythmia & Conduction 2,527 2.23 5,632 $19,698 $6,973 $4,796 1.420 $6,813
201 3 Card Arrhythmia & Conduction 713 3.89 2,777 $34,026 $12,033 $8,321 1.420 $11,820
201 4 Card Arrhythmia & Conduction 97 7.25 703 $90,102 $30,875 $20,782 1.420 $29,519
203 1 Chest Pain 10,849 1.28 13,888 $13,268 $4,535 $3,156 1.420 $4,483
203 2 Chest Pain 3,767 1.56 5,889 $15,997 $5,524 $3,828 1.420 $5,438
203 3 Chest Pain 231 2.14 494 $21,536 $7,375 $4,974 1.420 $7,066
203 4 Chest Pain 4 1.00 4 $10,928 $4,094 $3,110 1.420 $4,417
204 1 Syncope & Collapse 1,632 1.61 2,628 $15,630 $5,403 $3,707 1.420 $5,265
204 2 Syncope & Collapse 1,579 2.13 3,358 $19,142 $6,643 $4,635 1.420 $6,583
204 3 Syncope & Collapse 266 3.34 889 $28,764 $10,597 $7,303 1.420 $10,374
204 4 Syncope & Collapse 11 2.55 28 $29,304 $9,687 $6,628 1.420 $9,415
205 1 Cardiomyopathy 37 2.78 103 $21,427 $8,209 $5,928 1.420 $8,420
205 2 Cardiomyopathy 69 3.03 209 $26,097 $9,138 $6,499 1.420 $9,231
205 3 Cardiomyopathy 34 5.26 179 $43,512 $15,330 $11,210 1.420 $15,923
205 4 Cardiomyopathy 10 16.10 161 $181,548 $71,738 $53,428 1.420 $75,890
206 1 Comp Cardiac/Vasc Device 88 2.06 181 $19,037 $7,350 $5,067 1.420 $7,197
206 2 Comp Cardiac/Vasc Device 542 3.51 1,901 $27,195 $9,724 $7,115 1.420 $10,106
207 1 Oth Circulatory System Diag 752 1.99 1,495 $18,681 $6,588 $4,622 1.420 $6,564
207 4 Oth Circulatory System Diag 85 8.98 763 $103,812 $37,305 $28,789 1.420 $40,892
220 1 Maj Stom, Esoph,Duod Proc 651 4.32 2,814 $55,864 $19,462 $13,649 1.420 $19,387
221 1 Maj Small & Large Bowel Proc 3,040 5.01 15,243 $50,624 $18,265 $12,610 1.420 $17,912
Attachment B

221 4 Maj Small & Large Bowel Proc 512 22.56 11,551 $290,122 $105,898 $75,477 1.420 $107,208
222 1 Minor Stom,Esoph,Duod Proc 891 2.22 1,975 $31,872 $11,791 $8,327 1.420 $11,828
222 2 Minor Stom,Esoph,Duod Proc 281 3.58 1,007 $47,237 $17,159 $12,118 1.420 $17,213
222 3 Minor Stom,Esoph,Duod Proc 51 5.84 298 $65,084 $27,666 $18,224 1.420 $25,886
222 4 Minor Stom,Esoph,Duod Proc 14 13.86 194 $144,374 $53,897 $41,826 1.420 $59,410
223 1 Oth Small & Large Bowel Proc 863 4.63 3,993 $41,860 $14,625 $10,445 1.420 $14,836
224 1 Peritoneal Adhesiolysis 572 5.01 2,867 $44,905 $15,777 $10,716 1.420 $15,221
224 4 Peritoneal Adhesiolysis 33 18.91 624 $210,713 $70,213 $53,604 1.420 $76,140
225 1 Appendectomy 11,264 1.71 19,231 $25,914 $9,402 $6,524 1.420 $9,266
225 2 Appendectomy 4,958 3.92 19,415 $38,727 $14,000 $9,856 1.420 $13,999
225 3 Appendectomy 302 7.10 2,144 $68,079 $24,565 $17,027 1.420 $24,185
225 4 Appendectomy 49 13.73 673 $164,510 $55,334 $37,665 1.420 $53,500
226 1 Anal Procedures 1,023 2.18 2,232 $20,257 $7,216 $4,970 1.420 $7,060
226 2 Anal Procedures 271 3.76 1,020 $30,511 $11,102 $7,846 1.420 $11,145
226 3 Anal Procedures 44 5.66 249 $54,578 $17,803 $13,252 1.420 $18,823
226 4 Anal Procedures 1 10.00 10 $152,304 $51,914 $34,402 1.420 $48,866
227 1 Hernia Proc Exc Inguinal/Fem 1,618 2.51 4,068 $31,660 $11,273 $7,743 1.420 $10,998
227 2 Hernia Proc Exc Inguinal/Fem 846 3.75 3,169 $41,807 $15,082 $10,344 1.420 $14,692
227 3 Hernia Proc Exc Inguinal/Fem 104 7.29 758 $77,506 $26,286 $18,408 1.420 $26,147
227 4 Hernia Proc Exc Inguinal/Fem 18 12.11 218 $161,677 $52,700 $35,297 1.420 $50,136
228 1 Ing, Fem & Umbil Hernia Proc 718 1.57 1,125 $21,446 $7,883 $5,518 1.420 $7,837
228 2 Ing, Fem & Umbil Hernia Proc 280 2.47 692 $30,758 $10,849 $7,650 1.420 $10,866
229 1 Oth Digest Sys & Abdom Proc 376 3.40 1,280 $38,552 $14,089 $9,795 1.420 $13,914
229 4 Oth Digest Sys & Abdom Proc 55 16.60 913 $245,184 $91,802 $62,396 1.420 $88,628
240 1 Digestive Malignancy 126 2.96 373 $22,593 $7,894 $5,581 1.420 $7,928
240 2 Digestive Malignancy 499 4.11 2,051 $30,850 $11,125 $7,786 1.420 $11,060
241 1 Peptic Ulcer & Gastritis 1,827 2.28 4,172 $18,657 $6,590 $4,503 1.420 $6,397
241 2 Peptic Ulcer & Gastritis 2,108 2.90 6,107 $23,933 $8,285 $5,741 1.420 $8,155
241 3 Peptic Ulcer & Gastritis 880 4.05 3,560 $36,908 $12,783 $9,004 1.420 $12,789
241 4 Peptic Ulcer & Gastritis 96 9.74 935 $112,511 $38,991 $26,794 1.420 $38,059
242 1 Major Esophageal Disorder 114 1.81 206 $14,580 $5,147 $3,557 1.420 $5,052
243 1 Other Esophageal Disorder 1,395 1.74 2,423 $15,921 $5,809 $4,040 1.420 $5,739
243 2 Other Esophageal Disorder 962 2.55 2,452 $21,285 $7,596 $5,235 1.420 $7,436
243 3 Other Esophageal Disorder 223 4.22 942 $33,306 $12,380 $8,545 1.420 $12,137
243 4 Other Esophageal Disorder 19 9.00 171 $80,641 $30,563 $21,082 1.420 $29,945
244 1 Diverticulitis & Divertic 2,224 2.76 6,140 $19,425 $6,901 $4,710 1.420 $6,691
244 2 Diverticulitis & Divertic 1,577 3.45 5,438 $25,328 $8,773 $6,119 1.420 $8,692
244 3 Diverticulitis & Divertic 278 4.68 1,302 $37,971 $12,579 $9,093 1.420 $12,915
244 4 Diverticulitis & Divertic 29 10.03 291 $79,467 $27,214 $21,303 1.420 $30,259
245 1 Inflammatory Bowel Disease 611 3.51 2,142 $22,958 $8,528 $5,863 1.420 $8,328
245 4 Inflammatory Bowel Disease 63 13.02 820 $101,758 $36,163 $25,466 1.420 $36,172
246 1 Gi Vascular Insufficiency 231 3.07 709 $23,345 $8,192 $5,507 1.420 $7,822
247 1 Intestinal Obstruction 2,314 2.61 6,028 $16,904 $6,085 $4,220 1.420 $5,994
247 2 Intestinal Obstruction 1,611 3.56 5,736 $24,612 $8,669 $6,043 1.420 $8,583
247 3 Intestinal Obstruction 389 6.65 2,587 $47,885 $16,767 $12,153 1.420 $17,263
247 4 Intestinal Obstruction 54 13.91 751 $130,491 $43,673 $29,272 1.420 $41,578
248 1 Major Gi Infections 476 2.95 1,403 $17,589 $6,362 $4,474 1.420 $6,355
248 4 Major Gi Infections 67 9.34 626 $88,292 $31,845 $22,146 1.420 $31,457
249 1 Non-Bacterial Gi 5,035 1.85 9,305 $10,624 $3,874 $2,704 1.420 $3,840
249 2 Non-Bacterial Gi 2,857 2.50 7,138 $16,394 $5,838 $4,092 1.420 $5,813
249 3 Non-Bacterial Gi 570 4.29 2,444 $30,211 $11,353 $8,099 1.420 $11,504
249 4 Non-Bacterial Gi 36 7.19 259 $59,523 $20,386 $15,374 1.420 $21,837
251 1 Abdominal Pain 2,719 1.91 5,184 $15,191 $5,338 $3,741 1.420 $5,314
251 2 Abdominal Pain 1,468 2.66 3,910 $20,626 $7,508 $5,104 1.420 $7,250
251 3 Abdominal Pain 218 4.19 913 $33,359 $12,380 $8,395 1.420 $11,924
251 4 Abdominal Pain 11 5.00 55 $57,238 $16,326 $11,479 1.420 $16,305
Attachment B

252 1 Malfunction, React Gi Device 438 3.22 1,411 $20,653 $7,287 $5,106 1.420 $7,252
252 4 Malfunction, React Gi Device 44 11.00 484 $98,773 $37,387 $25,608 1.420 $36,374
253 1 Oth/Unspec Gi Hemorrhage 558 2.21 1,235 $16,801 $5,745 $4,003 1.420 $5,686
253 4 Oth/Unspec Gi Hemorrhage 56 6.25 350 $64,255 $23,989 $17,331 1.420 $24,618
254 1 Oth Digestive System Diag 3,040 2.06 6,254 $15,154 $5,455 $3,824 1.420 $5,431
254 2 Oth Digestive System Diag 1,635 3.47 5,669 $25,480 $9,156 $6,355 1.420 $9,027
254 3 Oth Digestive System Diag 518 5.69 2,948 $44,848 $16,317 $11,702 1.420 $16,621
254 4 Oth Digestive System Diag 68 14.99 1,019 $157,651 $65,214 $44,159 1.420 $62,724
260 1 Maj Pancreas/Liver/Shunt Proc 227 5.14 1,167 $68,216 $24,189 $17,038 1.420 $24,202
261 1 Major Biliary Tract Proc 43 5.02 216 $52,782 $20,897 $13,634 1.420 $19,366
261 2 Major Biliary Tract Proc 163 7.93 1,293 $79,129 $29,442 $20,983 1.420 $29,805
262 1 Cholecystectomy Exc Lap 549 3.98 2,184 $41,493 $14,305 $9,968 1.420 $14,159
262 4 Cholecystectomy Exc Lap 37 16.16 598 $224,533 $76,743 $52,098 1.420 $74,001
263 1 Lap Cholecystectomy 6,206 1.90 11,789 $28,301 $10,158 $6,934 1.420 $9,849
263 2 Lap Cholecystectomy 3,437 3.22 11,055 $39,908 $14,227 $9,688 1.420 $13,760
263 3 Lap Cholecystectomy 867 5.97 5,180 $62,221 $22,407 $15,273 1.420 $21,694
263 4 Lap Cholecystectomy 89 16.19 1,441 $183,730 $63,899 $47,305 1.420 $67,192
264 1 Oth Hepatobili/Pancreas Proc 101 4.52 457 $52,232 $19,628 $13,983 1.420 $19,862
264 2 Oth Hepatobili/Pancreas Proc 92 5.73 527 $61,910 $22,463 $15,736 1.420 $22,352
264 3 Oth Hepatobili/Pancreas Proc 107 9.66 1,034 $93,636 $36,713 $24,691 1.420 $35,072
264 4 Oth Hepatobili/Pancreas Proc 51 25.27 1,289 $285,393 $108,583 $84,787 1.420 $120,432
279 1 Hepatic Coma/Oth Maj Liv Dis 145 2.68 388 $16,312 $5,846 $4,104 1.420 $5,829
279 2 Hepatic Coma/Oth Maj Liv Dis 742 3.61 2,680 $25,223 $8,975 $6,497 1.420 $9,228
280 1 Alcoholic Liver Disease 42 2.02 85 $16,018 $6,085 $3,937 1.420 $5,592
280 2 Alcoholic Liver Disease 367 3.45 1,265 $24,424 $8,377 $5,907 1.420 $8,390
281 1 Malignancy-Hepatobilia Sys 123 3.37 415 $21,812 $7,804 $5,683 1.420 $8,072
281 2 Malignancy-Hepatobilia Sys 577 4.24 2,444 $31,518 $11,071 $7,658 1.420 $10,877
282 1 Pancreas Disord Exc Malig 2,515 3.38 8,496 $22,753 $7,842 $5,467 1.420 $7,766
282 2 Pancreas Disord Exc Malig 2,245 4.45 9,981 $31,654 $10,973 $7,625 1.420 $10,831
282 3 Pancreas Disord Exc Malig 671 7.69 5,160 $64,094 $22,043 $15,112 1.420 $21,466
282 4 Pancreas Disord Exc Malig 148 14.55 2,154 $168,532 $58,477 $40,511 1.420 $57,543
283 1 Other Disorders Of Liver 335 2.67 893 $17,651 $6,267 $4,452 1.420 $6,323
283 2 Other Disorders Of Liver 685 3.36 2,300 $26,746 $9,588 $6,636 1.420 $9,426
284 1 Disorders Of Gallbladder 1,082 2.24 2,425 $18,614 $6,694 $4,605 1.420 $6,541
284 2 Disorders Of Gallbladder 1,029 3.26 3,350 $26,925 $9,341 $6,471 1.420 $9,191
284 3 Disorders Of Gallbladder 335 5.08 1,701 $42,170 $15,022 $10,733 1.420 $15,245
284 4 Disorders Of Gallbladder 50 12.14 607 $120,645 $43,517 $30,089 1.420 $42,738
301 1 Hip Joint Replacement 4,228 3.52 14,901 $61,469 $22,422 $15,431 1.420 $21,918
301 2 Hip Joint Replacement 2,767 3.86 10,687 $68,395 $24,542 $17,069 1.420 $24,245
301 3 Hip Joint Replacement 480 5.31 2,548 $89,199 $31,806 $22,518 1.420 $31,985
301 4 Hip Joint Replacement 38 17.71 673 $237,041 $85,982 $59,523 1.420 $84,547
302 1 Knee Joint Replacement 5,643 3.45 19,478 $60,283 $21,519 $14,765 1.420 $20,972
302 2 Knee Joint Replacement 3,336 3.93 13,103 $69,123 $24,337 $16,800 1.420 $23,863
302 3 Knee Joint Replacement 282 5.72 1,614 $100,628 $35,014 $24,341 1.420 $34,574
302 4 Knee Joint Replacement 18 16.78 302 $256,114 $96,346 $61,965 1.420 $88,015
303 1 Dorsal/Lumbar Fusion Proc 238 5.29 1,258 $144,307 $56,839 $44,876 1.420 $63,742
303 4 Dorsal/Lumbar Fusion Proc 27 17.30 467 $371,006 $146,487 $116,506 1.420 $165,486
304 1 Dor/ Lumb Fus Exc Crv Bck 2,610 3.98 10,377 $101,925 $36,793 $25,154 1.420 $35,729
304 2 Dor/ Lumb Fus Exc Crv Bck 1,715 5.05 8,662 $130,320 $46,737 $31,949 1.420 $45,381
304 3 Dor/ Lumb Fus Exc Crv Bck 668 8.34 5,569 $197,701 $72,746 $50,813 1.420 $72,175
304 4 Dor/ Lumb Fus Exc Crv Bck 51 20.35 1,038 $378,604 $130,892 $95,986 1.420 $136,339
305 1 Amputation Of Lower Limb 64 4.89 313 $40,534 $14,673 $11,155 1.420 $15,845
305 2 Amputation Of Lower Limb 153 6.40 979 $48,193 $16,659 $11,816 1.420 $16,784
305 3 Amputation Of Lower Limb 200 9.54 1,908 $78,813 $27,207 $18,592 1.420 $26,409
305 4 Amputation Of Lower Limb 79 22.01 1,739 $278,954 $90,699 $64,437 1.420 $91,527
308 1 Hip & Femur Proc Traum 583 3.58 2,086 $39,628 $14,565 $10,216 1.420 $14,510
308 2 Hip & Femur Proc Traum 1,244 4.55 5,655 $54,709 $20,276 $14,128 1.420 $20,067
Attachment B

309 1 Hip & Femur Proc Nontrauma 665 2.69 1,789 $37,651 $14,848 $11,310 1.420 $16,064
309 2 Hip & Femur Proc Nontrauma 410 4.96 2,032 $57,913 $21,220 $15,828 1.420 $22,482
309 3 Hip & Femur Proc Nontrauma 94 9.96 936 $104,806 $36,299 $26,392 1.420 $37,488
309 4 Hip & Femur Proc Nontrauma 11 22.55 248 $203,514 $77,492 $54,544 1.420 $77,475
310 1 Intervertebral Disc Excision 6,415 1.73 11,105 $32,540 $11,431 $7,748 1.420 $11,005
310 2 Intervertebral Disc Excision 1,797 2.59 4,663 $43,189 $15,524 $10,534 1.420 $14,963
310 3 Intervertebral Disc Excision 231 5.68 1,312 $68,895 $24,480 $17,544 1.420 $24,919
310 4 Intervertebral Disc Excision 19 15.42 293 $230,023 $88,395 $63,743 1.420 $90,541
312 1 Skin Graft, Except Hand 90 4.29 386 $51,689 $18,633 $13,581 1.420 $19,291
313 1 Knee & Lower Leg Proc 4,422 2.22 9,815 $34,007 $12,667 $8,794 1.420 $12,492
313 2 Knee & Lower Leg Proc 2,094 4.00 8,367 $52,477 $19,855 $13,510 1.420 $19,190
313 3 Knee & Lower Leg Proc 486 7.63 3,708 $96,734 $36,441 $24,821 1.420 $35,256
313 4 Knee & Lower Leg Proc 45 16.53 744 $210,729 $73,257 $51,433 1.420 $73,056
314 1 Foot & Toe Procedures 550 1.82 1,002 $27,815 $10,195 $7,509 1.420 $10,666
314 4 Foot & Toe Procedures 34 15.26 519 $135,679 $47,031 $31,491 1.420 $44,730
315 1 Shoulder,Up Arm,Forearm Proc 2,841 1.49 4,230 $25,596 $9,328 $6,504 1.420 $9,239
315 2 Shoulder,Up Arm,Forearm Proc 2,591 2.57 6,653 $46,297 $17,039 $11,664 1.420 $16,567
315 3 Shoulder,Up Arm,Forearm Proc 169 6.78 1,146 $102,245 $37,173 $24,625 1.420 $34,977
315 4 Shoulder,Up Arm,Forearm Proc 28 14.61 409 $231,470 $74,209 $50,472 1.420 $71,690
316 1 Hand & Wrist Procedures 622 2.03 1,261 $26,992 $9,943 $6,884 1.420 $9,778
316 2 Hand & Wrist Procedures 213 3.80 810 $42,737 $16,866 $11,382 1.420 $16,167
317 1 Tendon/Muscle/Soft Tiss Proc 864 2.38 2,055 $27,527 $9,868 $7,137 1.420 $10,138
317 2 Tendon/Muscle/Soft Tiss Proc 281 4.67 1,311 $47,417 $17,304 $12,462 1.420 $17,701
317 3 Tendon/Muscle/Soft Tiss Proc 83 8.73 725 $84,687 $28,851 $20,770 1.420 $29,502
317 4 Tendon/Muscle/Soft Tiss Proc 18 17.78 320 $242,906 $93,919 $62,618 1.420 $88,943
320 1 Oth Musculoskeletal Proc 692 1.97 1,362 $31,101 $11,322 $7,848 1.420 $11,148
320 4 Oth Musculoskeletal Proc 23 26.39 607 $297,341 $105,490 $76,919 1.420 $109,257
321 1 Cerv Spinal Fus & Oth Neck 4,336 1.94 8,418 $55,821 $20,077 $13,714 1.420 $19,480
321 2 Cerv Spinal Fus & Oth Neck 1,164 3.32 3,868 $73,745 $26,997 $18,585 1.420 $26,399
321 3 Cerv Spinal Fus & Oth Neck 133 9.38 1,247 $156,409 $58,434 $40,541 1.420 $57,585
321 4 Cerv Spinal Fus & Oth Neck 28 20.57 576 $317,905 $117,372 $86,761 1.420 $123,236
340 1 Fracture Of Femur 115 2.35 270 $17,395 $6,284 $4,526 1.420 $6,428
341 1 Fx Pelvis/Hip Dislocation 184 2.60 478 $21,472 $8,506 $5,721 1.420 $8,127
342 1 Fx/Dislocation Exc Femur 1,245 1.64 2,046 $15,728 $6,322 $4,333 1.420 $6,154
342 2 Fx/Dislocation Exc Femur 614 2.93 1,796 $26,717 $10,247 $7,123 1.420 $10,118
342 3 Fx/Dislocation Exc Femur 101 5.23 528 $35,361 $14,033 $9,661 1.420 $13,722
342 4 Fx/Dislocation Exc Femur 8 13.00 104 $112,641 $39,665 $30,667 1.420 $43,560
343 1 Musculoskeletal Malig 69 3.46 239 $30,724 $10,464 $7,520 1.420 $10,681
343 2 Musculoskeletal Malig 286 4.71 1,348 $33,370 $11,687 $8,596 1.420 $12,210
343 3 Musculoskeletal Malig 290 7.82 2,269 $53,562 $19,375 $14,018 1.420 $19,911
343 4 Musculoskeletal Malig 28 19.75 553 $170,062 $64,439 $46,258 1.420 $65,706
344 1 Osteomyelitis 165 4.12 680 $23,867 $8,213 $6,028 1.420 $8,563
344 2 Osteomyelitis 404 5.30 2,142 $33,193 $11,781 $8,461 1.420 $12,019
344 3 Osteomyelitis 166 7.87 1,307 $45,963 $17,750 $12,573 1.420 $17,859
344 4 Osteomyelitis 37 10.46 387 $107,505 $32,108 $26,332 1.420 $37,402
346 1 Connective Tissue Disorder 593 3.01 1,785 $20,589 $7,666 $5,876 1.420 $8,346
347 1 Back & Neck Disorders 2,598 2.58 6,714 $18,703 $6,934 $4,716 1.420 $6,698
347 2 Back & Neck Disorders 1,263 3.74 4,721 $28,312 $10,656 $7,268 1.420 $10,323
347 3 Back & Neck Disorders 302 5.21 1,574 $40,633 $16,086 $10,965 1.420 $15,574
347 4 Back & Neck Disorders 26 14.77 384 $122,531 $45,634 $32,461 1.420 $46,108
349 1 Malf/React/Comp Orth Dev 175 2.17 380 $22,036 $8,001 $5,534 1.420 $7,861
351 1 Oth Musculoskeletal Sys Dx 1,266 2.34 2,966 $15,825 $5,895 $4,196 1.420 $5,961
351 2 Oth Musculoskeletal Sys Dx 1,100 3.55 3,908 $20,552 $7,695 $5,596 1.420 $7,949
351 3 Oth Musculoskeletal Sys Dx 212 5.59 1,186 $38,377 $14,862 $11,045 1.420 $15,688
351 4 Oth Musculoskeletal Sys Dx 23 8.17 188 $77,070 $28,616 $21,536 1.420 $30,590
361 1 Skin Graft-Skin & Subcu Dx 635 2.95 1,875 $43,022 $15,366 $11,383 1.420 $16,169
Attachment B

361 4 Skin Graft-Skin & Subcu Dx 5 30.80 154 $494,457 $102,130 $130,445 1.420 $185,286
362 1 Mastectomy Procedures 2,397 1.79 4,280 $32,318 $12,001 $8,303 1.420 $11,794
362 2 Mastectomy Procedures 826 2.57 2,123 $47,462 $18,043 $12,306 1.420 $17,480
362 3 Mastectomy Procedures 11 4.45 49 $66,848 $27,585 $16,923 1.420 $24,037
362 4 Mastectomy Procedures 3 7.33 22 $80,383 $30,703 $20,004 1.420 $28,414
363 1 Breast Proc Exc Mastectomy 1,484 1.36 2,011 $30,476 $11,152 $7,731 1.420 $10,982
363 2 Breast Proc Exc Mastectomy 194 2.91 564 $51,143 $19,118 $13,101 1.420 $18,608
364 1 Other Skin & Subcut Proc 1,137 2.55 2,900 $31,975 $11,647 $8,107 1.420 $11,515
364 2 Other Skin & Subcut Proc 478 4.23 2,024 $43,589 $15,992 $10,967 1.420 $15,578
364 3 Other Skin & Subcut Proc 132 8.73 1,152 $85,514 $30,070 $20,339 1.420 $28,890
364 4 Other Skin & Subcut Proc 26 23.46 610 $290,330 $105,802 $71,806 1.420 $101,995
380 1 Skin Ulcers 96 4.09 393 $22,815 $7,609 $5,366 1.420 $7,622
380 2 Skin Ulcers 276 4.66 1,286 $26,108 $8,916 $6,325 1.420 $8,984
380 3 Skin Ulcers 139 9.01 1,253 $53,535 $19,710 $13,775 1.420 $19,566
380 4 Skin Ulcers 24 20.04 481 $136,662 $56,296 $40,165 1.420 $57,051
381 1 Major Skin Disorders 141 2.77 391 $15,260 $6,004 $4,398 1.420 $6,246
382 1 Malignant Breast Disorders 15 3.07 46 $12,151 $5,444 $4,108 1.420 $5,835
383 1 Cellulitis & Other Bact Inf 5,072 3.00 15,235 $16,601 $5,884 $4,114 1.420 $5,843
383 2 Cellulitis & Other Bact Inf 2,935 4.18 12,254 $24,775 $8,562 $5,956 1.420 $8,460
383 3 Cellulitis & Other Bact Inf 757 5.63 4,260 $38,182 $13,285 $9,113 1.420 $12,944
383 4 Cellulitis & Other Bact Inf 71 10.48 744 $83,412 $29,744 $21,813 1.420 $30,984
384 1 Contusion/Open Wound Skin 1,204 1.58 1,901 $22,087 $8,832 $5,962 1.420 $8,469
384 2 Contusion/Open Wound Skin 588 2.25 1,325 $27,385 $10,585 $7,069 1.420 $10,040
384 3 Contusion/Open Wound Skin 88 3.99 351 $32,843 $11,888 $8,742 1.420 $12,418
384 4 Contusion/Open Wound Skin 6 8.50 51 $80,550 $33,800 $22,841 1.420 $32,444
385 1 Oth Skin/Subcut/Breast Dis 561 2.31 1,296 $13,741 $4,946 $3,541 1.420 $5,029
385 2 Oth Skin/Subcut/Breast Dis 340 3.40 1,155 $21,375 $8,062 $5,573 1.420 $7,916
385 3 Oth Skin/Subcut/Breast Dis 68 5.57 379 $37,770 $13,632 $9,961 1.420 $14,148
385 4 Oth Skin/Subcut/Breast Dis 4 16.75 67 $145,344 $67,350 $49,777 1.420 $70,704
401 1 Pituitary & Adrenal Proc 520 2.75 1,429 $49,884 $18,438 $13,040 1.420 $18,522
401 2 Pituitary & Adrenal Proc 191 3.62 691 $64,575 $24,769 $17,002 1.420 $24,149
403 1 Procedures For Obesity 4,638 2.29 10,635 $47,469 $16,614 $11,615 1.420 $16,498
403 2 Procedures For Obesity 4,529 2.81 12,722 $55,326 $20,031 $13,656 1.420 $19,397
403 3 Procedures For Obesity 227 5.73 1,301 $93,822 $32,915 $22,609 1.420 $32,114
403 4 Procedures For Obesity 44 18.86 830 $270,526 $99,283 $67,371 1.420 $95,695
404 1 Thyroid/Parathyroid Proc 3,798 1.35 5,120 $23,340 $8,299 $5,749 1.420 $8,166
404 2 Thyroid/Parathyroid Proc 837 2.06 1,723 $31,816 $11,305 $7,938 1.420 $11,276
404 3 Thyroid/Parathyroid Proc 36 5.44 196 $76,705 $28,094 $20,456 1.420 $29,056
404 4 Thyroid/Parathyroid Proc 4 11.50 46 $192,369 $77,373 $51,296 1.420 $72,862
405 1 Oth Proc For Endocrine Dx 45 2.73 123 $36,521 $13,151 $9,590 1.420 $13,622
420 1 Diabetes 1,274 2.24 2,856 $11,813 $4,328 $3,111 1.420 $4,419
420 2 Diabetes 2,506 2.60 6,528 $20,019 $7,163 $5,020 1.420 $7,131
420 3 Diabetes 651 3.80 2,477 $32,968 $11,360 $8,060 1.420 $11,449
420 4 Diabetes 100 8.36 836 $97,971 $36,483 $24,401 1.420 $34,659
421 1 Malnutrition Disorders 103 4.59 473 $18,901 $7,939 $5,803 1.420 $8,243
421 2 Malnutrition Disorders 212 4.77 1,012 $25,989 $10,291 $7,776 1.420 $11,045
421 3 Malnutrition Disorders 174 5.79 1,007 $37,101 $14,436 $10,283 1.420 $14,607
421 4 Malnutrition Disorders 21 13.90 292 $103,104 $34,215 $34,641 1.420 $49,204
422 1 Hypovolemia/Electrolyte Dis 813 1.81 1,468 $10,526 $3,737 $2,571 1.420 $3,651
422 2 Hypovolemia/Electrolyte Dis 1,271 2.89 3,667 $18,687 $6,750 $4,706 1.420 $6,684
422 3 Hypovolemia/Electrolyte Dis 533 4.67 2,490 $34,271 $11,761 $8,469 1.420 $12,030
422 4 Hypovolemia/Electrolyte Dis 45 10.18 458 $122,295 $40,883 $29,002 1.420 $41,195
423 1 Inborn Errors Metabolism 46 1.80 83 $13,338 $4,869 $3,628 1.420 $5,153
424 1 Oth Endocrine Disorders 905 2.17 1,962 $12,534 $4,439 $3,148 1.420 $4,471
424 4 Oth Endocrine Disorders 24 11.38 273 $134,779 $46,812 $33,944 1.420 $48,215
425 1 Electrolyte Dis Exc Hypovol 412 1.91 785 $13,343 $4,626 $3,220 1.420 $4,574
425 2 Electrolyte Dis Exc Hypovol 921 2.69 2,475 $19,527 $6,789 $4,768 1.420 $6,772
425 3 Electrolyte Dis Exc Hypovol 404 4.26 1,720 $31,517 $11,300 $7,963 1.420 $11,310
425 4 Electrolyte Dis Exc Hypovol 53 8.83 468 $78,934 $27,434 $19,702 1.420 $27,985
440 1 Kidney Transplant 110 5.07 558 $121,605 $49,748 $34,166 1.420 $48,529
Attachment B

440 2 Kidney Transplant 184 5.81 1,069 $131,363 $53,650 $36,993 1.420 $52,546
441 1 Major Bladder Proc 27 4.33 117 $42,447 $16,279 $11,418 1.420 $16,218
441 3 Major Bladder Proc 140 11.12 1,557 $125,941 $47,819 $34,722 1.420 $49,320
442 1 Kidney/Urinary Tract Malig 476 3.59 1,708 $48,328 $17,504 $12,363 1.420 $17,561
442 4 Kidney/Urinary Tract Malig 20 11.25 225 $158,473 $60,769 $47,445 1.420 $67,391
443 1 Kidney/Urin Tract-Nonmalig 1,194 2.68 3,196 $39,800 $14,731 $10,605 1.420 $15,063
443 2 Kidney/Urin Tract-Nonmalig 809 3.33 2,693 $44,124 $16,422 $11,606 1.420 $16,485
443 3 Kidney/Urin Tract-Nonmalig 194 8.32 1,614 $88,438 $31,879 $22,531 1.420 $32,003
443 4 Kidney/Urin Tract-Nonmalig 40 22.95 918 $368,185 $125,986 $100,525 1.420 $142,787
444 1 Renal Dialysis Access Dev 75 2.76 207 $31,237 $10,665 $7,620 1.420 $10,824
444 2 Renal Dialysis Access Dev 234 4.52 1,057 $46,447 $15,528 $11,103 1.420 $15,771
444 3 Renal Dialysis Access Dev 159 8.87 1,410 $87,890 $29,716 $20,550 1.420 $29,190
444 4 Renal Dialysis Access Dev 23 16.74 385 $170,080 $64,757 $46,908 1.420 $66,629
445 1 Other Bladder Proc 334 1.69 563 $25,518 $9,208 $6,473 1.420 $9,194
446 1 Urethral & Transureth Proc 567 1.63 925 $22,554 $7,955 $5,382 1.420 $7,644
446 2 Urethral & Transureth Proc 892 2.24 2,000 $29,462 $9,989 $6,889 1.420 $9,786
447 1 Oth Kidney/Urinary Tract Proc 113 2.34 264 $47,679 $17,410 $11,548 1.420 $16,402
447 3 Oth Kidney/Urinary Tract Proc 147 8.58 1,261 $90,931 $32,838 $22,448 1.420 $31,885
460 1 Renal Failure 101 2.78 281 $20,373 $7,120 $5,070 1.420 $7,202
460 2 Renal Failure 511 3.78 1,933 $29,701 $9,985 $7,000 1.420 $9,943
460 3 Renal Failure 2,133 5.00 10,664 $39,336 $13,609 $9,514 1.420 $13,514
460 4 Renal Failure 302 10.40 3,140 $115,727 $40,972 $29,082 1.420 $41,308
462 1 Nephritis 95 2.01 191 $12,525 $4,910 $3,718 1.420 $5,281
462 2 Nephritis 92 3.79 349 $23,550 $9,416 $6,694 1.420 $9,509
462 3 Nephritis 65 5.06 329 $41,321 $16,583 $11,363 1.420 $16,141
462 4 Nephritis 8 13.50 108 $128,647 $56,662 $41,061 1.420 $58,323
463 1 Kidney/Urin Tract Infect 2,226 2.55 5,668 $14,385 $5,208 $3,663 1.420 $5,202
463 2 Kidney/Urin Tract Infect 2,865 3.06 8,779 $19,581 $6,812 $4,782 1.420 $6,792
463 3 Kidney/Urin Tract Infect 974 4.57 4,452 $31,802 $11,257 $7,757 1.420 $11,019
463 4 Kidney/Urin Tract Infect 109 7.86 857 $67,922 $23,710 $17,920 1.420 $25,454
465 1 Urinary Stones & Acq Obstruc 956 1.62 1,552 $15,201 $5,306 $3,631 1.420 $5,157
465 2 Urinary Stones & Acq Obstruc 1,849 2.00 3,702 $19,397 $6,718 $4,571 1.420 $6,493
465 3 Urinary Stones & Acq Obstruc 168 3.74 628 $35,640 $11,914 $8,181 1.420 $11,620
465 4 Urinary Stones & Acq Obstruc 16 9.81 157 $115,131 $37,446 $28,161 1.420 $40,000
466 1 Malf/Reac/Comp Gu Device 69 1.90 131 $12,914 $4,596 $3,240 1.420 $4,603
466 2 Malf/Reac/Comp Gu Device 339 2.63 892 $22,908 $7,502 $5,728 1.420 $8,136
466 3 Malf/Reac/Comp Gu Device 664 4.33 2,877 $36,255 $13,344 $9,141 1.420 $12,984
466 4 Malf/Reac/Comp Gu Device 130 10.47 1,361 $113,256 $45,664 $31,486 1.420 $44,723
468 1 Oth Kidney/Urinary Tract Dx 563 2.12 1,195 $17,895 $6,301 $4,465 1.420 $6,342
468 4 Oth Kidney/Urinary Tract Dx 24 9.58 230 $113,279 $41,277 $31,718 1.420 $45,053
480 1 Major Male Pelvic Proc 2,259 2.44 5,512 $40,312 $14,576 $10,416 1.420 $14,795
480 2 Major Male Pelvic Proc 718 2.82 2,023 $43,476 $16,504 $11,802 1.420 $16,763
480 3 Major Male Pelvic Proc 38 4.92 187 $77,513 $26,806 $19,631 1.420 $27,885
480 4 Major Male Pelvic Proc 5 12.40 62 $147,217 $57,900 $45,444 1.420 $64,549
481 1 Penis Procedures 172 1.86 320 $26,230 $9,032 $7,109 1.420 $10,098
482 1 Transurethral Prostatectomy 937 1.56 1,462 $20,041 $6,879 $4,763 1.420 $6,765
482 2 Transurethral Prostatectomy 294 2.13 625 $24,015 $8,200 $5,782 1.420 $8,213
483 1 Testes & Scrotal Proc 217 1.41 307 $18,575 $6,795 $4,844 1.420 $6,880
484 1 Other Male Reprod Syst Proc 55 1.64 90 $20,619 $7,113 $5,191 1.420 $7,373
Attachment B

500 1 Malignancy, Male Repro Sys 18 2.28 41 $20,035 $6,139 $4,666 1.420 $6,628
501 1 Male Reproductive System Dx 283 2.43 687 $15,572 $5,596 $3,768 1.420 $5,352
501 2 Male Reproductive System Dx 279 3.63 1,012 $23,543 $8,215 $5,690 1.420 $8,081
510 1 Pelvic Evisc/Hysterectomy 268 3.44 923 $44,405 $15,696 $10,802 1.420 $15,344
511 1 Uter/Adnex Proc For Malig 191 3.49 666 $40,987 $14,645 $10,325 1.420 $14,666
511 2 Uter/Adnex Proc For Malig 328 5.23 1,716 $57,505 $20,299 $14,413 1.420 $20,472
511 3 Uter/Adnex Proc For Malig 134 9.13 1,224 $106,556 $38,042 $26,688 1.420 $37,908
511 4 Uter/Adnex Proc For Malig 13 16.77 218 $209,237 $95,373 $63,111 1.420 $89,644
512 1 Uter/Adnex Proc - Non Mal 587 2.90 1,701 $37,028 $13,354 $9,161 1.420 $13,013
512 2 Uter/Adnex Proc - Non Mal 476 3.80 1,809 $45,836 $16,183 $11,073 1.420 $15,729
512 3 Uter/Adnex Proc - Non Mal 56 7.86 440 $90,277 $33,832 $23,121 1.420 $32,842
512 4 Uter/Adnex Proc - Non Mal 1 46.00 46 $695,584 $270,557 $171,181 1.420 $243,147
513 1 Uter/Adnex Exc Leiomyoma 13,991 2.31 32,354 $27,298 $9,584 $6,580 1.420 $9,346
513 2 Uter/Adnex Exc Leiomyoma 3,692 2.91 10,730 $33,189 $11,712 $8,046 1.420 $11,429
513 3 Uter/Adnex Exc Leiomyoma 209 5.78 1,207 $61,283 $21,876 $15,021 1.420 $21,336
513 4 Uter/Adnex Exc Leiomyoma 22 13.14 289 $154,236 $48,203 $38,569 1.420 $54,784
514 1 Female Reproductive Sys Proc 2,571 1.52 3,914 $22,691 $7,895 $5,507 1.420 $7,822
514 2 Female Reproductive Sys Proc 766 2.09 1,603 $32,357 $11,464 $7,789 1.420 $11,064
514 3 Female Reproductive Sys Proc 14 5.07 71 $72,640 $25,435 $16,919 1.420 $24,032
514 4 Female Reproductive Sys Proc 2 11.00 22 $154,318 $45,140 $41,122 1.420 $58,411
517 1 Dilation & Curettage 233 1.49 347 $18,637 $5,792 $4,111 1.420 $5,840
518 1 Other Female Repro Sys Proc 627 2.13 1,336 $26,675 $9,524 $6,500 1.420 $9,232
518 2 Other Female Repro Sys Proc 303 3.75 1,137 $39,691 $13,995 $9,657 1.420 $13,717
518 3 Other Female Repro Sys Proc 31 8.87 275 $81,037 $28,400 $18,816 1.420 $26,726
518 4 Other Female Repro Sys Proc 7 38.71 271 $380,518 $112,423 $86,789 1.420 $123,276
519 1 Uterine/Adnexa Procedures 11,958 2.48 29,659 $27,283 $9,547 $6,598 1.420 $9,372
519 2 Uterine/Adnexa Procedures 2,312 3.04 7,029 $33,619 $11,979 $8,156 1.420 $11,585
519 3 Uterine/Adnexa Procedures 77 5.25 404 $59,674 $19,485 $13,512 1.420 $19,193
519 4 Uterine/Adnexa Procedures 13 17.23 224 $245,953 $86,565 $59,692 1.420 $84,787
530 1 Female Repro Syst Malig 38 3.55 135 $20,602 $8,050 $6,250 1.420 $8,877
531 1 Female Repro Syst Infection 406 2.72 1,105 $18,164 $6,355 $4,396 1.420 $6,244
531 2 Female Repro Syst Infection 182 3.90 710 $26,424 $8,751 $6,181 1.420 $8,779
532 1 Menstrual/Other Female Dx 1,317 1.56 2,058 $15,945 $5,768 $4,019 1.420 $5,708
532 2 Menstrual/Other Female Dx 378 2.14 810 $16,647 $6,075 $4,212 1.420 $5,982
540 1 Cesarean Delivery 44,708 3.35 149,559 $19,915 $7,147 $4,907 1.420 $6,970
540 4 Cesarean Delivery 135 10.05 1,357 $100,483 $36,831 $25,753 1.420 $36,579
541 1 Vaginal Delivery W Steril 2,887 2.03 5,867 $16,733 $5,820 $4,037 1.420 $5,734
541 2 Vaginal Delivery W Steril 836 2.54 2,124 $20,328 $7,055 $4,946 1.420 $7,026
541 3 Vaginal Delivery W Steril 128 5.07 649 $36,480 $14,238 $9,410 1.420 $13,366
541 4 Vaginal Delivery W Steril 8 16.63 133 $135,599 $52,702 $34,388 1.420 $48,845
542 1 Vaginal Delivery W Compli 791 1.94 1,536 $10,686 $4,045 $2,765 1.420 $3,927
542 2 Vaginal Delivery W Compli 635 2.27 1,440 $13,755 $5,296 $3,537 1.420 $5,024
542 3 Vaginal Delivery W Compli 59 8.12 479 $47,376 $19,095 $12,660 1.420 $17,983
542 4 Vaginal Delivery W Compli 5 7.00 35 $48,310 $18,413 $13,304 1.420 $18,897
544 1 D&C, Aspiration Curettage 782 1.25 979 $14,435 $4,831 $3,425 1.420 $4,864
545 1 Ectopic Pregnancy Proc 742 1.82 1,353 $23,994 $8,357 $5,777 1.420 $8,206
545 2 Ectopic Pregnancy Proc 443 2.04 905 $26,613 $9,215 $6,372 1.420 $9,051
546 1 Oth O.R. Proc For Obstetrics 358 3.43 1,227 $21,594 $7,768 $5,416 1.420 $7,692
546 2 Oth O.R. Proc For Obstetrics 204 5.08 1,036 $37,307 $13,314 $9,241 1.420 $13,126
546 3 Oth O.R. Proc For Obstetrics 22 9.41 207 $92,613 $31,840 $21,925 1.420 $31,143
546 4 Oth O.R. Proc For Obstetrics 9 8.11 73 $196,586 $60,212 $34,525 1.420 $49,040
560 1 Vaginal Delivery 87,090 1.91 165,959 $10,909 $3,922 $2,692 1.420 $3,824
Attachment B

560 4 Vaginal Delivery 50 7.50 375 $58,287 $20,273 $15,057 1.420 $21,387
561 1 Postpartum & Post Abortion 463 1.87 865 $9,432 $3,460 $2,322 1.420 $3,298
561 2 Postpartum & Post Abortion 831 2.65 2,203 $16,163 $6,049 $4,159 1.420 $5,907
563 1 Threatened Abortion 2,320 3.15 7,307 $14,310 $5,387 $3,606 1.420 $5,122
563 2 Threatened Abortion 944 5.48 5,169 $22,671 $8,672 $5,896 1.420 $8,375
563 3 Threatened Abortion 48 12.02 577 $41,031 $16,749 $11,051 1.420 $15,697
563 4 Threatened Abortion 0 0.00 0 $0 $0 $0 1.420 $0
564 1 Abort W/O D&C, Asp Curet 434 1.43 620 $9,522 $3,293 $2,262 1.420 $3,212
565 1 False Labor 320 1.28 409 $6,254 $2,183 $1,472 1.420 $2,090
565 2 False Labor 44 1.70 75 $8,958 $3,319 $2,144 1.420 $3,045
565 3 False Labor 1 3.00 3 $24,410 $9,838 $6,000 1.420 $8,522
565 4 False Labor 0 0.00 0 $0 $0 $0 1.420 $0
566 1 Other Antepartum Diagnoses 3,114 1.90 5,931 $9,467 $3,456 $2,354 1.420 $3,344
566 2 Other Antepartum Diagnoses 3,734 2.91 10,883 $14,167 $5,159 $3,560 1.420 $5,057
566 3 Other Antepartum Diagnoses 617 6.52 4,022 $30,069 $10,682 $7,462 1.420 $10,599
566 4 Other Antepartum Diagnoses 20 8.10 162 $75,946 $27,902 $20,268 1.420 $28,789
580 1 Neo,Trans <5D Not Born Here 85 1.66 141 $8,940 $3,853 $3,061 1.420 $4,348
581 1 Neo,Trans <5D Born Here 1,276 1.15 1,462 $2,848 $1,119 $747 1.420 $1,062
581 2 Neo,Trans <5D Born Here 962 1.24 1,189 $5,132 $1,937 $1,298 1.420 $1,844
581 3 Neo,Trans <5D Born Here 392 1.23 482 $10,990 $3,924 $2,689 1.420 $3,819
581 4 Neo,Trans <5D Born Here 180 1.54 278 $26,209 $8,484 $6,060 1.420 $8,608
583 1 Neonate With Ecmo 0 0.00 0 $0 $0 $0 1.420 $0
583 2 Neonate With Ecmo 0 0.00 0 $0 $0 $0 1.420 $0
583 3 Neonate With Ecmo 18 37.61 677 $575,607 $229,392 $194,322 1.420 $276,017
583 4 Neonate With Ecmo 6 27.17 163 $835,501 $374,485 $284,653 1.420 $404,324
588 1 Neo Bwt<1500G W/Maj Proc 0 0.00 0 $0 $0 $0 1.420 $0
588 2 Neo Bwt<1500G W/Maj Proc 2 39.00 78 $241,211 $111,281 $80,120 1.420 $113,803
588 3 Neo Bwt<1500G W/Maj Proc 39 80.54 3,141 $790,451 $314,020 $217,836 1.420 $309,417
588 4 Neo Bwt<1500G W/Maj Proc 188 90.57 17,028 $1,046,059 $421,015 $292,023 1.420 $414,792
589 1 Neo Bwt<500G/Gest Age<24W 120 1.01 121 $1,731 $661 $452 1.420 $643
589 2 Neo Bwt<500G/Gest Age<24W 11 1.00 11 $7,109 $3,244 $1,933 1.420 $2,745
591 1 Neo Bwt 500-749G Wo/Maj 73 1.27 93 $3,701 $1,474 $1,025 1.420 $1,455
591 2 Neo Bwt 500-749G Wo/Maj 18 12.89 232 $125,502 $49,638 $34,365 1.420 $48,813
591 3 Neo Bwt 500-749G Wo/Maj 47 26.85 1,262 $235,547 $86,091 $61,635 1.420 $87,546
591 4 Neo Bwt 500-749G Wo/Maj 174 62.45 10,866 $650,287 $242,696 $173,317 1.420 $246,180
593 1 Neo Bwt 750-999G Wo/Maj 9 11.78 106 $60,261 $28,444 $18,873 1.420 $26,808
593 2 Neo Bwt 750-999G Wo/Maj 38 36.89 1,402 $238,237 $92,669 $65,223 1.420 $92,644
593 3 Neo Bwt 750-999G Wo/Maj 106 56.39 5,977 $434,686 $166,125 $116,266 1.420 $165,146
593 4 Neo Bwt 750-999G Wo/Maj 245 61.30 15,019 $567,014 $211,522 $149,341 1.420 $212,125
602 1 Neo Bwt 1000-1249G W/Rds 3 18.67 56 $165,734 $42,588 $39,768 1.420 $56,487
602 2 Neo Bwt 1000-1249G W/Rds 33 39.03 1,288 $244,392 $88,300 $61,814 1.420 $87,801
602 3 Neo Bwt 1000-1249G W/Rds 148 49.93 7,390 $334,762 $125,348 $86,025 1.420 $122,191
602 4 Neo Bwt 1000-1249G W/Rds 164 52.37 8,588 $433,729 $158,840 $113,578 1.420 $161,327
603 1 Neo Bwt 1000-1249G Oth Sig 17 18.88 321 $117,627 $44,661 $29,876 1.420 $42,436
603 2 Neo Bwt 1000-1249G Oth Sig 53 32.55 1,725 $177,284 $68,573 $45,669 1.420 $64,868
603 3 Neo Bwt 1000-1249G Oth Sig 44 44.05 1,938 $312,836 $114,912 $85,114 1.420 $120,896
603 4 Neo Bwt 1000-1249G Oth Sig 21 59.14 1,242 $602,543 $193,317 $136,990 1.420 $194,581
607 1 Neo Bwt 1250-1499G W/Rds 18 21.33 384 $136,805 $59,074 $37,843 1.420 $53,752
607 2 Neo Bwt 1250-1499G W/Rds 73 31.18 2,276 $183,954 $71,114 $49,889 1.420 $70,863
607 3 Neo Bwt 1250-1499G W/Rds 176 39.73 6,992 $268,159 $100,024 $69,121 1.420 $98,180
607 4 Neo Bwt 1250-1499G W/Rds 98 48.01 4,705 $396,381 $144,045 $101,584 1.420 $144,291
608 1 Neo Bwt 1250-1499G Oth Sig 64 20.92 1,339 $121,094 $47,262 $32,011 1.420 $45,469
608 2 Neo Bwt 1250-1499G Oth Sig 123 31.78 3,909 $179,999 $67,735 $46,124 1.420 $65,516
608 3 Neo Bwt 1250-1499G Oth Sig 71 39.35 2,794 $244,534 $87,250 $62,857 1.420 $89,283
608 4 Neo Bwt 1250-1499G Oth Sig 14 43.64 611 $367,244 $136,701 $95,309 1.420 $135,378
609 1 Neo Bwt 1500-2499G W/Maj 0 0.00 0 $0 $0 $0 1.420 $0
609 2 Neo Bwt 1500-2499G W/Maj 4 33.25 133 $298,518 $132,857 $86,338 1.420 $122,635
609 3 Neo Bwt 1500-2499G W/Maj 19 37.89 720 $311,751 $137,930 $97,908 1.420 $139,070
609 4 Neo Bwt 1500-2499G W/Maj 44 59.98 2,639 $621,929 $257,036 $181,488 1.420 $257,787
611 1 Neo Bwt 1500-1999G Maj Anom 43 12.07 519 $65,997 $22,891 $17,290 1.420 $24,560
611 2 Neo Bwt 1500-1999G Maj Anom 78 22.54 1,758 $158,507 $58,141 $41,220 1.420 $58,549
611 3 Neo Bwt 1500-1999G Maj Anom 113 32.57 3,680 $232,706 $87,654 $61,636 1.420 $87,548
611 4 Neo Bwt 1500-1999G Maj Anom 41 40.37 1,655 $332,874 $131,217 $92,890 1.420 $131,942
612 1 Neo Bwt 1500-1999G W/Rds 64 17.91 1,146 $122,637 $47,752 $30,498 1.420 $43,320
612 2 Neo Bwt 1500-1999G W/Rds 162 23.85 3,863 $139,060 $51,603 $35,440 1.420 $50,339
612 3 Neo Bwt 1500-1999G W/Rds 282 30.39 8,570 $209,129 $76,426 $53,089 1.420 $75,408
612 4 Neo Bwt 1500-1999G W/Rds 58 35.79 2,076 $284,212 $100,323 $68,515 1.420 $97,319
613 1 Neo Bwt 1500-1999G Perin Inf 44 12.27 540 $62,503 $20,235 $15,704 1.420 $22,306
613 2 Neo Bwt 1500-1999G Perin Inf 64 24.78 1,586 $148,777 $49,588 $36,515 1.420 $51,867
Attachment B

614 1 Neo Bwt 1500-1999G Oth Sig 810 11.98 9,705 $61,384 $23,369 $16,190 1.420 $22,996
614 2 Neo Bwt 1500-1999G Oth Sig 596 20.18 12,027 $115,186 $41,337 $28,548 1.420 $40,550
614 3 Neo Bwt 1500-1999G Oth Sig 107 30.28 3,240 $180,103 $68,078 $47,034 1.420 $66,808
614 4 Neo Bwt 1500-1999G Oth Sig 9 29.78 268 $254,375 $95,338 $62,569 1.420 $88,873
621 1 Neo Bwt 2000-2499G W/Anom 57 7.70 439 $42,878 $16,821 $11,637 1.420 $16,529
621 2 Neo Bwt 2000-2499G W/Anom 98 18.33 1,796 $109,833 $41,669 $29,213 1.420 $41,494
621 3 Neo Bwt 2000-2499G W/Anom 57 22.74 1,296 $169,194 $62,004 $42,525 1.420 $60,403
621 4 Neo Bwt 2000-2499G W/Anom 21 19.33 406 $205,044 $70,736 $54,587 1.420 $77,536
622 1 Neo Bwt 2000-2499G W/Rds 112 10.88 1,219 $67,399 $25,870 $17,283 1.420 $24,548
622 2 Neo Bwt 2000-2499G W/Rds 177 14.42 2,553 $93,354 $33,743 $23,349 1.420 $33,165
622 3 Neo Bwt 2000-2499G W/Rds 170 18.71 3,180 $142,400 $51,974 $35,990 1.420 $51,120
622 4 Neo Bwt 2000-2499G W/Rds 52 23.79 1,237 $222,180 $79,863 $52,635 1.420 $74,763
625 1 Neo Bwt 2000-2499G Oth Sig 401 11.77 4,721 $61,689 $21,680 $15,230 1.420 $21,633
625 2 Neo Bwt 2000-2499G Oth Sig 202 17.64 3,564 $96,586 $34,236 $24,677 1.420 $35,051
625 3 Neo Bwt 2000-2499G Oth Sig 46 18.83 866 $119,446 $43,529 $28,703 1.420 $40,770
625 4 Neo Bwt 2000-2499G Oth Sig 5 11.00 55 $94,931 $33,660 $27,949 1.420 $39,699
626 1 Neo Bwt 2000-2499G Normal Nb 1,667 2.94 4,893 $5,599 $2,134 $1,459 1.420 $2,072
626 4 Neo Bwt 2000-2499G Normal Nb 2 11.00 22 $71,073 $20,808 $15,946 1.420 $22,649
630 1 Neo Bwt>2499G Maj Cv Proc 1 5.00 5 $12,750 $3,809 $2,065 1.420 $2,933
630 4 Neo Bwt>2499G Maj Cv Proc 51 47.10 2,402 $704,089 $314,294 $229,070 1.420 $325,373
631 1 Neo Bwt>2499G W/Maj Proc 19 4.00 76 $44,556 $18,492 $14,411 1.420 $20,470
631 4 Neo Bwt>2499G W/Maj Proc 48 49.38 2,370 $645,803 $261,026 $191,353 1.420 $271,800
633 1 Neo Bwt>2499G W/Anom 1,050 2.99 3,141 $9,561 $3,573 $2,506 1.420 $3,560
633 2 Neo Bwt>2499G W/Anom 450 6.96 3,131 $40,235 $15,140 $10,589 1.420 $15,041
633 3 Neo Bwt>2499G W/Anom 246 12.82 3,153 $96,204 $37,195 $26,176 1.420 $37,180
633 4 Neo Bwt>2499G W/Anom 115 19.96 2,295 $236,346 $92,288 $63,749 1.420 $90,550
634 1 Neo Bwt>2499G W/Rds 599 4.61 2,764 $24,647 $9,478 $6,386 1.420 $9,071
634 2 Neo Bwt>2499G W/Rds 597 8.30 4,958 $57,570 $21,131 $14,610 1.420 $20,753
634 3 Neo Bwt>2499G W/Rds 457 12.09 5,523 $102,211 $36,541 $25,528 1.420 $36,260
634 4 Neo Bwt>2499G W/Rds 189 19.30 3,648 $203,535 $77,215 $55,204 1.420 $78,412
636 1 Neo Bwt>2499G Perin Inf 1,436 5.28 7,575 $26,326 $9,588 $6,722 1.420 $9,548
636 2 Neo Bwt>2499G Perin Inf 547 7.16 3,914 $41,641 $14,401 $10,498 1.420 $14,912
636 3 Neo Bwt>2499G Perin Inf 128 10.27 1,315 $71,035 $24,832 $17,934 1.420 $25,474
636 4 Neo Bwt>2499G Perin Inf 12 15.33 184 $150,417 $45,195 $29,990 1.420 $42,598
639 1 Neo Bwt >2499G Oth Sig Cond 2,563 3.46 8,873 $14,628 $5,313 $3,689 1.420 $5,240
639 2 Neo Bwt >2499G Oth Sig Cond 631 7.70 4,857 $44,646 $15,830 $11,028 1.420 $15,664
639 3 Neo Bwt >2499G Oth Sig Cond 120 9.85 1,182 $75,032 $26,766 $19,294 1.420 $27,405
639 4 Neo Bwt >2499G Oth Sig Cond 20 13.80 276 $134,819 $61,325 $41,397 1.420 $58,801
640 1 Neo Bwt >2499G Normal Nb 150,009 2.11 315,890 $3,023 $1,115 $757 1.420 $1,075
640 2 Neo Bwt >2499G Normal Nb 19,589 2.55 49,902 $5,512 $2,043 $1,418 1.420 $2,014
640 3 Neo Bwt >2499G Normal Nb 4,046 4.04 16,329 $18,253 $6,839 $4,752 1.420 $6,749
640 4 Neo Bwt >2499G Normal Nb 2 6.50 13 $44,445 $16,997 $10,290 1.420 $14,617
650 1 Splenectomy 165 3.85 636 $49,589 $19,661 $13,726 1.420 $19,496
650 2 Splenectomy 123 5.37 660 $68,839 $26,019 $17,639 1.420 $25,055
650 3 Splenectomy 49 8.10 397 $99,720 $36,514 $26,642 1.420 $37,843
650 4 Splenectomy 12 15.75 189 $269,868 $108,694 $73,233 1.420 $104,021
651 1 Other Procedures Of Blood 196 3.17 621 $33,264 $12,549 $8,845 1.420 $12,563
660 1 Maj Hematologic/Immunol Dx 400 3.42 1,368 $26,657 $10,183 $7,558 1.420 $10,736
660 2 Maj Hematologic/Immunol Dx 1,370 4.51 6,178 $32,786 $12,782 $9,737 1.420 $13,830
661 1 Coagulation Disorders 375 2.39 896 $21,912 $7,733 $5,707 1.420 $8,106
662 1 Sickle Cell Anemia Crisis 202 3.71 749 $20,726 $7,628 $5,456 1.420 $7,750
663 1 Other Anemia/Blood Disord 1,654 1.97 3,265 $13,730 $4,793 $3,419 1.420 $4,856
663 2 Other Anemia/Blood Disord 1,156 2.82 3,260 $22,620 $8,116 $5,774 1.420 $8,201
663 3 Other Anemia/Blood Disord 405 4.19 1,695 $36,823 $13,163 $9,393 1.420 $13,341
663 4 Other Anemia/Blood Disord 42 8.10 340 $89,089 $32,963 $24,317 1.420 $34,540
680 1 Maj Proc Lymph/Hemat/Neopl 218 4.42 964 $53,399 $19,454 $14,277 1.420 $20,280
Attachment B

680 2 Maj Proc Lymph/Hemat/Neopl 238 7.49 1,783 $90,025 $33,387 $23,866 1.420 $33,900
681 1 Oth Proc Lymph/Hemat/Neopl 490 2.46 1,207 $35,329 $12,578 $9,132 1.420 $12,971
690 1 Acute Leukemia 135 5.26 710 $45,461 $18,643 $14,278 1.420 $20,280
690 2 Acute Leukemia 211 10.82 2,284 $84,513 $32,839 $25,490 1.420 $36,207
690 3 Acute Leukemia 311 18.17 5,652 $155,029 $60,536 $46,859 1.420 $66,559
690 4 Acute Leukemia 197 28.29 5,574 $307,527 $123,874 $91,553 1.420 $130,043
691 1 Lymph/Myelo/Non-Ac Leuk 233 3.89 907 $35,309 $13,705 $9,998 1.420 $14,201
691 2 Lymph/Myelo/Non-Ac Leuk 488 5.66 2,764 $49,586 $18,374 $13,099 1.420 $18,606
692 1 Radiotherapy 140 2.59 363 $17,289 $6,333 $4,310 1.420 $6,122
692 2 Radiotherapy 68 3.44 234 $48,182 $16,223 $12,178 1.420 $17,298
692 3 Radiotherapy 9 9.11 82 $93,404 $36,323 $25,281 1.420 $35,910
692 4 Radiotherapy 4 16.25 65 $139,035 $43,849 $33,098 1.420 $47,013
693 1 Chemotherapy 442 2.73 1,205 $24,564 $8,762 $6,608 1.420 $9,387
693 2 Chemotherapy 3,422 3.63 12,437 $35,228 $13,585 $10,284 1.420 $14,608
693 3 Chemotherapy 682 9.77 6,661 $84,677 $31,950 $24,492 1.420 $34,789
693 4 Chemotherapy 118 23.65 2,791 $228,249 $86,156 $67,081 1.420 $95,282
694 1 Lymph & Oth Malig & Neopl 79 2.70 213 $23,350 $7,954 $5,949 1.420 $8,450
694 3 Lymph & Oth Malig & Neopl 236 7.90 1,864 $68,768 $22,968 $16,961 1.420 $24,091
710 1 Infect & Parasitic Disease 63 5.90 372 $51,420 $18,161 $12,667 1.420 $17,992
710 2 Infect & Parasitic Disease 147 8.24 1,212 $77,507 $27,334 $18,746 1.420 $26,627
711 1 Post-Op/Trauma Infect Proc 543 4.59 2,491 $40,573 $14,819 $10,047 1.420 $14,270
720 1 Septicemia & Dissem Infect 345 3.77 1,301 $24,482 $9,284 $6,390 1.420 $9,076
720 2 Septicemia & Dissem Infect 1,262 4.73 5,964 $33,612 $11,492 $8,200 1.420 $11,648
721 1 Post-Op/Post-Traum Infec 1,313 3.68 4,838 $23,098 $8,420 $5,843 1.420 $8,299
721 2 Post-Op/Post-Traum Infec 1,088 4.93 5,367 $33,764 $12,027 $8,369 1.420 $11,888
721 3 Post-Op/Post-Traum Infec 400 6.83 2,730 $49,648 $18,133 $12,805 1.420 $18,188
721 4 Post-Op/Post-Traum Infec 87 15.53 1,351 $137,801 $48,019 $34,689 1.420 $49,273
722 1 Fever 705 2.49 1,756 $14,535 $5,455 $3,814 1.420 $5,417
722 2 Fever 714 3.05 2,181 $21,319 $8,064 $5,831 1.420 $8,282
722 3 Fever 247 4.76 1,176 $38,383 $14,686 $10,689 1.420 $15,182
722 4 Fever 29 11.41 331 $117,753 $42,687 $31,249 1.420 $44,387
723 1 Viral Illness 961 2.13 2,047 $12,584 $4,650 $3,304 1.420 $4,693
723 2 Viral Illness 559 2.64 1,478 $17,895 $6,671 $4,793 1.420 $6,808
723 3 Viral Illness 222 4.74 1,053 $36,181 $14,166 $10,221 1.420 $14,519
723 4 Viral Illness 19 12.63 240 $157,431 $62,457 $48,276 1.420 $68,571
724 1 Oth Infect & Parasitic Dis 338 4.19 1,416 $26,101 $9,504 $7,008 1.420 $9,955
740 1 Mental Illness Diag 14 2.57 36 $35,436 $13,443 $9,392 1.420 $13,340
750 1 Schizophrenia 2,647 10.58 27,994 $18,345 $7,370 $6,291 1.420 $8,935
750 2 Schizophrenia 1,606 11.31 18,165 $23,704 $8,549 $7,122 1.420 $10,115
750 3 Schizophrenia 82 18.39 1,508 $42,307 $16,010 $12,369 1.420 $17,569
750 4 Schizophrenia 25 30.68 767 $91,436 $32,844 $27,698 1.420 $39,343
751 1 Major Depressive Disorder 11,284 4.95 55,805 $9,278 $3,855 $3,154 1.420 $4,480
751 2 Major Depressive Disorder 8,157 7.02 57,227 $15,303 $6,186 $4,652 1.420 $6,608
751 3 Major Depressive Disorder 692 14.17 9,807 $35,722 $17,050 $10,812 1.420 $15,357
751 4 Major Depressive Disorder 175 19.13 3,348 $60,756 $24,433 $18,440 1.420 $26,192
752 1 Disorders Of Personality 26 6.38 166 $13,523 $6,220 $5,106 1.420 $7,253
752 2 Disorders Of Personality 21 5.14 108 $17,917 $6,857 $5,079 1.420 $7,214
752 3 Disorders Of Personality 0 0.00 0 $0 $0 $0 1.420 $0
752 4 Disorders Of Personality 0 0.00 0 $0 $0 $0 1.420 $0
753 1 Bipolar Disorders 7,320 6.55 47,960 $12,378 $5,167 $4,227 1.420 $6,004
753 2 Bipolar Disorders 3,900 7.85 30,613 $17,484 $6,853 $5,449 1.420 $7,740
753 3 Bipolar Disorders 241 12.04 2,901 $34,760 $13,517 $11,185 1.420 $15,888
753 4 Bipolar Disorders 76 15.75 1,197 $54,217 $20,525 $16,436 1.420 $23,345
754 1 Depression Exc Maj Disorder 3,390 3.32 11,269 $7,135 $2,809 $2,365 1.420 $3,360
754 2 Depression Exc Maj Disorder 928 4.37 4,052 $10,144 $3,865 $3,279 1.420 $4,658
754 3 Depression Exc Maj Disorder 35 5.51 193 $18,213 $6,946 $5,008 1.420 $7,114
754 4 Depression Exc Maj Disorder 4 11.25 45 $22,155 $9,857 $6,269 1.420 $8,905
Attachment B

755 1 Adjust Dis Exc Depressive Dx 868 2.77 2,403 $6,324 $2,447 $2,091 1.420 $2,970
755 2 Adjust Dis Exc Depressive Dx 278 5.59 1,554 $12,872 $5,168 $4,500 1.420 $6,391
755 3 Adjust Dis Exc Depressive Dx 29 9.21 267 $25,226 $10,022 $7,787 1.420 $11,061
755 4 Adjust Dis Exc Depressive Dx 0 0.00 0 $0 $0 $0 1.420 $0
756 1 Acute Anxiety & Delirium 656 2.91 1,907 $12,414 $4,645 $3,652 1.420 $5,188
756 2 Acute Anxiety & Delirium 147 3.56 524 $18,431 $6,905 $5,164 1.420 $7,335
757 1 Organic Mental Health Dis 188 6.83 1,284 $15,170 $6,268 $5,725 1.420 $8,132
757 2 Organic Mental Health Dis 233 7.48 1,743 $19,906 $7,501 $6,568 1.420 $9,330
757 3 Organic Mental Health Dis 36 8.64 311 $41,680 $14,439 $10,778 1.420 $15,310
757 4 Organic Mental Health Dis 7 13.86 97 $75,979 $27,065 $25,324 1.420 $35,970
758 1 Childhood Behavioral Dis 650 5.32 3,457 $10,045 $4,074 $3,462 1.420 $4,917
758 2 Childhood Behavioral Dis 346 6.41 2,217 $13,277 $5,230 $4,256 1.420 $6,045
758 3 Childhood Behavioral Dis 16 7.31 117 $21,443 $7,875 $5,479 1.420 $7,782
758 4 Childhood Behavioral Dis 0 0.00 0 $0 $0 $0 1.420 $0
759 1 Eating Disorders 166 25.75 4,275 $47,547 $19,998 $23,728 1.420 $33,703
759 4 Eating Disorders 5 20.60 103 $128,295 $55,001 $38,991 1.420 $55,383
760 1 Oth Mental Health Disorder 136 9.65 1,312 $20,806 $8,403 $7,695 1.420 $10,930
760 2 Oth Mental Health Disorder 85 8.39 713 $20,727 $7,755 $6,987 1.420 $9,924
760 3 Oth Mental Health Disorder 16 6.00 96 $21,694 $8,545 $6,622 1.420 $9,407
760 4 Oth Mental Health Disorder 0 0.00 0 $0 $0 $0 1.420 $0
770 1 Drug & Alcohol Abuse 660 3.51 2,316 $5,996 $2,302 $1,950 1.420 $2,770
770 2 Drug & Alcohol Abuse 402 3.64 1,462 $9,036 $2,943 $2,404 1.420 $3,415
770 3 Drug & Alcohol Abuse 37 2.97 110 $19,163 $5,743 $4,147 1.420 $5,891
770 4 Drug & Alcohol Abuse 2 2.00 4 $23,434 $8,384 $4,406 1.420 $6,258
772 1 Alcohol/Drug Dep W Rehab 806 12.08 9,739 $15,086 $4,832 $4,448 1.420 $6,318
772 2 Alcohol/Drug Dep W Rehab 982 13.03 12,800 $19,144 $5,816 $5,058 1.420 $7,185
772 3 Alcohol/Drug Dep W Rehab 38 14.55 553 $26,851 $9,275 $7,629 1.420 $10,836
772 4 Alcohol/Drug Dep W Rehab 1 20.00 20 $94,887 $22,765 $24,370 1.420 $34,615
773 1 Opioid Abuse & Dependence 1,217 5.19 6,321 $11,636 $4,010 $3,343 1.420 $4,749
773 2 Opioid Abuse & Dependence 1,428 6.31 9,017 $11,820 $4,533 $3,745 1.420 $5,319
773 3 Opioid Abuse & Dependence 129 6.50 838 $20,268 $6,846 $5,203 1.420 $7,391
773 4 Opioid Abuse & Dependence 2 1.50 3 $57,727 $21,384 $14,060 1.420 $19,971
774 1 Cocaine Abuse & Dependence 108 6.27 677 $8,235 $3,303 $2,831 1.420 $4,021
774 2 Cocaine Abuse & Dependence 399 5.70 2,276 $9,410 $3,468 $2,987 1.420 $4,242
775 1 Alcohol Abuse & Dependence 2,260 4.65 10,501 $9,127 $3,660 $2,966 1.420 $4,212
775 2 Alcohol Abuse & Dependence 2,554 4.65 11,877 $12,899 $4,948 $3,702 1.420 $5,258
775 3 Alcohol Abuse & Dependence 345 5.26 1,814 $32,186 $11,853 $8,174 1.420 $11,611
775 4 Alcohol Abuse & Dependence 43 11.02 474 $120,977 $46,656 $30,927 1.420 $43,929
776 1 Other Drug Abuse & Depend 586 7.49 4,389 $8,994 $3,896 $3,356 1.420 $4,767
776 2 Other Drug Abuse & Depend 456 5.08 2,315 $13,279 $4,945 $3,979 1.420 $5,652
776 3 Other Drug Abuse & Depend 52 4.23 220 $25,543 $9,690 $6,911 1.420 $9,817
776 4 Other Drug Abuse & Depend 6 10.67 64 $114,151 $40,082 $28,632 1.420 $40,670
791 1 O.R. Proc Oth Comp Treat 771 2.52 1,940 $30,723 $10,827 $7,607 1.420 $10,805
811 1 Allergic Reactions 301 1.43 431 $10,037 $3,603 $2,489 1.420 $3,535
812 1 Poisoning Medicinal Agent 1,070 1.60 1,714 $12,826 $4,594 $3,243 1.420 $4,607
812 2 Poisoning Medicinal Agent 1,867 2.00 3,740 $16,243 $5,900 $4,052 1.420 $5,755
812 3 Poisoning Medicinal Agent 745 3.01 2,246 $31,347 $11,360 $7,701 1.420 $10,939
812 4 Poisoning Medicinal Agent 303 6.43 1,949 $79,947 $29,056 $19,621 1.420 $27,869
813 1 Oth Comp Of Treatment 992 2.13 2,109 $16,087 $5,823 $4,037 1.420 $5,734
813 4 Oth Comp Of Treatment 53 13.58 720 $151,986 $57,503 $41,991 1.420 $59,645
815 1 Oth Inj/ Poison/Toxic Dx 495 1.28 632 $20,255 $6,976 $5,103 1.420 $7,249
816 1 Toxic Effects Of Non-Medc 268 1.58 424 $18,611 $7,248 $5,084 1.420 $7,221
841 1 Exten 3Rd Deg Burn W Graft 0 0.00 0 $0 $0 $0 1.420 $0
841 2 Exten 3Rd Deg Burn W Graft 0 0.00 0 $0 $0 $0 1.420 $0
841 3 Exten 3Rd Deg Burn W Graft 15 22.67 340 $343,109 $92,210 $91,805 1.420 $130,401
841 4 Exten 3Rd Deg Burn W Graft 11 42.91 472 $690,846 $237,059 $212,368 1.420 $301,649
842 1 Full Thick Burns W Graft 64 5.97 382 $57,165 $20,856 $16,488 1.420 $23,419
Attachment B

843 1 Extens 3Rd Deg/Full Thick 21 3.14 66 $28,228 $11,449 $8,143 1.420 $11,567
844 1 Part Thick Burns 232 3.13 727 $29,798 $12,093 $9,666 1.420 $13,729
844 2 Part Thick Burns 102 5.83 595 $60,185 $21,568 $17,912 1.420 $25,442
844 3 Part Thick Burns 40 8.25 330 $80,292 $27,564 $22,527 1.420 $31,997
844 4 Part Thick Burns 12 15.08 181 $212,157 $92,210 $74,436 1.420 $105,729
850 1 Proc W Diag Of Rehab 623 2.70 1,684 $40,566 $14,790 $10,130 1.420 $14,389
850 2 Proc W Diag Of Rehab 110 7.74 851 $69,203 $25,594 $18,629 1.420 $26,461
860 1 Rehabilitation 639 8.08 5,163 $29,759 $10,038 $7,267 1.420 $10,323
860 2 Rehabilitation 1,790 12.06 21,582 $47,044 $15,964 $11,819 1.420 $16,788
860 3 Rehabilitation 2,194 18.86 41,376 $79,920 $29,774 $21,936 1.420 $31,159
860 4 Rehabilitation 550 24.22 13,319 $114,989 $43,620 $32,682 1.420 $46,421
861 1 Signs/Symptons/Oth Factors 1,227 7.20 8,832 $16,627 $5,098 $3,692 1.420 $5,244
861 2 Signs/Symptons/Oth Factors 402 3.93 1,581 $18,261 $6,289 $4,447 1.420 $6,316
861 3 Signs/Symptons/Oth Factors 90 5.72 515 $37,354 $14,104 $10,415 1.420 $14,793
861 4 Signs/Symptons/Oth Factors 13 8.62 112 $74,717 $24,960 $18,214 1.420 $25,872
862 1 Oth Aftercare & Convales 199 3.47 690 $13,200 $5,230 $3,561 1.420 $5,058
863 1 Neonatal Aftercare 0 0.00 0 $0 $0 $0 1.420 $0
863 4 Neonatal Aftercare 1 6.00 6 $80,277 $31,105 $40,961 1.420 $58,181
890 1 Hiv W Multiple Major Hiv 0 0.00 0 $0 $0 $0 1.420 $0
890 2 Hiv W Multiple Major Hiv 11 5.09 56 $40,436 $15,809 $9,799 1.420 $13,919
890 3 Hiv W Multiple Major Hiv 119 11.33 1,348 $92,252 $31,636 $21,434 1.420 $30,445
890 4 Hiv W Multiple Major Hiv 159 16.26 2,585 $204,441 $71,317 $47,787 1.420 $67,877
892 1 Hiv W Major Hiv Rel Cond 2 2.50 5 $3,027 $1,686 $1,423 1.420 $2,021
892 3 Hiv W Major Hiv Rel Cond 210 8.28 1,739 $63,276 $21,837 $15,036 1.420 $21,357
893 1 Hiv W Multiple Sign Hiv Cond 3 7.67 23 $50,152 $16,855 $11,196 1.420 $15,903
893 4 Hiv W Multiple Sign Hiv Cond 0 0.00 0 $0 $0 $0 1.420 $0
894 1 Hiv W One Signif Hiv Cond 89 3.56 317 $22,575 $8,732 $5,698 1.420 $8,093
894 4 Hiv W One Signif Hiv Cond 0 0.00 0 $0 $0 $0 1.420 $0
910 1 Craniotomy Mult Sig Trauma 0 0.00 0 $0 $0 $0 1.420 $0
910 2 Craniotomy Mult Sig Trauma 11 6.73 74 $103,154 $42,262 $32,192 1.420 $45,726
910 3 Craniotomy Mult Sig Trauma 31 9.97 309 $212,706 $81,427 $55,400 1.420 $78,691
910 4 Craniotomy Mult Sig Trauma 108 17.50 1,890 $339,237 $129,806 $89,437 1.420 $127,037
911 1 Ext Abd/Thorac Proc For Mst 0 0.00 0 $0 $0 $0 1.420 $0
911 2 Ext Abd/Thorac Proc For Mst 50 5.62 281 $75,151 $29,553 $20,383 1.420 $28,953
911 3 Ext Abd/Thorac Proc For Mst 127 8.76 1,112 $161,032 $59,647 $40,197 1.420 $57,096
911 4 Ext Abd/Thorac Proc For Mst 280 14.17 3,968 $295,917 $114,405 $75,463 1.420 $107,188
912 1 Oth Proc Mult Sig Trauma 2 8.00 16 $61,134 $26,875 $18,660 1.420 $26,505
912 2 Oth Proc Mult Sig Trauma 235 6.01 1,412 $100,322 $38,477 $25,488 1.420 $36,203
930 1 Multiple Sig Trauma W/O Proc 29 3.93 114 $32,292 $12,391 $8,465 1.420 $12,024
930 2 Multiple Sig Trauma W/O Proc 452 4.47 2,022 $46,467 $18,530 $13,008 1.420 $18,476
950 1 Extensive Proc Unrel Pdx 219 2.87 629 $50,099 $18,563 $12,976 1.420 $18,431
950 2 Extensive Proc Unrel Pdx 295 6.89 2,032 $98,044 $36,227 $28,308 1.420 $40,209
951 1 Mod Extensive Proc Unrel Pdx 571 2.39 1,364 $34,741 $12,468 $8,751 1.420 $12,431
952 1 Nonextensive Proc Unrel Pdx 497 2.36 1,174 $26,754 $9,597 $6,811 1.420 $9,674
Attachment C
Buyer Cost Index
(A) (B) (C=A/B) (D) (E=C/D)

Allowed Based
Area Inpatient
Teaching
Buyer Normalized Adjusted Percent
Major
Estimated Benchmark Cost Medicare Buyer Cost Indigent and
OSHPD ID Hospital Cost Index Area TPMC Allowed TPMC Allowed Index Area Factor Index Medi-Cal
Total $12,107,677,080 $12,107,677,080 1.000 1.000 1.000 0.245
106010735 ALAMEDA HOSPITAL Alameda-Contra Costa-Solano $9,964,747 $11,810,493 0.844 1.182 0.714 0.230
106010739 ALTA BATES SUMMIT MED CTR-ALTA BATES Alameda-Contra Costa-Solano $126,260,219 $112,762,709 1.120 1.182 0.947 0.347
106481015 CALIFORNIA SPECIALTY HOSPITAL Alameda-Contra Costa-Solano $8,048,437 $7,678,678 1.048 1.134 0.924 0.403
106010776 CHILDRENS HOSP & RESEARCH CTR OAKLAND Alameda-Contra Costa-Solano $45,776,915 $55,494,012 0.825 1.182 0.698 0.435
106070924 CONTRA COSTA REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano $6,215,829 $7,091,903 0.876 1.182 0.741 0.691
106070904 DRS MEDICAL CENTER - SAN PABLO-PINOLE Alameda-Contra Costa-Solano $22,922,452 $28,972,446 0.791 1.182 0.669 0.294
106010805 EDEN MEDICAL CENTER Alameda-Contra Costa-Solano $76,352,919 $50,144,542 1.523 1.182 1.288 0.130
106014034 FREMONT HOSPITAL Alameda-Contra Costa-Solano $8,738,359 $11,988,513 0.729 1.182 0.616 0.275
106070988 JOHN MUIR MEDICAL CENTER Alameda-Contra Costa-Solano $226,839,394 $145,583,976 1.558 1.182 1.318 0.045
106013687 MERRITT PERALTA INSTITUTE CDRH Alameda-Contra Costa-Solano $1,502,123 $2,951,956 0.509 1.182 0.430 0.000
106071018 MT DIABLO MEDICAL CENTER Alameda-Contra Costa-Solano $69,757,427 $61,139,414 1.141 1.182 0.965 0.089
106074039 MT DIABLO MEDICAL PAVILION Alameda-Contra Costa-Solano $8,943,646 $8,333,142 1.073 1.182 0.908 0.168
106481357 NORTH BAY MEDICAL CENTER Alameda-Contra Costa-Solano $36,873,071 $16,235,010 2.271 1.134 2.002 0.361
106074017 SAN RAMON REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano $46,479,723 $46,115,671 1.008 1.182 0.852 0.022
106010967 ST. ROSE HOSPITAL Alameda-Contra Costa-Solano $10,485,030 $11,821,102 0.887 1.182 0.750 0.351
106010937 SUMMIT MEDICAL CENTER Alameda-Contra Costa-Solano $125,371,075 $116,796,975 1.073 1.182 0.908 0.169
106070934 SUTTER DELTA MEDICAL CENTER Alameda-Contra Costa-Solano $28,896,506 $25,583,039 1.130 1.182 0.955 0.183
106010782 THUNDER ROAD CHEMICAL DEPENDCY RCVRY HSP Alameda-Contra Costa-Solano $1,141,165 $516,830 2.208 1.182 1.867 0.499
106484001 VACA VALLEY HOSPITAL Alameda-Contra Costa-Solano $17,770,978 $7,540,476 2.357 1.134 2.078 0.163
106010983 VALLEY MEMORIAL HOSPITAL Alameda-Contra Costa-Solano $55,434,880 $43,926,126 1.262 1.182 1.067 0.074
106010987 WASHINGTON HOSPITAL - FREMONT Alameda-Contra Costa-Solano $105,402,480 $61,389,562 1.717 1.182 1.452 0.192
106150722 BAKERSFIELD MEMORIAL HOSPITAL Central $76,959,901 $83,881,227 0.917 0.923 0.994 0.124
106160787 CENTRAL VALLEY GENERAL HOSPITAL Central $5,383,099 $7,954,338 0.677 0.923 0.733 0.476
106204019 CHILDRENS HOSP CENTRAL CALIF Central $56,436,381 $64,044,202 0.881 0.923 0.955 0.712
106100005 CLOVIS COMMUNITY HOSPITAL Central $36,165,187 $58,045,497 0.623 0.923 0.675 0.113
106100697 COALINGA REGIONAL MEDICAL CENTER Central $908,850 $2,059,101 0.441 0.923 0.478 0.488
106100717 COMMUNITY REGIONAL MEDICAL CENTER Central $59,330,652 $71,183,734 0.833 0.923 0.903 0.466
106390846 DAMERON HOSPITAL Central $41,591,435 $61,310,776 0.678 0.939 0.722 0.120
106150706 DELANO REGIONAL MEDICAL CENTER Central $5,509,132 $7,206,711 0.764 0.923 0.828 0.480
106392287 DOCTORS HOSPITAL OF MANTECA Central $16,891,036 $14,653,586 1.153 0.939 1.228 0.126
106500852 DOCTORS MEDICAL CENTER Central $117,238,431 $78,412,191 1.495 0.954 1.567 0.384
106500867 EMANUEL MEDICAL CENTER Central $34,057,997 $38,712,332 0.880 0.954 0.922 0.166
106150775 GOOD SAMARITAN HOSPITAL - BAKERSFIELD Central $774,270 $1,390,157 0.557 0.923 0.603 0.423
106160725 HANFORD COMMUNITY HOSPITAL Central $11,295,355 $11,364,659 0.994 0.923 1.077 0.208
106154022 HEALTHSOUTH BAKERSFIELD REG REHAB HOSP Central $2,544,420 $3,427,484 0.742 0.923 0.804 0.060
106540734 KAWEAH DELTA DISTRICT HOSPITAL Central $65,861,085 $84,236,355 0.782 0.923 0.847 0.244
106150736 KERN MEDICAL CENTER Central $15,664,462 $15,774,165 0.993 0.923 1.076 0.733
106100745 KINGSBURG MEDICAL HOSPITAL Central $397,657 $835,453 0.476 0.923 0.516 0.390
106390923 LODI MEMORIAL HOSPITAL Central $27,169,776 $20,671,347 1.314 0.939 1.400 0.277
106201281 MADERA COMMUNITY HOSPITAL Central $7,934,050 $7,442,660 1.066 0.923 1.155 0.306
106260011 MAMMOTH HOSPITAL Central $8,556,161 $4,194,635 2.040 0.923 2.210 0.126
106050932 MARK TWAIN ST. JOSEPHS HOSPITAL Central $3,901,879 $4,592,579 0.850 0.923 0.921 0.151
106500939 MEMORIAL HOSPITAL MODESTO Central $90,355,711 $92,053,801 0.982 0.954 1.028 0.140
106150761 MERCY HOSPITAL - BAKERSFIELD Central $76,006,044 $99,540,760 0.764 0.923 0.827 0.088
106240942 MERCY MERCED MED CTR-COMMUNITY CAMPUS Central $25,432,632 $24,371,231 1.044 0.935 1.116 0.295
106141273 NORTHERN INYO HOSPITAL Central $6,335,570 $3,506,861 1.807 0.923 1.957 0.200
106500967 OAK VALLEY DISTRICT HOSPITAL Central $2,197,334 $4,150,100 0.529 0.954 0.555 0.284
106104023 SAN JOAQUIN VALLEY REHAB HOSPITAL Central $2,438,002 $2,421,923 1.007 0.923 1.091 0.036
106100793 SELMA DISTRICT HOSPITAL Central $2,669,837 $3,280,275 0.814 0.923 0.882 0.470
106100797 SIERRA KINGS DISTRICT HOSPITAL Central $1,339,522 $2,664,397 0.503 0.923 0.545 0.532
106540798 SIERRA VIEW DISTRICT HOSPITAL Central $15,211,949 $14,560,955 1.045 0.923 1.132 0.386
106100899 ST. AGNES MEDICAL CENTER Central $70,686,261 $101,272,930 0.698 0.923 0.756 0.123
106392232 ST. JOSEPHS BEHAVIORAL HEALTH CENTER Central $3,612,274 $5,098,241 0.709 0.939 0.755 0.000
106391042 ST. JOSEPHS MEDICAL CENTER OF STOCKTON Central $64,258,704 $65,978,479 0.974 0.939 1.037 0.225
106540816 TULARE DISTRICT HOSPITAL Central $5,641,097 $9,833,693 0.574 0.923 0.622 0.368
106551061 TUOLUMNE GENERAL HOSPITAL Central $1,609,598 $2,796,395 0.576 0.923 0.624 0.409
106400466 ARROYO GRANDE COMMUNITY HOSPITAL Central Coast $1,925,847 $7,654,169 0.252 0.923 0.273 0.080
106560203 AURORA VISTA DEL MAR HOSPITAL Central Coast $5,725,277 $7,856,713 0.729 0.923 0.790 0.269
106560473 COMMUNITY MEM HOSP-SAN BUENAVENTURA Central Coast $26,928,433 $85,576,141 0.315 0.923 0.341 0.085
106400480 FRENCH HOSPITAL MEDICAL CENTER Central Coast $5,208,501 $17,664,891 0.295 0.923 0.319 0.075
106420491 LOMPOC HEALTHCARE DISTRICT Central Coast $2,591,462 $6,032,133 0.430 0.923 0.465 0.325
106560492 LOS ROBLES REGIONAL MEDICAL CENTER Central Coast $80,732,304 $80,084,253 1.008 0.923 1.092 0.040
106420493 MARIAN MEDICAL CENTER Central Coast $29,020,578 $31,475,524 0.922 0.923 0.999 0.228
106560501 OJAI VALLEY COMMUNITY HOSPITAL Central Coast $2,761,462 $5,704,628 0.484 0.923 0.524 0.194
106560838 PACIFIC SHORES Central Coast $10,920,196 $3,798,107 2.875 0.923 3.115 0.000
106424047 REHABILITATION INST AT SANTA BARBARA Central Coast $3,032,315 $3,095,053 0.980 0.923 1.062 0.066
106400524 SIERRA VISTA REGIONAL MEDICAL CENTER Central Coast $45,942,891 $40,028,178 1.148 0.923 1.244 0.187
106560525 SIMI VALLEY HOSP & HLTH SVCS-SYCAMORE Central Coast $23,090,490 $27,727,480 0.833 0.923 0.902 0.119
106560508 ST. JOHNS PLEASANT VALLEY HOSPITAL Central Coast $14,203,536 $13,164,191 1.079 0.923 1.169 0.064
106560529 ST. JOHNS REGIONAL MEDICAL CENTER Central Coast $48,496,058 $51,288,280 0.946 0.923 1.025 0.124
106564121 THOUSAND OAKS SURGICAL HOSPITAL Central Coast $1,935,703 $3,909,540 0.495 0.923 0.536 0.000
106400548 TWIN CITIES COMMUNITY HOSPITAL Central Coast $20,726,716 $16,871,778 1.228 0.923 1.331 0.127
106560481 VENTURA COUNTY MEDICAL CENTER Central Coast $5,915,317 $13,291,770 0.445 0.923 0.482 0.571
106190017 ALHAMBRA HOSPITAL Los Angeles-NE $3,937,982 $4,735,364 0.832 0.951 0.874 0.329
106190081 BEVERLY HOSPITAL Los Angeles-NE $10,329,374 $22,604,486 0.457 0.951 0.480 0.304
106190020 BHC ALHAMBRA HOSPITAL Los Angeles-NE $7,160,654 $12,728,370 0.563 0.951 0.591 0.331
106190125 CALIFORNIA HOSPITAL MEDICAL CENTER Los Angeles-NE $12,456,566 $15,111,843 0.824 0.951 0.866 0.691
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Q:\Projects\WFox\PBGH\60 Public\Reports\\Attach G 20071012.xls [Att C] Milliman Page 1 of 4
Attachment C
Buyer Cost Index
(A) (B) (C=A/B) (D) (E=C/D)

Allowed Based
Area Inpatient
Teaching
Major
106190555 CEDARS-SINAI MEDICAL CENTER Los Angeles-NE $588,838,520 $345,762,284 1.703 0.951 1.790 0.112
106190170 CHILDRENS HOSPITAL OF LOS ANGELES Los Angeles-NE $75,854,043 $97,855,099 0.775 0.951 0.815 0.658
106190392 GOOD SAMARITAN HOSPITAL - LA Los Angeles-NE $57,409,869 $94,183,196 0.610 0.951 0.641 0.182
106190382 HOLLYWOOD PRESBYTERIAN MEDICAL CTR Los Angeles-NE $7,470,316 $11,602,942 0.644 0.951 0.677 0.553
106190400 HUNTINGTON MEMORIAL HOSPITAL Los Angeles-NE $123,493,409 $142,442,441 0.867 0.951 0.911 0.152
106191228 LAC/USC MEDICAL CENTER Los Angeles-NE T $23,737,694 $15,314,485 1.550 0.951 1.629 0.871
106190462 LAS ENCINAS HOSPITAL Los Angeles-NE $9,694,070 $9,800,289 0.989 0.951 1.040 0.043
106190198 LOS ANGELES COMMUNITY HOSPITAL Los Angeles-NE $1,033,857 $6,406,393 0.161 0.951 0.170 0.611
106190547 MONTEREY PARK HOSPITAL Los Angeles-NE $3,247,411 $4,843,992 0.670 0.951 0.705 0.463
106190534 OLYMPIA MEDICAL CENTER Los Angeles-NE $11,608,161 $15,804,742 0.734 0.951 0.772 0.100
106190581 ORTHOPAEDIC HOSPITAL Los Angeles-NE $2,130,827 $2,815,073 0.757 0.951 0.796 0.358
106190307 PACIFIC ALLIANCE MEDICAL CENTER Los Angeles-NE $812,324 $2,585,666 0.314 0.951 0.330 0.464
106190468 PROMISE HOSPITAL OF EAST LOS ANGELES Los Angeles-NE $1,525,829 $1,858,423 0.821 0.951 0.863 0.201
106190200 SAN GABRIEL VALLEY MEDICAL CENTER Los Angeles-NE $20,403,940 $28,014,714 0.728 0.951 0.765 0.159
106190762 ST. VINCENT MEDICAL CENTER Los Angeles-NE $66,676,904 $59,564,589 1.119 0.951 1.176 0.168
106190784 TEMPLE COMMUNITY HOSPITAL Los Angeles-NE $6,820,335 $3,403,461 2.004 0.951 2.106 0.337
106190796 UCLA MEDICAL CENTER Los Angeles-NE T $261,901,388 $325,364,625 0.805 0.951 0.846 0.184
106190930 UCLA NEUROPSYCHIATRIC HOSPITAL Los Angeles-NE $10,067,243 $9,255,332 1.088 0.951 1.143 0.062
106191216 USC KENNETH NORRIS JR. CANCER HOSPITAL Los Angeles-NE $24,748,517 $29,539,764 0.838 0.951 0.881 0.010
106194219 USC UNIVERSITY HOSPITAL Los Angeles-NE $117,635,744 $99,057,308 1.188 0.951 1.248 0.163
106190878 WHITE MEMORIAL MEDICAL CENTER Los Angeles-NE $17,621,048 $25,124,335 0.701 0.951 0.737 0.492
106190280 ENCINO TARZANA REGIONAL MEDICAL CENTER Los Angeles-NW $8,113,816 $10,097,098 0.804 0.951 0.845 0.231
106190323 GLENDALE ADVENTIST MEDICAL CENTER Los Angeles-NW $56,841,628 $65,031,826 0.874 0.951 0.919 0.290
106190522 GLENDALE MEMORIAL HOSPITAL & HEALTH CTR Los Angeles-NW $23,839,264 $32,252,076 0.739 0.951 0.777 0.302
106191231 LAC/OLIVE VIEW -UCLA MED CTR Los Angeles-NW T $1,667,992 $1,521,599 1.096 0.951 1.152 0.902
106190455 LANCASTER COMMUNITY HOSPITAL Los Angeles-NW $24,414,477 $49,838,382 0.490 0.951 0.515 0.064
106190568 NORTHRIDGE HOSPITAL MEDICAL CENTER Los Angeles-NW $79,678,574 $82,001,664 0.972 0.951 1.021 0.226
106190385 PROVIDENCE HOLY CROSS MEDICAL CENTER Los Angeles-NW $42,657,661 $83,030,751 0.514 0.951 0.540 0.261
106190758 PROVIDENCE SAINT JOSEPH MEDICAL CENTER Los Angeles-NW $76,432,629 $96,862,032 0.789 0.951 0.829 0.146
106190708 SHERMAN OAKS HOSPITAL & HEALTH CENTER Los Angeles-NW $9,270,725 $14,634,241 0.633 0.951 0.666 0.099
106190812 VALLEY PRESBYTERIAN HOSPITAL Los Angeles-NW $35,181,473 $40,559,132 0.867 0.951 0.912 0.487
106190818 VERDUGO HILLS HOSPITAL Los Angeles-NW $12,037,080 $29,500,669 0.408 0.951 0.429 0.077
106190859 WEST HILLS HOSPITAL & MEDICAL CENTER Los Angeles-NW $42,010,878 $42,368,857 0.992 0.951 1.042 0.053
106190163 AURORA CHARTER OAK Los Angeles-SE $4,951,858 $8,972,373 0.552 0.951 0.580 0.318
106190066 BELLFLOWER MEDICAL CENTER Los Angeles-SE $780,583 $4,753,073 0.164 0.951 0.173 0.465
106190137 CASA COLINA HOSPITAL FOR REHABILITATIVE Los Angeles-SE $6,049,131 $5,682,888 1.064 0.951 1.119 0.014
106190636 CITRUS VALLEY MEDICAL CENTER - QV CAMPUS Los Angeles-SE $51,481,413 $73,720,076 0.698 0.951 0.734 0.338
106190176 CITY OF HOPE NATIONAL MEDICAL CENTER Los Angeles-SE $125,415,842 $111,104,416 1.129 0.951 1.186 0.183
106190184 COLLEGE HOSPITAL Los Angeles-SE $12,722,279 $20,348,264 0.625 0.951 0.657 0.186
106190328 EAST VALLEY HOSPITAL MED CTR Los Angeles-SE $1,356,118 $3,414,074 0.397 0.951 0.417 0.371
106190298 FOOTHILL PRESBYTERIAN HOSPITAL Los Angeles-SE $11,250,961 $18,934,062 0.594 0.951 0.625 0.114
106190352 GREATER EL MONTE COMMUNITY HOSPITAL Los Angeles-SE $2,179,682 $4,149,600 0.525 0.951 0.552 0.584
106190630 POMONA VALLEY HOSPITAL MEDICAL CENTER Los Angeles-SE $66,285,148 $72,795,153 0.911 0.951 0.957 0.408
106190631 PRESBYTERIAN INTERCOMMUNITY HOSPITAL Los Angeles-SE $78,688,515 $81,023,795 0.971 0.951 1.021 0.168
106190673 SAN DIMAS COMMUNITY HOSPITAL Los Angeles-SE $11,158,014 $18,308,667 0.609 0.951 0.641 0.322
106190754 ST. FRANCIS MEDICAL CENTER Los Angeles-SE $6,700,269 $29,856,691 0.224 0.951 0.236 0.493
106190159 TRI-CITY REGIONAL MEDICAL CENTER Los Angeles-SE $8,337,239 $3,360,316 2.481 0.951 2.608 0.183
106190883 WHITTIER HOSPITAL MEDICAL CENTER Los Angeles-SE $4,101,039 $24,807,985 0.165 0.951 0.174 0.331
106190110 BROTMAN MEDICAL CENTER Los Angeles-SW $13,998,614 $22,967,370 0.610 0.951 0.641 0.200
106190230 CENTINELA FREEMAN M.C-MEMORIAL Los Angeles-SW $21,076,305 $36,408,281 0.579 0.951 0.608 0.373
106190148 CENTINELA FREEMAN MED CTR-CENTINELA Los Angeles-SW $52,964,237 $58,623,011 0.903 0.951 0.950 0.259
106190500 CENTINELA FREEMAN MED CTR-MARINA Los Angeles-SW $9,625,679 $14,206,677 0.678 0.951 0.712 0.103
106190197 COMMUNITY & MISSION HOSP-HTG PARK Los Angeles-SW $1,468,488 $2,321,441 0.633 0.951 0.665 0.704
106190232 DEL AMO HOSPITAL Los Angeles-SW $7,735,112 $8,924,798 0.867 0.951 0.911 0.137
106196168 E & L MILLER CHILDRENS HOSPITAL Los Angeles-SW $92,103,925 $83,334,977 1.105 0.951 1.162 0.316
106190240 LAKEWOOD REGIONAL MEDICAL CENTER - SOUTH Los Angeles-SW $20,997,715 $31,743,983 0.661 0.951 0.695 0.164
106190680 LITTLE CO OF MARY-SAN PEDRO HOSPITAL Los Angeles-SW $15,983,330 $16,440,182 0.972 0.951 1.022 0.400
106190470 LITTLE COMPANY OF MARY HOSPITAL Los Angeles-SW $55,670,418 $67,939,045 0.819 0.951 0.861 0.113
106190525 LONG BEACH MEMORIAL MEDICAL CENTER Los Angeles-SW $74,341,379 $93,988,206 0.791 0.951 0.831 0.162
106190687 SANTA MONICA - UCLA MEDICAL CENTER Los Angeles-SW $36,808,330 $60,696,393 0.606 0.951 0.637 0.100
106190756 ST. JOHNS HOSPITAL AND HEALTH CENTER Los Angeles-SW $73,272,028 $89,563,063 0.818 0.951 0.860 0.009
106190053 ST. MARY MEDICAL CENTER Los Angeles-SW $16,748,115 $20,539,118 0.815 0.951 0.857 0.414
106190422 TORRANCE MEMORIAL MEDICAL CENTER Los Angeles-SW $129,096,338 $181,159,857 0.713 0.951 0.749 0.075
106060870 COLUSA REGIONAL MEDICAL CENTER North $1,070,099 $1,124,494 0.952 0.923 1.031 0.275
106040962 ENLOE MEDICAL CENTER - ESPLANADE CAMPUS North $53,424,983 $55,745,958 0.958 0.923 1.038 0.189
106040937 OROVILLE HOSPITAL North $9,963,876 $12,153,691 0.820 0.923 0.888 0.303
106454013 PATIENTS HOSPITAL OF REDDING North $1,334,265 $2,394,523 0.557 0.997 0.559 0.003
106121051 REDWOOD MEMORIAL HOSPITAL North $3,930,404 $3,271,234 1.202 0.923 1.302 0.224
106580996 RIDEOUT MEMORIAL HOSPITAL North $44,717,005 $36,328,326 1.231 0.923 1.334 0.232
106450940 SHASTA REGIONAL MEDICAL CENTER North $15,121,631 $23,426,684 0.645 0.997 0.648 0.174
106121080 ST. JOSEPH HOSPITAL - EUREKA North $27,670,274 $23,837,268 1.161 0.923 1.258 0.194
106171395 SUTTER LAKESIDE HOSPITAL North $10,705,770 $6,547,471 1.635 0.923 1.772 0.185
106291053 TAHOE FOREST HOSPITAL North $15,604,457 $10,876,962 1.435 0.923 1.554 0.154
106231396 UKIAH VALLEY MEDICAL CENTER North $9,263,094 $10,119,095 0.915 0.923 0.992 0.311
106301098 ANAHEIM MEMORIAL MEDICAL CENTER Orange $51,468,357 $82,782,514 0.622 0.932 0.667 0.136
106301140 CHAPMAN MEDICAL CENTER Orange $8,261,872 $11,265,258 0.733 0.932 0.787 0.360
106304113 CHILDRENS HOSPITAL AT MISSION Orange $19,515,199 $19,180,520 1.017 0.932 1.092 0.219
106300032 CHILDRENS HOSPITAL OF ORANGE COUNTY Orange $93,290,166 $82,378,393 1.132 0.932 1.216 0.538
CMM
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Attachment C
Buyer Cost Index
(A) (B) (C=A/B) (D) (E=C/D)

Allowed Based
Area Inpatient
Teaching
Major
106301258 COASTAL COMMUNITIES HOSPITAL Orange $6,058,864 $5,328,967 1.137 0.932 1.220 0.623
106301155 COLLEGE HOSPITAL COSTA MESA Orange $4,685,996 $7,679,188 0.610 0.932 0.655 0.668
106301175 FOUNTAIN VALLEY RGNL HOSP & MC-EUCLID Orange $60,246,803 $75,110,171 0.802 0.932 0.861 0.281
106301283 GARDEN GROVE HOSPITAL & MEDICAL CENTER Orange $12,076,696 $15,623,707 0.773 0.932 0.830 0.462
106301205 HOAG MEMORIAL HOSPITAL PRESBYTERIAN Orange $190,240,073 $181,718,516 1.047 0.932 1.124 0.044
106301209 HUNTINGTON BEACH HOSPITAL Orange $1,504,603 $14,743,895 0.102 0.932 0.110 0.311
106304045 IRVINE MEDICAL CENTER Orange $38,019,952 $58,283,052 0.652 0.932 0.700 0.040
106301234 LA PALMA INTERCOMMUNITY HOSPITAL Orange $7,239,522 $21,227,791 0.341 0.932 0.366 0.161
106301248 LOS ALAMITOS MEDICAL CENTER Orange $22,917,768 $29,008,302 0.790 0.932 0.848 0.077
106301262 MISSION HOSPITAL REGIONAL MEDICAL CENTER Orange $111,159,294 $93,932,380 1.183 0.932 1.270 0.102
106300225 ORANGE COAST MEMORIAL MEDICAL CENTER Orange $50,394,739 $76,785,678 0.656 0.932 0.704 0.045
106301297 PLACENTIA-LINDA COMMUNITY HOSPITAL Orange $15,792,158 $21,330,396 0.740 0.932 0.795 0.156
106301317 SADDLEBACK MEMORIAL MEDICAL CENTER Orange $73,844,564 $86,462,943 0.854 0.932 0.917 0.028
106301337 SOUTH COAST MEDICAL CENTER Orange $18,443,717 $20,779,392 0.888 0.932 0.953 0.131
106301340 ST. JOSEPH HOSPITAL - ORANGE Orange $137,965,439 $169,132,295 0.816 0.932 0.876 0.079
106301342 ST. JUDE MEDICAL CENTER Orange $118,925,499 $84,578,517 1.406 0.932 1.509 0.071
106301357 TUSTIN HOSPITAL MEDICAL CENTER Orange $512,472 $1,291,100 0.397 0.932 0.426 0.746
106304079 TUSTIN REHABILITATION HOSPITAL Orange $2,358,970 $3,002,531 0.786 0.932 0.843 0.037
106301279 UNIVERSITY OF CALIFORNIA IRVINE MED CTR Orange T $93,473,398 $84,170,507 1.111 0.932 1.192 0.466
106301379 WEST ANAHEIM MEDICAL CENTER Orange $11,852,610 $32,846,143 0.361 0.932 0.387 0.129
106301188 WESTERN MEDICAL CENTER-ANAHEIM Orange $5,463,175 $9,019,020 0.606 0.932 0.650 0.501
106301566 WESTERN MEDICAL CENTER-SANTA ANA Orange $34,434,711 $50,629,863 0.680 0.932 0.730 0.341
106361105 BARSTOW COMMUNITY HOSPITAL Riverside-San Bernardino $4,148,474 $5,920,612 0.701 0.923 0.759 0.236
106364050 CANYON RIDGE HOSPITAL Riverside-San Bernardino $3,190,159 $6,039,975 0.528 0.923 0.572 0.287
106361144 CHINO VALLEY MEDICAL CENTER Riverside-San Bernardino $24,109,118 $16,849,869 1.431 0.923 1.550 0.333
106361458 COLORADO RIVER MEDICAL CENTER Riverside-San Bernardino $3,277,201 $5,562,194 0.589 0.923 0.638 0.165
106361323 COMMUNITY HOSPITAL OF SAN BERNARDINO Riverside-San Bernardino $5,390,697 $9,221,743 0.585 0.923 0.633 0.608
106331152 CORONA REGIONAL MEDICAL CENTER Riverside-San Bernardino $29,020,606 $46,288,455 0.627 0.923 0.679 0.201
106331164 DESERT REGIONAL MEDICAL CENTER Riverside-San Bernardino $82,417,751 $72,266,728 1.140 0.923 1.236 0.268
106364144 DESERT VALLEY HOSPITAL Riverside-San Bernardino $33,000,367 $37,831,094 0.872 0.923 0.945 0.150
106361166 DOCTORS HSP MED CTR OF MONTCLAIR Riverside-San Bernardino $16,386,214 $21,816,236 0.751 0.923 0.814 0.285
106331168 EISENHOWER MEDICAL CENTER Riverside-San Bernardino $57,955,210 $62,886,990 0.922 0.923 0.999 0.032
106331194 HEMET VALLEY MEDICAL CENTER Riverside-San Bernardino $11,277,249 $20,088,912 0.561 0.923 0.608 0.157
106362041 HI-DESERT MEDICAL CENTER Riverside-San Bernardino $3,894,776 $10,413,314 0.374 0.923 0.405 0.383
106331216 JOHN F. KENNEDY MEMORIAL HOSPITAL Riverside-San Bernardino $11,388,963 $15,154,250 0.752 0.923 0.814 0.381
106364014 LOMA LINDA UNIVERSITY BEHAVIORAL MEDICIN Riverside-San Bernardino $9,474,925 $15,186,029 0.624 0.923 0.676 0.170
106361246 LOMA LINDA UNIVERSITY MEDICAL CENTER Riverside-San Bernardino T $201,156,461 $195,428,025 1.029 0.923 1.115 0.437
106334018 MENIFEE VALLEY MEDICAL CENTER Riverside-San Bernardino $3,318,767 $6,735,360 0.493 0.923 0.534 0.063
106334048 MORENO VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino $6,193,362 $11,674,505 0.531 0.923 0.575 0.325
106361266 MOUNTAINS COMMUNITY HOSPITAL Riverside-San Bernardino $1,692,972 $1,582,151 1.070 0.923 1.159 0.440
106331288 PALO VERDE HOSPITAL Riverside-San Bernardino $4,078,276 $3,424,700 1.191 0.923 1.290 0.259
106331293 PARKVIEW COMMUNITY HOSPITAL Riverside-San Bernardino $22,873,430 $24,734,302 0.925 0.923 1.002 0.278
106361308 REDLANDS COMMUNITY HOSPITAL Riverside-San Bernardino $51,388,172 $60,816,992 0.845 0.923 0.916 0.120
106331226 RIVERSIDE CENTER FOR BEHAVIORAL MEDICINE Riverside-San Bernardino $532,485 $740,098 0.719 0.923 0.780 0.000
106331312 RIVERSIDE COMMUNITY HOSPITAL Riverside-San Bernardino $85,594,396 $93,257,107 0.918 0.923 0.994 0.185
106334487 RIVERSIDE COUNTY REGIONAL MEDICAL CENTER Riverside-San Bernardino $30,739,672 $40,672,190 0.756 0.923 0.819 0.658
106361318 SAN ANTONIO COMMUNITY HOSPITAL Riverside-San Bernardino $58,131,857 $89,185,511 0.652 0.923 0.706 0.095
106334068 SOUTHWEST HEALTHCARE SYSTEM-MURRIETA Riverside-San Bernardino $84,215,605 $126,475,795 0.666 0.923 0.721 0.110
106361339 ST. BERNARDINE MEDICAL CENTER Riverside-San Bernardino $54,265,914 $82,360,958 0.659 0.923 0.714 0.220
106361370 VICTOR VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino $7,793,144 $20,782,702 0.375 0.923 0.406 0.344
106090793 BARTON MEMORIAL HOSPITAL Sacramento $29,853,135 $18,468,826 1.616 1.028 1.572 0.229
106340947 MERCY GENERAL HOSPITAL Sacramento $104,462,857 $125,258,941 0.834 1.028 0.811 0.128
106344029 MERCY HOSPITAL - FOLSOM Sacramento $21,882,123 $23,311,762 0.939 1.028 0.913 0.088
106340950 MERCY SAN JUAN HOSPITAL Sacramento $102,128,945 $83,822,585 1.218 1.028 1.185 0.272
106340951 METHODIST HOSPITAL OF SACRAMENTO Sacramento $25,579,634 $24,135,799 1.060 1.028 1.031 0.354
106342392 SIERRA VISTA HOSPITAL Sacramento $6,768,612 $8,304,177 0.815 1.028 0.793 0.177
106310791 SUTTER AUBURN FAITH HOSPITAL Sacramento $19,208,154 $14,831,172 1.295 1.028 1.260 0.126
106344017 SUTTER CENTER FOR PSYCHIATRY Sacramento $9,552,971 $9,911,150 0.964 1.028 0.938 0.126
106574010 SUTTER DAVIS HOSPITAL Sacramento $12,244,677 $12,219,154 1.002 1.028 0.975 0.265
106341051 SUTTER MEDICAL CENTER-SACRAMENTO Sacramento $250,777,020 $154,609,830 1.622 1.028 1.578 0.257
106311000 SUTTER ROSEVILLE MEDICAL CENTER Sacramento $104,496,215 $76,391,045 1.368 1.028 1.331 0.176
106341006 UNIVERSITY OF CALIFORNIA DAVIS MED CTR Sacramento T $269,671,997 $164,233,095 1.642 1.028 1.597 0.395
106571086 WOODLAND MEMORIAL HOSPITAL Sacramento $6,863,595 $13,379,888 0.513 1.028 0.499 0.193
106370652 ALVARADO HOSPITAL MEDICAL CENTER San Diego $27,949,785 $26,002,775 1.075 0.923 1.165 0.171
106370749 ALVARADO PARKWAY INSTITUTE BHS San Diego $1,021,168 $2,234,747 0.457 0.923 0.495 0.010
106374024 AURORA SAN DIEGO San Diego $7,343,510 $9,531,660 0.770 0.923 0.835 0.077
106370673 CHILDRENS HOSPITAL-SAN DIEGO San Diego $87,593,264 $120,326,460 0.728 0.923 0.789 0.515
106130699 EL CENTRO REGIONAL MEDICAL CENTER San Diego $9,458,349 $13,889,159 0.681 0.923 0.738 0.265
106370705 FALLBROOK HOSPITAL DISTRICT San Diego $5,074,163 $8,380,780 0.605 0.923 0.656 0.125
106370714 GROSSMONT HOSPITAL San Diego $94,570,662 $82,624,038 1.145 0.923 1.240 0.206
106370755 PALOMAR MEDICAL CENTER San Diego $76,013,406 $79,725,688 0.953 0.923 1.033 0.230
106370759 PARADISE VALLEY HOSPITAL San Diego $9,391,369 $14,283,266 0.658 0.923 0.712 0.410
106130760 PIONEERS MEMORIAL HOSPITAL San Diego $9,424,888 $11,324,047 0.832 0.923 0.902 0.392
106370977 POMERADO HOSPITAL San Diego $27,135,242 $30,850,337 0.880 0.923 0.953 0.136
106374084 SAN DIEGO HOSPICE ACUTE CARE CENTER San Diego $538,137 $1,580,490 0.340 0.923 0.369 0.230
106371256 SCRIPPS GREEN HOSPITAL San Diego $77,046,265 $85,093,804 0.905 0.923 0.981 0.011
106371394 SCRIPPS MEMORIAL HOSPITAL - ENCINITAS San Diego $37,702,167 $33,881,539 1.113 0.923 1.206 0.089
106370771 SCRIPPS MEMORIAL HOSPITAL-LA JOLLA San Diego $134,259,213 $145,181,054 0.925 0.923 1.002 0.053
106370744 SCRIPPS MERCY HOSPITAL San Diego $95,598,679 $107,565,528 0.889 0.923 0.963 0.229
CMM
10/12/2007 11:25 AM
Attachment C
Buyer Cost Index
(A) (B) (C=A/B) (D) (E=C/D)

Allowed Based
Area Inpatient
Teaching
Major
106370875 SHARP CHULA VISTA MEDICAL CENTER San Diego $42,824,391 $37,971,008 1.128 0.923 1.222 0.241
106370689 SHARP CORONADO HOSPITAL & HEALTHCARE CTR San Diego $6,820,019 $8,471,110 0.805 0.923 0.872 0.396
106370695 SHARP MARY BIRCH HOSPITAL FOR WOMEN San Diego $71,682,507 $74,716,699 0.959 0.923 1.040 0.334
106370694 SHARP MEMORIAL HOSPITAL San Diego $140,886,614 $128,015,089 1.101 0.923 1.192 0.135
106374049 SHARP VISTA PACIFICA San Diego $950,838 $974,177 0.976 0.923 1.058 0.000
106370780 TRI-CITY MEDICAL CENTER San Diego $46,251,013 $65,449,074 0.707 0.923 0.766 0.108
106370782 UNIVERSITY OF CALIF - SAN DIEGO MED CTR San Diego T $110,627,992 $133,475,874 0.829 0.923 0.898 0.394
106380929 CALIFORNIA PACIFIC MEDICAL CENTER San Francisco-San Mateo-Marin $397,030,604 $246,082,464 1.613 1.171 1.378 0.121
106382715 CHINESE HOSPITAL San Francisco-San Mateo-Marin $3,338,131 $1,993,073 1.675 1.171 1.430 0.106
106210993 KENTFIELD REHABILITATION CENTER San Francisco-San Mateo-Marin $5,235,561 $2,661,887 1.967 1.171 1.680 0.042
106380868 LANGLEY PORTER PSYCHIATRIC INSTITUTE San Francisco-San Mateo-Marin $3,378,728 $3,582,329 0.943 1.171 0.806 0.062
106211006 MARIN GENERAL HOSPITAL San Francisco-San Mateo-Marin $73,742,112 $49,622,105 1.486 1.171 1.269 0.145
106214034 NOVATO COMMUNITY HOSPITAL - CURRENT LOC San Francisco-San Mateo-Marin $9,532,529 $7,049,841 1.352 1.171 1.155 0.092
106410852 PENINSULA MEDICAL CENTER San Francisco-San Mateo-Marin $55,114,966 $70,015,563 0.787 1.171 0.672 0.047
106410891 SEQUOIA HOSPITAL San Francisco-San Mateo-Marin $66,145,095 $52,878,968 1.251 1.171 1.068 0.027
106410817 SETON MEDICAL CENTER San Francisco-San Mateo-Marin $56,553,469 $33,978,932 1.664 1.171 1.422 0.218
106380960 ST. FRANCIS MEMORIAL HOSPITAL San Francisco-San Mateo-Marin $8,299,202 $25,605,263 0.324 1.171 0.277 0.185
106380964 ST. LUKES HOSPITAL San Francisco-San Mateo-Marin $15,570,506 $10,570,698 1.473 1.171 1.258 0.422
106380965 ST. MARYS MEDICAL CENTER San Francisco-San Mateo-Marin $40,418,762 $30,782,357 1.313 1.171 1.121 0.070
106381154 UCSF MEDICAL CENTER San Francisco-San Mateo-Marin T $263,988,982 $308,670,077 0.855 1.171 0.730 0.241
106490964 HEALDSBURG DISTRICT HOSPITAL Sonoma-Napa $975,950 $1,329,168 0.734 1.107 0.664 0.228
106491338 PALM DRIVE HOSPITAL Sonoma-Napa $7,944,340 $4,597,847 1.728 1.107 1.562 0.081
106491001 PETALUMA VALLEY HOSPITAL Sonoma-Napa $9,267,090 $7,905,594 1.172 1.107 1.059 0.177
106281047 QUEEN OF THE VALLEY HOSPITAL Sonoma-Napa $30,323,139 $25,575,479 1.186 1.025 1.157 0.121
106491064 SANTA ROSA MEMORIAL HOSPITAL Sonoma-Napa $87,397,398 $69,596,825 1.256 1.107 1.135 0.182
106491076 SONOMA VALLEY HOSPITAL Sonoma-Napa $4,522,899 $4,471,512 1.011 1.107 0.914 0.122
106281078 ST. HELENA HOSPITAL Sonoma-Napa $14,522,858 $16,344,389 0.889 1.025 0.867 0.130
106490919 SUTTER MEDICAL CENTER OF SANTA ROSA Sonoma-Napa $36,021,423 $30,220,628 1.192 1.107 1.077 0.265
106430743 COMMUNITY HOSPITAL OF LOS GATOS South Bay $30,418,507 $30,592,982 0.994 1.165 0.853 0.021
106430763 EL CAMINO HOSPITAL South Bay $112,323,274 $101,373,236 1.108 1.165 0.951 0.073
106270777 GEORGE L. MEE MEMORIAL HOSPITAL South Bay $6,699,881 $3,043,234 2.202 1.101 2.000 0.445
106430779 GOOD SAMARITAN HOSPITAL - SAN JOSE South Bay $169,996,084 $169,516,144 1.003 1.165 0.861 0.050
106350784 HAZEL HAWKINS MEMORIAL HOSPITAL South Bay $8,793,874 $8,062,759 1.091 1.165 0.936 0.302
106434040 LUCILE S PACKARD CHILDRENS HOSPITAL South Bay $284,414,050 $159,572,682 1.782 1.165 1.530 0.370
106430837 O CONNOR HOSPITAL South Bay $62,595,346 $55,396,727 1.130 1.165 0.970 0.127
106430705 REGIONAL MEDICAL CENTER OF SAN JOSE South Bay $48,001,430 $38,811,052 1.237 1.165 1.061 0.179
106270875 SALINAS VALLEY MEMORIAL HOSPITAL South Bay $105,009,732 $63,810,437 1.646 1.101 1.495 0.112
106430883 SANTA CLARA VALLEY MEDICAL CENTER South Bay $66,389,908 $41,606,300 1.596 1.165 1.369 0.691
106434138 ST. LOUISE REGIONAL HOSPITAL South Bay $16,843,003 $12,999,929 1.296 1.165 1.112 0.155
106430905 STANFORD UNIVERSITY HOSPITAL South Bay T $337,723,338 $242,698,051 1.392 1.165 1.194 0.108
106444013 WATSONVILLE COMMUNITY HOSPITAL South Bay $18,250,570 $14,576,497 1.252 1.150 1.089 0.286
CMM
10/12/2007 11:25 AM
Attachment D
Hospital Cost Index
(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

Cost Based
Area
Initial Normalized Normalized Adjusted
Benchmark Hospital Hospital Cost Medicare Hospital
OSHPD ID Hospital Cost Index Area Estimated Cost Allowed Cost Index Index Area Factor Cost Index
Total $8,524,074,269 $12,107,677,080 0.704 1.000 1.000 1.000
106010735 ALAMEDA HOSPITAL Alameda-Contra Costa-Solano $6,770,946 $11,810,493 0.573 0.814 1.182 0.689
106010739 ALTA BATES SUMMIT MED CTR-ALTA BATES Alameda-Contra Costa-Solano $122,522,813 $112,762,709 1.087 1.543 1.182 1.305
106481015 CALIFORNIA SPECIALTY HOSPITAL Alameda-Contra Costa-Solano $6,001,800 $7,678,678 0.782 1.110 1.134 0.979
106010776 CHILDRENS HOSP & RESEARCH CTR OAKLAND Alameda-Contra Costa-Solano $50,888,568 $55,494,012 0.917 1.303 1.182 1.102
106070924 CONTRA COSTA REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano $8,151,407 $7,091,903 1.149 1.633 1.182 1.381
106070904 DRS MEDICAL CENTER - SAN PABLO-PINOLE Alameda-Contra Costa-Solano $19,583,475 $28,972,446 0.676 0.960 1.182 0.812
106010805 EDEN MEDICAL CENTER Alameda-Contra Costa-Solano $38,570,405 $50,144,542 0.769 1.093 1.182 0.924
106014034 FREMONT HOSPITAL Alameda-Contra Costa-Solano $6,586,048 $11,988,513 0.549 0.780 1.182 0.660
106070988 JOHN MUIR MEDICAL CENTER Alameda-Contra Costa-Solano $143,520,909 $145,583,976 0.986 1.400 1.182 1.184
106013687 MERRITT PERALTA INSTITUTE CDRH Alameda-Contra Costa-Solano $2,825,061 $2,951,956 0.957 1.359 1.182 1.150
106071018 MT DIABLO MEDICAL CENTER Alameda-Contra Costa-Solano $50,192,325 $61,139,414 0.821 1.166 1.182 0.986
106074039 MT DIABLO MEDICAL PAVILION Alameda-Contra Costa-Solano $10,054,554 $8,333,142 1.207 1.714 1.182 1.449
106481357 NORTH BAY MEDICAL CENTER Alameda-Contra Costa-Solano $14,512,351 $16,235,010 0.894 1.270 1.134 1.119
106074017 SAN RAMON REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano $37,954,634 $46,115,671 0.823 1.169 1.182 0.989
106010967 ST. ROSE HOSPITAL Alameda-Contra Costa-Solano $7,675,285 $11,821,102 0.649 0.922 1.182 0.780
106010937 SUMMIT MEDICAL CENTER Alameda-Contra Costa-Solano $80,391,394 $116,796,975 0.688 0.978 1.182 0.827
106070934 SUTTER DELTA MEDICAL CENTER Alameda-Contra Costa-Solano $20,502,966 $25,583,039 0.801 1.138 1.182 0.963
106010782 THUNDER ROAD CHEMICAL DEPENDCY RCVRY HSP Alameda-Contra Costa-Solano $1,119,145 $516,830 2.165 3.076 1.182 2.601
106484001 VACA VALLEY HOSPITAL Alameda-Contra Costa-Solano $7,283,241 $7,540,476 0.966 1.372 1.134 1.210
106010983 VALLEY MEMORIAL HOSPITAL Alameda-Contra Costa-Solano $40,433,443 $43,926,126 0.920 1.307 1.182 1.106
106010987 WASHINGTON HOSPITAL - FREMONT Alameda-Contra Costa-Solano $56,326,127 $61,389,562 0.918 1.303 1.182 1.102
106150722 BAKERSFIELD MEMORIAL HOSPITAL Central $41,659,489 $83,881,227 0.497 0.705 0.923 0.764
106160787 CENTRAL VALLEY GENERAL HOSPITAL Central $6,056,477 $7,954,338 0.761 1.082 0.923 1.172
106204019 CHILDRENS HOSP CENTRAL CALIF Central $43,794,355 $64,044,202 0.684 0.971 0.923 1.052
106100005 CLOVIS COMMUNITY HOSPITAL Central $27,436,580 $58,045,497 0.473 0.671 0.923 0.727
106100697 COALINGA REGIONAL MEDICAL CENTER Central $887,723 $2,059,101 0.431 0.612 0.923 0.664
106100717 COMMUNITY REGIONAL MEDICAL CENTER Central $44,049,985 $71,183,734 0.619 0.879 0.923 0.952
106390846 DAMERON HOSPITAL Central $34,936,763 $61,310,776 0.570 0.809 0.939 0.862
106150706 DELANO REGIONAL MEDICAL CENTER Central $4,093,557 $7,206,711 0.568 0.807 0.923 0.874
106392287 DOCTORS HOSPITAL OF MANTECA Central $8,960,788 $14,653,586 0.612 0.869 0.939 0.925
106500852 DOCTORS MEDICAL CENTER Central $52,504,073 $78,412,191 0.670 0.951 0.954 0.997
106500867 EMANUEL MEDICAL CENTER Central $21,346,231 $38,712,332 0.551 0.783 0.954 0.821
106150775 GOOD SAMARITAN HOSPITAL - BAKERSFIELD Central $816,049 $1,390,157 0.587 0.834 0.923 0.903
106160725 HANFORD COMMUNITY HOSPITAL Central $7,677,632 $11,364,659 0.676 0.960 0.923 1.040
106154022 HEALTHSOUTH BAKERSFIELD REG REHAB HOSP Central $2,584,609 $3,427,484 0.754 1.071 0.923 1.161
106540734 KAWEAH DELTA DISTRICT HOSPITAL Central $46,109,779 $84,236,355 0.547 0.778 0.923 0.842
106150736 KERN MEDICAL CENTER Central $12,661,594 $15,774,165 0.803 1.140 0.923 1.235
106100745 KINGSBURG MEDICAL HOSPITAL Central $438,526 $835,453 0.525 0.746 0.923 0.808
106390923 LODI MEMORIAL HOSPITAL Central $12,660,775 $20,671,347 0.612 0.870 0.939 0.927
106201281 MADERA COMMUNITY HOSPITAL Central $4,071,587 $7,442,660 0.547 0.777 0.923 0.842
106260011 MAMMOTH HOSPITAL Central $6,404,376 $4,194,635 1.527 2.169 0.923 2.350
106050932 MARK TWAIN ST. JOSEPHS HOSPITAL Central $3,138,840 $4,592,579 0.683 0.971 0.923 1.052
106500939 MEMORIAL HOSPITAL MODESTO Central $63,923,418 $92,053,801 0.694 0.986 0.954 1.034
106150761 MERCY HOSPITAL - BAKERSFIELD Central $57,661,945 $99,540,760 0.579 0.823 0.923 0.892
106240942 MERCY MERCED MED CTR-COMMUNITY CAMPUS Central $14,357,434 $24,371,231 0.589 0.837 0.935 0.895
106141273 NORTHERN INYO HOSPITAL Central $3,474,287 $3,506,861 0.991 1.407 0.923 1.525
106500967 OAK VALLEY DISTRICT HOSPITAL Central $2,910,059 $4,150,100 0.701 0.996 0.954 1.044
106104023 SAN JOAQUIN VALLEY REHAB HOSPITAL Central $1,950,541 $2,421,923 0.805 1.144 0.923 1.239
106100793 SELMA DISTRICT HOSPITAL Central $2,234,627 $3,280,275 0.681 0.968 0.923 1.048
106100797 SIERRA KINGS DISTRICT HOSPITAL Central $1,073,560 $2,664,397 0.403 0.572 0.923 0.620
106540798 SIERRA VIEW DISTRICT HOSPITAL Central $6,543,044 $14,560,955 0.449 0.638 0.923 0.692
106100899 ST. AGNES MEDICAL CENTER Central $54,167,118 $101,272,930 0.535 0.760 0.923 0.823
106392232 ST. JOSEPHS BEHAVIORAL HEALTH CENTER Central $2,811,693 $5,098,241 0.552 0.783 0.939 0.834
106391042 ST. JOSEPHS MEDICAL CENTER OF STOCKTON Central $35,846,659 $65,978,479 0.543 0.772 0.939 0.822
106540816 TULARE DISTRICT HOSPITAL Central $4,785,620 $9,833,693 0.487 0.691 0.923 0.749
106551061 TUOLUMNE GENERAL HOSPITAL Central $1,949,494 $2,796,395 0.697 0.990 0.923 1.073
106400466 ARROYO GRANDE COMMUNITY HOSPITAL Central Coast $3,938,369 $7,654,169 0.515 0.731 0.923 0.792
106560203 AURORA VISTA DEL MAR HOSPITAL Central Coast $4,270,922 $7,856,713 0.544 0.772 0.923 0.837
106560473 COMMUNITY MEM HOSP-SAN BUENAVENTURA Central Coast $43,352,951 $85,576,141 0.507 0.720 0.923 0.780
106400480 FRENCH HOSPITAL MEDICAL CENTER Central Coast $9,381,122 $17,664,891 0.531 0.754 0.923 0.817
106420491 LOMPOC HEALTHCARE DISTRICT Central Coast $2,598,284 $6,032,133 0.431 0.612 0.923 0.663
106560492 LOS ROBLES REGIONAL MEDICAL CENTER Central Coast $44,595,473 $80,084,253 0.557 0.791 0.923 0.857
106420493 MARIAN MEDICAL CENTER Central Coast $18,443,626 $31,475,524 0.586 0.832 0.923 0.902
106560501 OJAI VALLEY COMMUNITY HOSPITAL Central Coast $3,045,504 $5,704,628 0.534 0.758 0.923 0.822
106560838 PACIFIC SHORES Central Coast $4,138,675 $3,798,107 1.090 1.548 0.923 1.677
106424047 REHABILITATION INST AT SANTA BARBARA Central Coast $3,764,312 $3,095,053 1.216 1.728 0.923 1.872
106400524 SIERRA VISTA REGIONAL MEDICAL CENTER Central Coast $28,197,259 $40,028,178 0.704 1.001 0.923 1.084
106560525 SIMI VALLEY HOSP & HLTH SVCS-SYCAMORE Central Coast $15,794,328 $27,727,480 0.570 0.809 0.923 0.877
106560508 ST. JOHNS PLEASANT VALLEY HOSPITAL Central Coast $8,644,248 $13,164,191 0.657 0.933 0.923 1.011
106560529 ST. JOHNS REGIONAL MEDICAL CENTER Central Coast $34,209,228 $51,288,280 0.667 0.947 0.923 1.027
106564121 THOUSAND OAKS SURGICAL HOSPITAL Central Coast $2,276,777 $3,909,540 0.582 0.827 0.923 0.896
106400548 TWIN CITIES COMMUNITY HOSPITAL Central Coast $11,082,856 $16,871,778 0.657 0.933 0.923 1.011
106560481 VENTURA COUNTY MEDICAL CENTER Central Coast $10,098,339 $13,291,770 0.760 1.079 0.923 1.169
CMM 10/12/2007 11:26 AM

Milliman
Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [Att D] Page 1 of 4
Attachment D
Hospital Cost Index
(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

Cost Based
Area
106190017 ALHAMBRA HOSPITAL Los Angeles-NE $2,177,559 $4,735,364 0.460 0.653 0.951 0.686
106190081 BEVERLY HOSPITAL Los Angeles-NE $10,317,201 $22,604,486 0.456 0.648 0.951 0.681
106190020 BHC ALHAMBRA HOSPITAL Los Angeles-NE $4,532,177 $12,728,370 0.356 0.506 0.951 0.532
106190125 CALIFORNIA HOSPITAL MEDICAL CENTER Los Angeles-NE $9,848,539 $15,111,843 0.652 0.926 0.951 0.973
106190555 CEDARS-SINAI MEDICAL CENTER Los Angeles-NE $331,312,071 $345,762,284 0.958 1.361 0.951 1.430
106190170 CHILDRENS HOSPITAL OF LOS ANGELES Los Angeles-NE $99,889,903 $97,855,099 1.021 1.450 0.951 1.524
106190392 GOOD SAMARITAN HOSPITAL - LA Los Angeles-NE $53,063,687 $94,183,196 0.563 0.800 0.951 0.841
106190382 HOLLYWOOD PRESBYTERIAN MEDICAL CTR Los Angeles-NE $5,676,935 $11,602,942 0.489 0.695 0.951 0.730
106190400 HUNTINGTON MEMORIAL HOSPITAL Los Angeles-NE $88,427,854 $142,442,441 0.621 0.882 0.951 0.927
106191228 LAC/USC MEDICAL CENTER Los Angeles-NE $16,731,692 $15,314,485 1.093 1.552 0.951 1.631
106190462 LAS ENCINAS HOSPITAL Los Angeles-NE $7,626,650 $9,800,289 0.778 1.105 0.951 1.162
106190198 LOS ANGELES COMMUNITY HOSPITAL Los Angeles-NE $2,475,718 $6,406,393 0.386 0.549 0.951 0.577
106190547 MONTEREY PARK HOSPITAL Los Angeles-NE $2,760,995 $4,843,992 0.570 0.810 0.951 0.851
106190534 OLYMPIA MEDICAL CENTER Los Angeles-NE $9,024,690 $15,804,742 0.571 0.811 0.951 0.852
106190581 ORTHOPAEDIC HOSPITAL Los Angeles-NE $3,411,324 $2,815,073 1.212 1.721 0.951 1.809
106190307 PACIFIC ALLIANCE MEDICAL CENTER Los Angeles-NE $1,658,760 $2,585,666 0.642 0.911 0.951 0.958
106190468 PROMISE HOSPITAL OF EAST LOS ANGELES Los Angeles-NE $1,931,746 $1,858,423 1.039 1.476 0.951 1.552
106190200 SAN GABRIEL VALLEY MEDICAL CENTER Los Angeles-NE $17,445,201 $28,014,714 0.623 0.885 0.951 0.930
106190762 ST. VINCENT MEDICAL CENTER Los Angeles-NE $36,044,154 $59,564,589 0.605 0.860 0.951 0.903
106190784 TEMPLE COMMUNITY HOSPITAL Los Angeles-NE $3,014,743 $3,403,461 0.886 1.258 0.951 1.322
106190796 UCLA MEDICAL CENTER Los Angeles-NE $220,563,915 $325,364,625 0.678 0.963 0.951 1.012
106190930 UCLA NEUROPSYCHIATRIC HOSPITAL Los Angeles-NE $14,860,671 $9,255,332 1.606 2.281 0.951 2.397
106191216 USC KENNETH NORRIS JR. CANCER HOSPITAL Los Angeles-NE $21,442,698 $29,539,764 0.726 1.031 0.951 1.084
106194219 USC UNIVERSITY HOSPITAL Los Angeles-NE $80,756,025 $99,057,308 0.815 1.158 0.951 1.217
106190878 WHITE MEMORIAL MEDICAL CENTER Los Angeles-NE $15,295,875 $25,124,335 0.609 0.865 0.951 0.909
106190323 GLENDALE ADVENTIST MEDICAL CENTER Los Angeles-NW $40,080,275 $65,031,826 0.616 0.875 0.951 0.920
106190522 GLENDALE MEMORIAL HOSPITAL & HEALTH CTR Los Angeles-NW $18,600,575 $32,252,076 0.577 0.819 0.951 0.861
106191231 LAC/OLIVE VIEW -UCLA MED CTR Los Angeles-NW $1,797,637 $1,521,599 1.181 1.678 0.951 1.764
106190455 LANCASTER COMMUNITY HOSPITAL Los Angeles-NW $22,689,878 $49,838,382 0.455 0.647 0.951 0.680
106190568 NORTHRIDGE HOSPITAL MEDICAL CENTER Los Angeles-NW $54,449,365 $82,001,664 0.664 0.943 0.951 0.991
106190385 PROVIDENCE HOLY CROSS MEDICAL CENTER Los Angeles-NW $38,574,246 $83,030,751 0.465 0.660 0.951 0.694
106190758 PROVIDENCE SAINT JOSEPH MEDICAL CENTER Los Angeles-NW $57,840,875 $96,862,032 0.597 0.848 0.951 0.891
106190708 SHERMAN OAKS HOSPITAL & HEALTH CENTER Los Angeles-NW $7,694,916 $14,634,241 0.526 0.747 0.951 0.785
106190812 VALLEY PRESBYTERIAN HOSPITAL Los Angeles-NW $23,351,197 $40,559,132 0.576 0.818 0.951 0.859
106190818 VERDUGO HILLS HOSPITAL Los Angeles-NW $15,479,929 $29,500,669 0.525 0.745 0.951 0.783
106190859 WEST HILLS HOSPITAL & MEDICAL CENTER Los Angeles-NW $29,255,931 $42,368,857 0.691 0.981 0.951 1.031
106190163 AURORA CHARTER OAK Los Angeles-SE $3,883,365 $8,972,373 0.433 0.615 0.951 0.646
106190066 BELLFLOWER MEDICAL CENTER Los Angeles-SE $2,618,072 $4,753,073 0.551 0.782 0.951 0.822
106190137 CASA COLINA HOSPITAL FOR REHABILITATIVE Los Angeles-SE $5,018,363 $5,682,888 0.883 1.254 0.951 1.318
106190636 CITRUS VALLEY MEDICAL CENTER - QV CAMPUS Los Angeles-SE $37,419,643 $73,720,076 0.508 0.721 0.951 0.758
106190176 CITY OF HOPE NATIONAL MEDICAL CENTER Los Angeles-SE $103,285,207 $111,104,416 0.930 1.320 0.951 1.388
106190184 COLLEGE HOSPITAL Los Angeles-SE $11,508,072 $20,348,264 0.566 0.803 0.951 0.844
106190328 EAST VALLEY HOSPITAL MED CTR Los Angeles-SE $1,507,653 $3,414,074 0.442 0.627 0.951 0.659
106190298 FOOTHILL PRESBYTERIAN HOSPITAL Los Angeles-SE $8,363,414 $18,934,062 0.442 0.627 0.951 0.659
106190352 GREATER EL MONTE COMMUNITY HOSPITAL Los Angeles-SE $2,487,028 $4,149,600 0.599 0.851 0.951 0.895
106190630 POMONA VALLEY HOSPITAL MEDICAL CENTER Los Angeles-SE $44,064,209 $72,795,153 0.605 0.860 0.951 0.904
106190631 PRESBYTERIAN INTERCOMMUNITY HOSPITAL Los Angeles-SE $44,739,656 $81,023,795 0.552 0.784 0.951 0.824
106190673 SAN DIMAS COMMUNITY HOSPITAL Los Angeles-SE $8,358,030 $18,308,667 0.457 0.648 0.951 0.681
106190754 ST. FRANCIS MEDICAL CENTER Los Angeles-SE $14,689,159 $29,856,691 0.492 0.699 0.951 0.734
106190159 TRI-CITY REGIONAL MEDICAL CENTER Los Angeles-SE $2,203,315 $3,360,316 0.656 0.931 0.951 0.979
106190883 WHITTIER HOSPITAL MEDICAL CENTER Los Angeles-SE $10,922,072 $24,807,985 0.440 0.625 0.951 0.657
106190110 BROTMAN MEDICAL CENTER Los Angeles-SW $15,087,353 $22,967,370 0.657 0.933 0.951 0.981
106190230 CENTINELA FREEMAN M.C-MEMORIAL Los Angeles-SW $21,502,791 $36,408,281 0.591 0.839 0.951 0.882
106190148 CENTINELA FREEMAN MED CTR-CENTINELA Los Angeles-SW $29,794,878 $58,623,011 0.508 0.722 0.951 0.759
106190500 CENTINELA FREEMAN MED CTR-MARINA Los Angeles-SW $8,668,890 $14,206,677 0.610 0.867 0.951 0.911
106190197 COMMUNITY & MISSION HOSP-HTG PARK Los Angeles-SW $1,422,345 $2,321,441 0.613 0.870 0.951 0.915
106190232 DEL AMO HOSPITAL Los Angeles-SW $6,037,716 $8,924,798 0.677 0.961 0.951 1.010
106196168 E & L MILLER CHILDRENS HOSPITAL Los Angeles-SW $73,800,454 $83,334,977 0.886 1.258 0.951 1.322
106190240 LAKEWOOD REGIONAL MEDICAL CENTER - SOUTH Los Angeles-SW $14,731,710 $31,743,983 0.464 0.659 0.951 0.693
106190680 LITTLE CO OF MARY-SAN PEDRO HOSPITAL Los Angeles-SW $10,433,686 $16,440,182 0.635 0.901 0.951 0.947
106190470 LITTLE COMPANY OF MARY HOSPITAL Los Angeles-SW $40,630,743 $67,939,045 0.598 0.849 0.951 0.893
106190525 LONG BEACH MEMORIAL MEDICAL CENTER Los Angeles-SW $51,587,574 $93,988,206 0.549 0.780 0.951 0.819
106190687 SANTA MONICA - UCLA MEDICAL CENTER Los Angeles-SW $37,944,269 $60,696,393 0.625 0.888 0.951 0.933
106190756 ST. JOHNS HOSPITAL AND HEALTH CENTER Los Angeles-SW $60,536,316 $89,563,063 0.676 0.960 0.951 1.009
106190053 ST. MARY MEDICAL CENTER Los Angeles-SW $12,884,574 $20,539,118 0.627 0.891 0.951 0.936
106190422 TORRANCE MEMORIAL MEDICAL CENTER Los Angeles-SW $99,434,689 $181,159,857 0.549 0.780 0.951 0.819
106060870 COLUSA REGIONAL MEDICAL CENTER North $701,596 $1,124,494 0.624 0.886 0.923 0.960
106040962 ENLOE MEDICAL CENTER - ESPLANADE CAMPUS North $34,716,114 $55,745,958 0.623 0.885 0.923 0.958
106040937 OROVILLE HOSPITAL North $6,845,866 $12,153,691 0.563 0.800 0.923 0.867
106454013 PATIENTS HOSPITAL OF REDDING North $1,019,074 $2,394,523 0.426 0.605 0.997 0.607
106121051 REDWOOD MEMORIAL HOSPITAL North $2,269,302 $3,271,234 0.694 0.985 0.923 1.068
106580996 RIDEOUT MEMORIAL HOSPITAL North $20,610,343 $36,328,326 0.567 0.806 0.923 0.873
106450940 SHASTA REGIONAL MEDICAL CENTER North $14,788,048 $23,426,684 0.631 0.897 0.997 0.900
CMM 10/12/2007 11:26 AM

Milliman
Attachment D
Hospital Cost Index
(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

Cost Based
Area
106121080 ST. JOSEPH HOSPITAL - EUREKA North $15,949,200 $23,837,268 0.669 0.950 0.923 1.030
106171395 SUTTER LAKESIDE HOSPITAL North $5,454,077 $6,547,471 0.833 1.183 0.923 1.282
106291053 TAHOE FOREST HOSPITAL North $12,063,294 $10,876,962 1.109 1.575 0.923 1.707
106231396 UKIAH VALLEY MEDICAL CENTER North $5,970,687 $10,119,095 0.590 0.838 0.923 0.908
106301098 ANAHEIM MEMORIAL MEDICAL CENTER Orange $44,250,765 $82,782,514 0.535 0.759 0.932 0.815
106301140 CHAPMAN MEDICAL CENTER Orange $8,868,382 $11,265,258 0.787 1.118 0.932 1.200
106304113 CHILDRENS HOSPITAL AT MISSION Orange $16,297,886 $19,180,520 0.850 1.207 0.932 1.296
106300032 CHILDRENS HOSPITAL OF ORANGE COUNTY Orange $78,531,848 $82,378,393 0.953 1.354 0.932 1.453
106301258 COASTAL COMMUNITIES HOSPITAL Orange $2,481,271 $5,328,967 0.466 0.661 0.932 0.710
106301155 COLLEGE HOSPITAL COSTA MESA Orange $4,798,802 $7,679,188 0.625 0.888 0.932 0.953
106301175 FOUNTAIN VALLEY RGNL HOSP & MC-EUCLID Orange $45,284,901 $75,110,171 0.603 0.856 0.932 0.919
106301283 GARDEN GROVE HOSPITAL & MEDICAL CENTER Orange $8,358,871 $15,623,707 0.535 0.760 0.932 0.816
106301205 HOAG MEMORIAL HOSPITAL PRESBYTERIAN Orange $129,423,945 $181,718,516 0.712 1.012 0.932 1.086
106301209 HUNTINGTON BEACH HOSPITAL Orange $6,683,558 $14,743,895 0.453 0.644 0.932 0.691
106304045 IRVINE MEDICAL CENTER Orange $33,009,247 $58,283,052 0.566 0.804 0.932 0.864
106301234 LA PALMA INTERCOMMUNITY HOSPITAL Orange $9,780,557 $21,227,791 0.461 0.654 0.932 0.702
106301248 LOS ALAMITOS MEDICAL CENTER Orange $15,185,776 $29,008,302 0.523 0.744 0.932 0.798
106301262 MISSION HOSPITAL REGIONAL MEDICAL CENTER Orange $66,153,206 $93,932,380 0.704 1.000 0.932 1.074
106300225 ORANGE COAST MEMORIAL MEDICAL CENTER Orange $48,859,552 $76,785,678 0.636 0.904 0.932 0.970
106301297 PLACENTIA-LINDA COMMUNITY HOSPITAL Orange $11,501,599 $21,330,396 0.539 0.766 0.932 0.822
106301317 SADDLEBACK MEMORIAL MEDICAL CENTER Orange $55,981,692 $86,462,943 0.647 0.920 0.932 0.987
106301337 SOUTH COAST MEDICAL CENTER Orange $15,398,291 $20,779,392 0.741 1.053 0.932 1.130
106301340 ST. JOSEPH HOSPITAL - ORANGE Orange $111,702,913 $169,132,295 0.660 0.938 0.932 1.007
106301342 ST. JUDE MEDICAL CENTER Orange $62,032,451 $84,578,517 0.733 1.042 0.932 1.118
106301357 TUSTIN HOSPITAL MEDICAL CENTER Orange $602,262 $1,291,100 0.466 0.663 0.932 0.711
106304079 TUSTIN REHABILITATION HOSPITAL Orange $2,755,522 $3,002,531 0.918 1.304 0.932 1.399
106301279 UNIVERSITY OF CALIFORNIA IRVINE MED CTR Orange $73,832,353 $84,170,507 0.877 1.246 0.932 1.337
106301379 WEST ANAHEIM MEDICAL CENTER Orange $12,853,560 $32,846,143 0.391 0.556 0.932 0.597
106301188 WESTERN MEDICAL CENTER-ANAHEIM Orange $5,823,955 $9,019,020 0.646 0.917 0.932 0.985
106301566 WESTERN MEDICAL CENTER-SANTA ANA Orange $28,582,678 $50,629,863 0.565 0.802 0.932 0.861
106361105 BARSTOW COMMUNITY HOSPITAL Riverside-San Bernardino $2,656,632 $5,920,612 0.449 0.637 0.923 0.691
106364050 CANYON RIDGE HOSPITAL Riverside-San Bernardino $2,736,803 $6,039,975 0.453 0.644 0.923 0.697
106361144 CHINO VALLEY MEDICAL CENTER Riverside-San Bernardino $8,075,892 $16,849,869 0.479 0.681 0.923 0.738
106361458 COLORADO RIVER MEDICAL CENTER Riverside-San Bernardino $2,895,533 $5,562,194 0.521 0.739 0.923 0.801
106361323 COMMUNITY HOSPITAL OF SAN BERNARDINO Riverside-San Bernardino $4,997,562 $9,221,743 0.542 0.770 0.923 0.834
106331152 CORONA REGIONAL MEDICAL CENTER Riverside-San Bernardino $20,004,806 $46,288,455 0.432 0.614 0.923 0.665
106331164 DESERT REGIONAL MEDICAL CENTER Riverside-San Bernardino $44,682,040 $72,266,728 0.618 0.878 0.923 0.952
106364144 DESERT VALLEY HOSPITAL Riverside-San Bernardino $21,087,934 $37,831,094 0.557 0.792 0.923 0.858
106361166 DOCTORS HSP MED CTR OF MONTCLAIR Riverside-San Bernardino $9,956,128 $21,816,236 0.456 0.648 0.923 0.702
106331168 EISENHOWER MEDICAL CENTER Riverside-San Bernardino $38,977,463 $62,886,990 0.620 0.880 0.923 0.954
106331194 HEMET VALLEY MEDICAL CENTER Riverside-San Bernardino $8,663,079 $20,088,912 0.431 0.613 0.923 0.664
106362041 HI-DESERT MEDICAL CENTER Riverside-San Bernardino $5,099,587 $10,413,314 0.490 0.696 0.923 0.754
106331216 JOHN F. KENNEDY MEMORIAL HOSPITAL Riverside-San Bernardino $8,486,314 $15,154,250 0.560 0.795 0.923 0.862
106364014 LOMA LINDA UNIVERSITY BEHAVIORAL MEDICIN Riverside-San Bernardino $8,281,133 $15,186,029 0.545 0.775 0.923 0.839
106361246 LOMA LINDA UNIVERSITY MEDICAL CENTER Riverside-San Bernardino $133,830,089 $195,428,025 0.685 0.973 0.923 1.054
106334018 MENIFEE VALLEY MEDICAL CENTER Riverside-San Bernardino $2,987,904 $6,735,360 0.444 0.630 0.923 0.683
106334048 MORENO VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino $5,383,753 $11,674,505 0.461 0.655 0.923 0.710
106361266 MOUNTAINS COMMUNITY HOSPITAL Riverside-San Bernardino $1,067,322 $1,582,151 0.675 0.958 0.923 1.038
106331288 PALO VERDE HOSPITAL Riverside-San Bernardino $2,631,938 $3,424,700 0.769 1.092 0.923 1.183
106331293 PARKVIEW COMMUNITY HOSPITAL Riverside-San Bernardino $16,102,943 $24,734,302 0.651 0.925 0.923 1.002
106361308 REDLANDS COMMUNITY HOSPITAL Riverside-San Bernardino $34,627,760 $60,816,992 0.569 0.809 0.923 0.876
106331226 RIVERSIDE CENTER FOR BEHAVIORAL MEDICINE Riverside-San Bernardino $533,263 $740,098 0.721 1.023 0.923 1.109
106331312 RIVERSIDE COMMUNITY HOSPITAL Riverside-San Bernardino $46,227,582 $93,257,107 0.496 0.704 0.923 0.763
106334487 RIVERSIDE COUNTY REGIONAL MEDICAL CENTER Riverside-San Bernardino $26,281,573 $40,672,190 0.646 0.918 0.923 0.994
106361318 SAN ANTONIO COMMUNITY HOSPITAL Riverside-San Bernardino $49,131,715 $89,185,511 0.551 0.782 0.923 0.848
106334068 SOUTHWEST HEALTHCARE SYSTEM-MURRIETA Riverside-San Bernardino $53,583,970 $126,475,795 0.424 0.602 0.923 0.652
106361339 ST. BERNARDINE MEDICAL CENTER Riverside-San Bernardino $41,585,609 $82,360,958 0.505 0.717 0.923 0.777
106361370 VICTOR VALLEY COMMUNITY HOSPITAL Riverside-San Bernardino $7,390,183 $20,782,702 0.356 0.505 0.923 0.547
106090793 BARTON MEMORIAL HOSPITAL Sacramento $16,106,425 $18,468,826 0.872 1.239 1.028 1.205
106340947 MERCY GENERAL HOSPITAL Sacramento $75,419,720 $125,258,941 0.602 0.855 1.028 0.832
106344029 MERCY HOSPITAL - FOLSOM Sacramento $12,577,935 $23,311,762 0.540 0.766 1.028 0.745
106340950 MERCY SAN JUAN HOSPITAL Sacramento $50,677,218 $83,822,585 0.605 0.859 1.028 0.835
106340951 METHODIST HOSPITAL OF SACRAMENTO Sacramento $16,020,930 $24,135,799 0.664 0.943 1.028 0.917
106342392 SIERRA VISTA HOSPITAL Sacramento $4,794,105 $8,304,177 0.577 0.820 1.028 0.798
106310791 SUTTER AUBURN FAITH HOSPITAL Sacramento $9,968,168 $14,831,172 0.672 0.955 1.028 0.929
106344017 SUTTER CENTER FOR PSYCHIATRY Sacramento $7,805,736 $9,911,150 0.788 1.119 1.028 1.088
106574010 SUTTER DAVIS HOSPITAL Sacramento $7,410,523 $12,219,154 0.606 0.861 1.028 0.838
106341051 SUTTER MEDICAL CENTER-SACRAMENTO Sacramento $118,299,171 $154,609,830 0.765 1.087 1.028 1.057
106311000 SUTTER ROSEVILLE MEDICAL CENTER Sacramento $52,562,336 $76,391,045 0.688 0.977 1.028 0.951
106341006 UNIVERSITY OF CALIFORNIA DAVIS MED CTR Sacramento $164,471,344 $164,233,095 1.001 1.422 1.028 1.384
106571086 WOODLAND MEMORIAL HOSPITAL Sacramento $8,475,763 $13,379,888 0.633 0.900 1.028 0.875
106370652 ALVARADO HOSPITAL MEDICAL CENTER San Diego $16,525,209 $26,002,775 0.636 0.903 0.923 0.978
106370749 ALVARADO PARKWAY INSTITUTE BHS San Diego $958,374 $2,234,747 0.429 0.609 0.923 0.660
106374024 AURORA SAN DIEGO San Diego $5,725,614 $9,531,660 0.601 0.853 0.923 0.924
106370673 CHILDRENS HOSPITAL-SAN DIEGO San Diego $78,754,084 $120,326,460 0.655 0.930 0.923 1.007
CMM 10/12/2007 11:26 AM

Milliman
Attachment D
Hospital Cost Index
(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

Cost Based
Area
106130699 EL CENTRO REGIONAL MEDICAL CENTER San Diego $6,864,546 $13,889,159 0.494 0.702 0.923 0.761
106370705 FALLBROOK HOSPITAL DISTRICT San Diego $4,166,303 $8,380,780 0.497 0.706 0.923 0.765
106370714 GROSSMONT HOSPITAL San Diego $53,542,736 $82,624,038 0.648 0.920 0.923 0.997
106370755 PALOMAR MEDICAL CENTER San Diego $51,401,818 $79,725,688 0.645 0.916 0.923 0.992
106370759 PARADISE VALLEY HOSPITAL San Diego $7,758,975 $14,283,266 0.543 0.772 0.923 0.836
106130760 PIONEERS MEMORIAL HOSPITAL San Diego $6,504,157 $11,324,047 0.574 0.816 0.923 0.884
106370977 POMERADO HOSPITAL San Diego $21,824,728 $30,850,337 0.707 1.005 0.923 1.089
106374084 SAN DIEGO HOSPICE ACUTE CARE CENTER San Diego $879,551 $1,580,490 0.557 0.790 0.923 0.856
106371256 SCRIPPS GREEN HOSPITAL San Diego $48,438,757 $85,093,804 0.569 0.809 0.923 0.876
106371394 SCRIPPS MEMORIAL HOSPITAL - ENCINITAS San Diego $24,147,431 $33,881,539 0.713 1.012 0.923 1.097
106370771 SCRIPPS MEMORIAL HOSPITAL-LA JOLLA San Diego $93,433,903 $145,181,054 0.644 0.914 0.923 0.990
106370744 SCRIPPS MERCY HOSPITAL San Diego $60,906,865 $107,565,528 0.566 0.804 0.923 0.871
106370875 SHARP CHULA VISTA MEDICAL CENTER San Diego $21,973,102 $37,971,008 0.579 0.822 0.923 0.891
106370689 SHARP CORONADO HOSPITAL & HEALTHCARE CTR San Diego $5,249,042 $8,471,110 0.620 0.880 0.923 0.954
106370695 SHARP MARY BIRCH HOSPITAL FOR WOMEN San Diego $45,297,079 $74,716,699 0.606 0.861 0.923 0.933
106370694 SHARP MEMORIAL HOSPITAL San Diego $88,643,487 $128,015,089 0.692 0.984 0.923 1.066
106374049 SHARP VISTA PACIFICA San Diego $814,728 $974,177 0.836 1.188 0.923 1.287
106370780 TRI-CITY MEDICAL CENTER San Diego $36,984,019 $65,449,074 0.565 0.803 0.923 0.870
106370782 UNIVERSITY OF CALIF - SAN DIEGO MED CTR San Diego $89,051,295 $133,475,874 0.667 0.948 0.923 1.027
106380929 CALIFORNIA PACIFIC MEDICAL CENTER San Francisco-San Mateo-Marin $243,194,900 $246,082,464 0.988 1.404 1.171 1.199
106382715 CHINESE HOSPITAL San Francisco-San Mateo-Marin $1,610,589 $1,993,073 0.808 1.148 1.171 0.980
106210993 KENTFIELD REHABILITATION CENTER San Francisco-San Mateo-Marin $3,500,494 $2,661,887 1.315 1.868 1.171 1.595
106380868 LANGLEY PORTER PSYCHIATRIC INSTITUTE San Francisco-San Mateo-Marin $4,948,067 $3,582,329 1.381 1.962 1.171 1.676
106211006 MARIN GENERAL HOSPITAL San Francisco-San Mateo-Marin $47,749,035 $49,622,105 0.962 1.367 1.171 1.167
106214034 NOVATO COMMUNITY HOSPITAL - CURRENT LOC San Francisco-San Mateo-Marin $6,196,270 $7,049,841 0.879 1.248 1.171 1.066
106410852 PENINSULA MEDICAL CENTER San Francisco-San Mateo-Marin $59,000,863 $70,015,563 0.843 1.197 1.171 1.022
106410891 SEQUOIA HOSPITAL San Francisco-San Mateo-Marin $39,855,366 $52,878,968 0.754 1.071 1.171 0.914
106410817 SETON MEDICAL CENTER San Francisco-San Mateo-Marin $28,444,679 $33,978,932 0.837 1.189 1.171 1.016
106380960 ST. FRANCIS MEMORIAL HOSPITAL San Francisco-San Mateo-Marin $19,960,354 $25,605,263 0.780 1.107 1.171 0.946
106380964 ST. LUKES HOSPITAL San Francisco-San Mateo-Marin $9,198,923 $10,570,698 0.870 1.236 1.171 1.056
106380965 ST. MARYS MEDICAL CENTER San Francisco-San Mateo-Marin $28,005,612 $30,782,357 0.910 1.292 1.171 1.104
106381154 UCSF MEDICAL CENTER San Francisco-San Mateo-Marin $246,944,538 $308,670,077 0.800 1.136 1.171 0.971
106490964 HEALDSBURG DISTRICT HOSPITAL Sonoma-Napa $749,790 $1,329,168 0.564 0.801 1.107 0.724
106491338 PALM DRIVE HOSPITAL Sonoma-Napa $2,693,376 $4,597,847 0.586 0.832 1.107 0.752
106491001 PETALUMA VALLEY HOSPITAL Sonoma-Napa $5,920,065 $7,905,594 0.749 1.064 1.107 0.961
106281047 QUEEN OF THE VALLEY HOSPITAL Sonoma-Napa $19,884,123 $25,575,479 0.777 1.104 1.025 1.077
106491064 SANTA ROSA MEMORIAL HOSPITAL Sonoma-Napa $57,157,257 $69,596,825 0.821 1.167 1.107 1.054
106491076 SONOMA VALLEY HOSPITAL Sonoma-Napa $2,983,719 $4,471,512 0.667 0.948 1.107 0.857
106281078 ST. HELENA HOSPITAL Sonoma-Napa $11,392,893 $16,344,389 0.697 0.990 1.025 0.966
106490919 SUTTER MEDICAL CENTER OF SANTA ROSA Sonoma-Napa $25,554,889 $30,220,628 0.846 1.201 1.107 1.085
106430743 COMMUNITY HOSPITAL OF LOS GATOS South Bay $27,074,871 $30,592,982 0.885 1.257 1.165 1.079
106430763 EL CAMINO HOSPITAL South Bay $74,294,140 $101,373,236 0.733 1.041 1.165 0.893
106270777 GEORGE L. MEE MEMORIAL HOSPITAL South Bay $3,318,143 $3,043,234 1.090 1.549 1.101 1.407
106430779 GOOD SAMARITAN HOSPITAL - SAN JOSE South Bay $135,957,944 $169,516,144 0.802 1.139 1.165 0.978
106350784 HAZEL HAWKINS MEMORIAL HOSPITAL South Bay $7,009,291 $8,062,759 0.869 1.235 1.165 1.060
106434040 LUCILE S PACKARD CHILDRENS HOSPITAL South Bay $195,465,050 $159,572,682 1.225 1.740 1.165 1.493
106430837 O CONNOR HOSPITAL South Bay $41,480,796 $55,396,727 0.749 1.064 1.165 0.913
106430705 REGIONAL MEDICAL CENTER OF SAN JOSE South Bay $31,960,038 $38,811,052 0.823 1.170 1.165 1.004
106270875 SALINAS VALLEY MEMORIAL HOSPITAL South Bay $61,712,770 $63,810,437 0.967 1.374 1.101 1.248
106430883 SANTA CLARA VALLEY MEDICAL CENTER South Bay $55,881,078 $41,606,300 1.343 1.908 1.165 1.637
106434138 ST. LOUISE REGIONAL HOSPITAL South Bay $10,529,316 $12,999,929 0.810 1.150 1.165 0.987
106430905 STANFORD UNIVERSITY HOSPITAL South Bay $244,497,209 $242,698,051 1.007 1.431 1.165 1.228
106444013 WATSONVILLE COMMUNITY HOSPITAL South Bay $12,030,298 $14,576,497 0.825 1.172 1.150 1.020
CMM 10/12/2007 11:26 AM

Milliman
Attachment E
California IPPS Medicare Geographic Factors (Effective 10/1/2006)
Weight Applied
64% 8%
CBSA
Code Urban Area (Constituent Counties) Wage Index GAF Avg*
12540 ²Bakersfield, CA 1.120 1.081 1.083
Kern County, CA
17020 ²Chico, CA 1.120 1.081 1.083
Butte County, CA
20940 ²El Centro, CA 1.120 1.081 1.083
Imperial County, CA
23420 ²Fresno, CA 1.120 1.081 1.083
Fresno County, CA
25260 ²Hanford-Corcoran, CA 1.120 1.081 1.083
Kings County, CA
31084 ¹Los Angeles-Long Beach-Glendale, CA 1.169 1.113 1.117
Los Angeles County, CA
31460 ²Madera, CA 1.120 1.081 1.083
Madera County, CA
32900 Merced, CA 1.141 1.095 1.098
Merced County, CA
33700 Modesto, CA 1.174 1.116 1.120
Stanislaus County, CA
34900 Napa, CA 1.293 1.193 1.203
Napa County, CA
36084 ¹Oakland-Fremont-Hayward, CA 1.562 1.357 1.388
Alameda County, CA
Contra Costa County, CA
37100 ²Oxnard-Thousand Oaks-Ventura, CA 1.120 1.081 1.083
Ventura County, CA
39820 Redding, CA 1.245 1.162 1.170
Shasta County, CA
40140 ¹,²Riverside-San Bernardino-Ontario, CA 1.120 1.081 1.083
Riverside County, CA
San Bernardino County, CA
40900 ¹Sacramento--Arden-Arcade--Roseville, CA 1.299 1.196 1.207
El Dorado County, CA
Placer County, CA
Sacramento County, CA
Yolo County, CA
41500 Salinas, CA 1.422 1.273 1.292
Monterey County, CA
41740 ¹,²San Diego-Carlsbad-San Marcos, CA 1.120 1.081 1.083
San Diego County, CA
41884 ¹San Francisco-San Mateo-Redwood City, CA 1.542 1.345 1.374
Marin County, CA
San Francisco County, CA
San Mateo County, CA
41940 ¹San Jose-Sunnyvale-Santa Clara, CA 1.532 1.340 1.368
San Benito County, CA
Santa Clara County, CA
CMM 10/12/2007 11:27 AM

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Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [Att E] Page 1 of 2
Attachment E
California IPPS Medicare Geographic Factors (Effective 10/1/2006)
Weight Applied
64% 8%
CBSA
Code Urban Area (Constituent Counties) Wage Index GAF Avg*
42020 ²San Luis Obispo-Paso Robles, CA 1.120 1.081 1.083
San Luis Obispo County, CA
42044 ¹Santa Ana-Anaheim-Irvine, CA 1.135 1.091 1.094
Orange County, CA
42060 ²Santa Barbara-Santa Maria, CA 1.120 1.081 1.083
Santa Barbara County, CA
42100 Santa Cruz-Watsonville, CA 1.506 1.323 1.350
Santa Cruz County, CA
42220 Santa Rosa-Petaluma, CA 1.432 1.279 1.299
Sonoma County, CA
44700 Stockton, CA 1.147 1.099 1.102
San Joaquin County, CA
46700 Vallejo-Fairfield, CA 1.479 1.308 1.331
Solano County, CA
47300 ²Visalia-Porterville, CA 1.120 1.081 1.083
Tulare County, CA
49700 ²Yuba City, CA 1.120 1.081 1.083
Sutter County, CA
Yuba County, CA
*Average is calculated as 64% of the Wage Index value plus 8% of the GAF value plus 28% of
1.0.
1
Large urban area.
2
Hospitals geographically located in the area are assigned the statewide rural wage index for FY
2007.
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Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [Att E] Page 2 of 2
Attachment F
County Reference Table
Normalized
Medicare Medicare
County Medicare Area Area Factor Area Factor Cost Index Area
Alameda ¹Oakland-Fremont-Hayward, CA 1.388 1.182 Alameda-Contra Costa-Solano
Alpine Rural 1.083 0.923 Central
Amador Rural 1.083 0.923 Central
Butte ²Chico, CA 1.083 0.923 North
Calaveras Rural 1.083 0.923 Central
Colusa Rural 1.083 0.923 North
Contra Costa ¹Oakland-Fremont-Hayward, CA 1.388 1.182 Alameda-Contra Costa-Solano
Del Norte Rural 1.083 0.923 North
El Dorado ¹Sacramento--Arden-Arcade--Roseville, CA 1.207 1.028 Sacramento
Fresno ²Fresno, CA 1.083 0.923 Central
Glenn Rural 1.083 0.923 North
Humboldt Rural 1.083 0.923 North
Imperial ²El Centro, CA 1.083 0.923 San Diego
Inyo Rural 1.083 0.923 Central
Kern ²Bakersfield, CA 1.083 0.923 Central
Kings ²Hanford-Corcoran, CA 1.083 0.923 Central
Lake Rural 1.083 0.923 North
Lassen Rural 1.083 0.923 North
Los Angeles ¹Los Angeles-Long Beach-Glendale, CA 1.117 0.951 Los Angeles-Long Beach-Glendale*
Madera ²Madera, CA 1.083 0.923 Central
Marin ¹San Francisco-San Mateo-Redwood City, CA 1.374 1.171 San Francisco-San Mateo-Marin
Mariposa Rural 1.083 0.923 Central
Mendocino Rural 1.083 0.923 North
Merced Merced, CA 1.098 0.935 Central
Modoc Rural 1.083 0.923 North
Mono Rural 1.083 0.923 Central
Monterey Salinas, CA 1.292 1.101 South Bay
Napa Napa, CA 1.203 1.025 Sonoma-Napa
Nevada Rural 1.083 0.923 North
Orange ¹Santa Ana-Anaheim-Irvine, CA 1.094 0.932 Orange
Placer ¹Sacramento--Arden-Arcade--Roseville, CA 1.207 1.028 Sacramento
Plumas Rural 1.083 0.923 North
Riverside ¹,²Riverside-San Bernardino-Ontario, CA 1.083 0.923 Riverside-San Bernardino
Sacramento ¹Sacramento--Arden-Arcade--Roseville, CA 1.207 1.028 Sacramento
San Benito ¹San Jose-Sunnyvale-Santa Clara, CA 1.368 1.165 South Bay
San Bernardino ¹,²Riverside-San Bernardino-Ontario, CA 1.083 0.923 Riverside-San Bernardino
San Diego ¹,²San Diego-Carlsbad-San Marcos, CA 1.083 0.923 San Diego
San Francisco ¹San Francisco-San Mateo-Redwood City, CA 1.374 1.171 San Francisco-San Mateo-Marin
San Joaquin Stockton, CA 1.102 0.939 Central
San Luis Obispo ²San Luis Obispo-Paso Robles, CA 1.083 0.923 Central Coast
San Mateo ¹San Francisco-San Mateo-Redwood City, CA 1.374 1.171 San Francisco-San Mateo-Marin
Santa Barbara ²Santa Barbara-Santa Maria, CA 1.083 0.923 Central Coast
Santa Clara ¹San Jose-Sunnyvale-Santa Clara, CA 1.368 1.165 South Bay
Santa Cruz Santa Cruz-Watsonville, CA 1.350 1.150 South Bay
Shasta Redding, CA 1.170 0.997 North
Sierra Rural 1.083 0.923 North
Siskiyou Rural 1.083 0.923 North
Solano Vallejo-Fairfield, CA 1.331 1.134 Alameda-Contra Costa-Solano
Sonoma Santa Rosa-Petaluma, CA 1.299 1.107 Sonoma-Napa
Stanislaus Modesto, CA 1.120 0.954 Central
Sutter ²Yuba City, CA 1.083 0.923 North
Tehama Rural 1.083 0.923 North
Trinity Rural 1.083 0.923 North
Tulare ²Visalia-Porterville, CA 1.083 0.923 Central
Tuolumne Rural 1.083 0.923 Central
Ventura ²Oxnard-Thousand Oaks-Ventura, CA 1.083 0.923 Central Coast
Yolo ¹Sacramento--Arden-Arcade--Roseville, CA 1.207 1.028 Sacramento
Yuba ²Yuba City, CA 1.083 0.923 North
* Los Angeles county is divided into four Areas
CMM 10/12/2007 11:27 AM

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Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [Att F] Page 1 of 1
Attachment G-1
Buyer Cost Index (BCI), Hospital Cost Index (HCI) and Ratio - Sort Descending by BCI
Limited to Hospitals with $10 million or greater Estimated Third Party Managed Care Allowed
(A) (B) (C=A/B)
Area Area Inpatient
Teaching
Adjusted Adjusted Percent
Major
Buyer Cost Hospital Indigent and
OSHPD ID Hospital Region Index Cost Index Ratio Medi-Cal
106484001 VACA VALLEY HOSPITAL Alameda-Contra Costa-Solano 2.078 1.210 1.718 0.163
106481357 NORTH BAY MEDICAL CENTER Alameda-Contra Costa-Solano 2.002 1.119 1.789 0.361
106190555 CEDARS-SINAI MEDICAL CENTER Los Angeles-NE 1.790 1.430 1.251 0.112
106171395 SUTTER LAKESIDE HOSPITAL North 1.772 1.282 1.382 0.185
106191228 LAC/USC MEDICAL CENTER Los Angeles-NE T 1.629 1.631 0.999 0.871
106341006 UNIVERSITY OF CALIFORNIA DAVIS MED CTR Sacramento T 1.597 1.384 1.154 0.395
106341051 SUTTER MEDICAL CENTER-SACRAMENTO Sacramento 1.578 1.057 1.492 0.257
106090793 BARTON MEMORIAL HOSPITAL Sacramento 1.572 1.205 1.305 0.229
106500852 DOCTORS MEDICAL CENTER Central 1.567 0.997 1.572 0.384
106291053 TAHOE FOREST HOSPITAL North 1.554 1.707 0.911 0.154
106361144 CHINO VALLEY MEDICAL CENTER Riverside-San Bernardino 1.550 0.738 2.102 0.333
106434040 LUCILE S PACKARD CHILDRENS HOSPITAL South Bay 1.530 1.493 1.024 0.370
106301342 ST. JUDE MEDICAL CENTER Orange 1.509 1.118 1.350 0.071
106270875 SALINAS VALLEY MEMORIAL HOSPITAL South Bay 1.495 1.248 1.198 0.112
106010987 WASHINGTON HOSPITAL - FREMONT Alameda-Contra Costa-Solano 1.452 1.102 1.317 0.192
106410817 SETON MEDICAL CENTER San Francisco-San Mateo-Marin 1.422 1.016 1.400 0.218
106390923 LODI MEMORIAL HOSPITAL Central 1.400 0.927 1.511 0.277
106380929 CALIFORNIA PACIFIC MEDICAL CENTER San Francisco-San Mateo-Marin 1.378 1.199 1.149 0.121
106430883 SANTA CLARA VALLEY MEDICAL CENTER South Bay 1.369 1.637 0.836 0.691
106580996 RIDEOUT MEMORIAL HOSPITAL North 1.334 0.873 1.527 0.232
106400548 TWIN CITIES COMMUNITY HOSPITAL Central Coast 1.331 1.011 1.317 0.127
106311000 SUTTER ROSEVILLE MEDICAL CENTER Sacramento 1.331 0.951 1.400 0.176
106070988 JOHN MUIR MEDICAL CENTER Alameda-Contra Costa-Solano 1.318 1.184 1.113 0.045
106010805 EDEN MEDICAL CENTER Alameda-Contra Costa-Solano 1.288 0.924 1.394 0.130
106301262 MISSION HOSPITAL REGIONAL MEDICAL CENTER Orange 1.270 1.074 1.183 0.102
106211006 MARIN GENERAL HOSPITAL San Francisco-San Mateo-Marin 1.269 1.167 1.087 0.145
106310791 SUTTER AUBURN FAITH HOSPITAL Sacramento 1.260 0.929 1.357 0.126
106380964 ST. LUKES HOSPITAL San Francisco-San Mateo-Marin 1.258 1.056 1.192 0.422
106121080 ST. JOSEPH HOSPITAL - EUREKA North 1.258 1.030 1.221 0.194
106194219 USC UNIVERSITY HOSPITAL Los Angeles-NE 1.248 1.217 1.026 0.163
106400524 SIERRA VISTA REGIONAL MEDICAL CENTER Central Coast 1.244 1.084 1.147 0.187
106370714 GROSSMONT HOSPITAL San Diego 1.240 0.997 1.243 0.206
106331164 DESERT REGIONAL MEDICAL CENTER Riverside-San Bernardino 1.236 0.952 1.299 0.268
106392287 DOCTORS HOSPITAL OF MANTECA Central 1.228 0.925 1.327 0.126
106370875 SHARP CHULA VISTA MEDICAL CENTER San Diego 1.222 0.891 1.372 0.241
106300032 CHILDRENS HOSPITAL OF ORANGE COUNTY Orange 1.216 1.453 0.836 0.538
106371394 SCRIPPS MEMORIAL HOSPITAL - ENCINITAS San Diego 1.206 1.097 1.099 0.089
106430905 STANFORD UNIVERSITY HOSPITAL South Bay T 1.194 1.228 0.972 0.108
106370694 SHARP MEMORIAL HOSPITAL San Diego 1.192 1.066 1.119 0.135
106301279 UNIVERSITY OF CALIFORNIA IRVINE MED CTR Orange T 1.192 1.337 0.891 0.466
106190176 CITY OF HOPE NATIONAL MEDICAL CENTER Los Angeles-SE 1.186 1.388 0.855 0.183
106340950 MERCY SAN JUAN HOSPITAL Sacramento 1.185 0.835 1.419 0.272
106190762 ST. VINCENT MEDICAL CENTER Los Angeles-NE 1.176 0.903 1.302 0.168
106560508 ST. JOHNS PLEASANT VALLEY HOSPITAL Central Coast 1.169 1.011 1.157 0.064
106370652 ALVARADO HOSPITAL MEDICAL CENTER San Diego 1.165 0.978 1.191 0.171
106196168 E & L MILLER CHILDRENS HOSPITAL Los Angeles-SW 1.162 1.322 0.879 0.316
106281047 QUEEN OF THE VALLEY HOSPITAL Sonoma-Napa 1.157 1.077 1.074 0.121
106190930 UCLA NEUROPSYCHIATRIC HOSPITAL Los Angeles-NE 1.143 2.397 0.477 0.062
106491064 SANTA ROSA MEMORIAL HOSPITAL Sonoma-Napa 1.135 1.054 1.076 0.182
106540798 SIERRA VIEW DISTRICT HOSPITAL Central 1.132 0.692 1.637 0.386
106301205 HOAG MEMORIAL HOSPITAL PRESBYTERIAN Orange 1.124 1.086 1.035 0.044
106380965 ST. MARYS MEDICAL CENTER San Francisco-San Mateo-Marin 1.121 1.104 1.016 0.070
106240942 MERCY MERCED MED CTR-COMMUNITY CAMPUS Central 1.116 0.895 1.247 0.295
106361246 LOMA LINDA UNIVERSITY MEDICAL CENTER Riverside-San Bernardino T 1.115 1.054 1.058 0.437
106434138 ST. LOUISE REGIONAL HOSPITAL South Bay 1.112 0.987 1.126 0.155
106560492 LOS ROBLES REGIONAL MEDICAL CENTER Central Coast 1.092 0.857 1.275 0.040
106304113 CHILDRENS HOSPITAL AT MISSION Orange 1.092 1.296 0.843 0.219
106444013 WATSONVILLE COMMUNITY HOSPITAL South Bay 1.089 1.020 1.068 0.286
106490919 SUTTER MEDICAL CENTER OF SANTA ROSA Sonoma-Napa 1.077 1.085 0.992 0.265
106160725 HANFORD COMMUNITY HOSPITAL Central 1.077 1.040 1.036 0.208
106150736 KERN MEDICAL CENTER Central 1.076 1.235 0.871 0.733
106410891 SEQUOIA HOSPITAL San Francisco-San Mateo-Marin 1.068 0.914 1.168 0.027
106010983 VALLEY MEMORIAL HOSPITAL Alameda-Contra Costa-Solano 1.067 1.106 0.965 0.074
106430705 REGIONAL MEDICAL CENTER OF SAN JOSE South Bay 1.061 1.004 1.057 0.179
106190859 WEST HILLS HOSPITAL & MEDICAL CENTER Los Angeles-NW 1.042 1.031 1.011 0.053
106370695 SHARP MARY BIRCH HOSPITAL FOR WOMEN San Diego 1.040 0.933 1.114 0.334
106040962 ENLOE MEDICAL CENTER - ESPLANADE CAMPUS North 1.038 0.958 1.083 0.189
106391042 ST. JOSEPHS MEDICAL CENTER OF STOCKTON Central 1.037 0.822 1.262 0.225
106370755 PALOMAR MEDICAL CENTER San Diego 1.033 0.992 1.041 0.230
106340951 METHODIST HOSPITAL OF SACRAMENTO Sacramento 1.031 0.917 1.124 0.354
106500939 MEMORIAL HOSPITAL MODESTO Central 1.028 1.034 0.995 0.140
106560529 ST. JOHNS REGIONAL MEDICAL CENTER Central Coast 1.025 1.027 0.998 0.124
106190680 LITTLE CO OF MARY-SAN PEDRO HOSPITAL Los Angeles-SW 1.022 0.947 1.078 0.400
CMM 10/12/2007 11:28 AM

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Q:\Projects\WFox\PBGH\60 Public\Reports\Attach G 20071012.xls\ [G-1] Attachment G-1 Page 1 of 3
Attachment G-1
(A) (B) (C=A/B)
Area Area Inpatient
Teaching
Major
106190568 NORTHRIDGE HOSPITAL MEDICAL CENTER Los Angeles-NW 1.021 0.991 1.030 0.226
106190631 PRESBYTERIAN INTERCOMMUNITY HOSPITAL Los Angeles-SE 1.021 0.824 1.238 0.168
106370771 SCRIPPS MEMORIAL HOSPITAL-LA JOLLA San Diego 1.002 0.990 1.012 0.053
106331293 PARKVIEW COMMUNITY HOSPITAL Riverside-San Bernardino 1.002 1.002 1.000 0.278
106420493 MARIAN MEDICAL CENTER Central Coast 0.999 0.902 1.108 0.228
106331168 EISENHOWER MEDICAL CENTER Riverside-San Bernardino 0.999 0.954 1.047 0.032
106331312 RIVERSIDE COMMUNITY HOSPITAL Riverside-San Bernardino 0.994 0.763 1.304 0.185
106150722 BAKERSFIELD MEMORIAL HOSPITAL Central 0.994 0.764 1.301 0.124
106371256 SCRIPPS GREEN HOSPITAL San Diego 0.981 0.876 1.120 0.011
106190517 ENCINO TARZANA REGIONAL MEDICAL CENTER Los Angeles-NW 0.980 0.978 1.001 0.179
106574010 SUTTER DAVIS HOSPITAL Sacramento 0.975 0.838 1.163 0.265
106430837 O CONNOR HOSPITAL South Bay 0.970 0.913 1.062 0.127
106071018 MT DIABLO MEDICAL CENTER Alameda-Contra Costa-Solano 0.965 0.986 0.978 0.089
106370744 SCRIPPS MERCY HOSPITAL San Diego 0.963 0.871 1.105 0.229
106190630 POMONA VALLEY HOSPITAL MEDICAL CENTER Los Angeles-SE 0.957 0.904 1.059 0.408
106070934 SUTTER DELTA MEDICAL CENTER Alameda-Contra Costa-Solano 0.955 0.963 0.992 0.183
106204019 CHILDRENS HOSP CENTRAL CALIF Central 0.955 1.052 0.907 0.712
106370977 POMERADO HOSPITAL San Diego 0.953 1.089 0.875 0.136
106301337 SOUTH COAST MEDICAL CENTER Orange 0.953 1.130 0.843 0.131
106430763 EL CAMINO HOSPITAL South Bay 0.951 0.893 1.064 0.073
106190148 CENTINELA FREEMAN MED CTR-CENTINELA Los Angeles-SW 0.950 0.759 1.251 0.259
106010739 ALTA BATES SUMMIT MED CTR-ALTA BATES Alameda-Contra Costa-Solano 0.947 1.305 0.725 0.347
106364144 DESERT VALLEY HOSPITAL Riverside-San Bernardino 0.945 0.858 1.102 0.150
106500867 EMANUEL MEDICAL CENTER Central 0.922 0.821 1.123 0.166
106190323 GLENDALE ADVENTIST MEDICAL CENTER Los Angeles-NW 0.919 0.920 0.998 0.290
106301317 SADDLEBACK MEMORIAL MEDICAL CENTER Orange 0.917 0.987 0.929 0.028
106361308 REDLANDS COMMUNITY HOSPITAL Riverside-San Bernardino 0.916 0.876 1.045 0.120
106344029 MERCY HOSPITAL - FOLSOM Sacramento 0.913 0.745 1.225 0.088
106190812 VALLEY PRESBYTERIAN HOSPITAL Los Angeles-NW 0.912 0.859 1.061 0.487
106190400 HUNTINGTON MEMORIAL HOSPITAL Los Angeles-NE 0.911 0.927 0.983 0.152
106010937 SUMMIT MEDICAL CENTER Alameda-Contra Costa-Solano 0.908 0.827 1.098 0.169
106100717 COMMUNITY REGIONAL MEDICAL CENTER Central 0.903 0.952 0.948 0.466
106560525 SIMI VALLEY HOSP & HLTH SVCS-SYCAMORE Central Coast 0.902 0.877 1.029 0.119
106370782 UNIVERSITY OF CALIF - SAN DIEGO MED CTR San Diego T 0.898 1.027 0.875 0.394
106191216 USC KENNETH NORRIS JR. CANCER HOSPITAL Los Angeles-NE 0.881 1.084 0.813 0.010
106301340 ST. JOSEPH HOSPITAL - ORANGE Orange 0.876 1.007 0.870 0.079
106281078 ST. HELENA HOSPITAL Sonoma-Napa 0.867 0.966 0.897 0.130
106190125 CALIFORNIA HOSPITAL MEDICAL CENTER Los Angeles-NE 0.866 0.973 0.890 0.691
106190470 LITTLE COMPANY OF MARY HOSPITAL Los Angeles-SW 0.861 0.893 0.965 0.113
106301175 FOUNTAIN VALLEY RGNL HOSP & MC-EUCLID Orange 0.861 0.919 0.937 0.281
106430779 GOOD SAMARITAN HOSPITAL - SAN JOSE South Bay 0.861 0.978 0.880 0.050
106190756 ST. JOHNS HOSPITAL AND HEALTH CENTER Los Angeles-SW 0.860 1.009 0.852 0.009
106190053 ST. MARY MEDICAL CENTER Los Angeles-SW 0.857 0.936 0.915 0.414
106430743 COMMUNITY HOSPITAL OF LOS GATOS South Bay 0.853 1.079 0.791 0.021
106074017 SAN RAMON REGIONAL MEDICAL CENTER Alameda-Contra Costa-Solano 0.852 0.989 0.862 0.022
106301248 LOS ALAMITOS MEDICAL CENTER Orange 0.848 0.798 1.062 0.077
106540734 KAWEAH DELTA DISTRICT HOSPITAL Central 0.847 0.842 1.006 0.244
106190796 UCLA MEDICAL CENTER Los Angeles-NE T 0.846 1.012 0.836 0.184
106190525 LONG BEACH MEMORIAL MEDICAL CENTER Los Angeles-SW 0.831 0.819 1.015 0.162
106301283 GARDEN GROVE HOSPITAL & MEDICAL CENTER Orange 0.830 0.816 1.017 0.462
106190758 PROVIDENCE SAINT JOSEPH MEDICAL CENTER Los Angeles-NW 0.829 0.891 0.930 0.146
106150761 MERCY HOSPITAL - BAKERSFIELD Central 0.827 0.892 0.928 0.088
106334487 RIVERSIDE COUNTY REGIONAL MEDICAL CENTER Riverside-San Bernardino 0.819 0.994 0.823 0.658
106190170 CHILDRENS HOSPITAL OF LOS ANGELES Los Angeles-NE 0.815 1.524 0.535 0.658
106331216 JOHN F. KENNEDY MEMORIAL HOSPITAL Riverside-San Bernardino 0.814 0.862 0.945 0.381
106361166 DOCTORS HSP MED CTR OF MONTCLAIR Riverside-San Bernardino 0.814 0.702 1.159 0.285
106340947 MERCY GENERAL HOSPITAL Sacramento 0.811 0.832 0.975 0.128
106301297 PLACENTIA-LINDA COMMUNITY HOSPITAL Orange 0.795 0.822 0.967 0.156
106370673 CHILDRENS HOSPITAL-SAN DIEGO San Diego 0.789 1.007 0.783 0.515
106190522 GLENDALE MEMORIAL HOSPITAL & HEALTH CTR Los Angeles-NW 0.777 0.861 0.902 0.302
106190534 OLYMPIA MEDICAL CENTER Los Angeles-NE 0.772 0.852 0.906 0.100
106370780 TRI-CITY MEDICAL CENTER San Diego 0.766 0.870 0.880 0.108
106190200 SAN GABRIEL VALLEY MEDICAL CENTER Los Angeles-NE 0.765 0.930 0.823 0.159
106100899 ST. AGNES MEDICAL CENTER Central 0.756 0.823 0.919 0.123
106010967 ST. ROSE HOSPITAL Alameda-Contra Costa-Solano 0.750 0.780 0.962 0.351
106190422 TORRANCE MEMORIAL MEDICAL CENTER Los Angeles-SW 0.749 0.819 0.914 0.075
106190878 WHITE MEMORIAL MEDICAL CENTER Los Angeles-NE 0.737 0.909 0.811 0.492
106190636 CITRUS VALLEY MEDICAL CENTER - QV CAMPUS Los Angeles-SE 0.734 0.758 0.969 0.338
106381154 UCSF MEDICAL CENTER San Francisco-San Mateo-Marin T 0.730 0.971 0.753 0.241
106301566 WESTERN MEDICAL CENTER-SANTA ANA Orange 0.730 0.861 0.848 0.341
106390846 DAMERON HOSPITAL Central 0.722 0.862 0.838 0.120
106334068 SOUTHWEST HEALTHCARE SYSTEM-MURRIETA Riverside-San Bernardino 0.721 0.652 1.106 0.110
106361339 ST. BERNARDINE MEDICAL CENTER Riverside-San Bernardino 0.714 0.777 0.919 0.220
CMM 10/12/2007 11:28 AM

Milliman
Attachment G-1
(A) (B) (C=A/B)
Area Area Inpatient
Teaching
Major
106361318 SAN ANTONIO COMMUNITY HOSPITAL Riverside-San Bernardino 0.706 0.848 0.833 0.095
106300225 ORANGE COAST MEMORIAL MEDICAL CENTER Orange 0.704 0.970 0.726 0.045
106304045 IRVINE MEDICAL CENTER Orange 0.700 0.864 0.811 0.040
106010776 CHILDRENS HOSP & RESEARCH CTR OAKLAND Alameda-Contra Costa-Solano 0.698 1.102 0.633 0.435
106190240 LAKEWOOD REGIONAL MEDICAL CENTER - SOUTH Los Angeles-SW 0.695 0.693 1.003 0.164
106331152 CORONA REGIONAL MEDICAL CENTER Riverside-San Bernardino 0.679 0.665 1.021 0.201
106100005 CLOVIS COMMUNITY HOSPITAL Central 0.675 0.727 0.928 0.113
106410852 PENINSULA MEDICAL CENTER San Francisco-San Mateo-Marin 0.672 1.022 0.658 0.047
106070904 DRS MEDICAL CENTER - SAN PABLO-PINOLE Alameda-Contra Costa-Solano 0.669 0.812 0.824 0.294
106301098 ANAHEIM MEMORIAL MEDICAL CENTER Orange 0.667 0.815 0.819 0.136
106190184 COLLEGE HOSPITAL Los Angeles-SE 0.657 0.844 0.778 0.186
106450940 SHASTA REGIONAL MEDICAL CENTER North 0.648 0.900 0.720 0.174
106190392 GOOD SAMARITAN HOSPITAL - LA Los Angeles-NE 0.641 0.841 0.762 0.182
106190110 BROTMAN MEDICAL CENTER Los Angeles-SW 0.641 0.981 0.653 0.200
106190673 SAN DIMAS COMMUNITY HOSPITAL Los Angeles-SE 0.641 0.681 0.940 0.322
106190687 SANTA MONICA - UCLA MEDICAL CENTER Los Angeles-SW 0.637 0.933 0.683 0.100
106190298 FOOTHILL PRESBYTERIAN HOSPITAL Los Angeles-SE 0.625 0.659 0.947 0.114
106190230 CENTINELA FREEMAN M.C-MEMORIAL Los Angeles-SW 0.608 0.882 0.690 0.373
106331194 HEMET VALLEY MEDICAL CENTER Riverside-San Bernardino 0.608 0.664 0.916 0.157
106190385 PROVIDENCE HOLY CROSS MEDICAL CENTER Los Angeles-NW 0.540 0.694 0.779 0.261
106190455 LANCASTER COMMUNITY HOSPITAL Los Angeles-NW 0.515 0.680 0.758 0.064
106190081 BEVERLY HOSPITAL Los Angeles-NE 0.480 0.681 0.705 0.304
106190818 VERDUGO HILLS HOSPITAL Los Angeles-NW 0.429 0.783 0.547 0.077
106301379 WEST ANAHEIM MEDICAL CENTER Orange 0.387 0.597 0.649 0.129
106560473 COMMUNITY MEM HOSP-SAN BUENAVENTURA Central Coast 0.341 0.780 0.437 0.085
CMM 10/12/2007 11:28 AM

Milliman
Attachment G-2
Buyer Cost Index (BCI), Hospital Cost Index (HCI) and Ratio - Sort Descending by HCI
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Adjusted Adjusted Indigent
Major
Buyer Cost Hospital and Medi-
OSHPD ID Hospital Region Index Cost Index Ratio Cal
CMM 10/12/2007 11:28 AM

Milliman
Attachment G-2
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:28 AM

Milliman
Attachment G-2
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:28 AM

Milliman
Attachment G-3
Buyer Cost Index (BCI), Hospital Cost Index (HCI) and Ratio - Sort Descending by Ratio
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:29 AM

Milliman
Attachment G-3
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:29 AM

Milliman
Attachment G-3
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:29 AM

Milliman
Attachment G-4
Buyer Cost Index (BCI), Hospital Cost Index (HCI) and Ratio - Sort by Region and Name
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:31 AM

Milliman
Attachment G-4
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:31 AM

Milliman
Attachment G-4
(A) (B) (C=A/B)

Inpatient
Area Area Percent
Teaching
Major
CMM 10/12/2007 11:31 AM

Milliman

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COST EFFICIENCY AT HOSPITAL

A REPORT BASED ON PUBLICLY

October 17, 2007

ATTACHMENT A – HOSPITAL ALLOWED/BILLED AND COST/CHARGE RATIOS

The major steps in creating the Buyer Cost Index were:

1. Use California Office of Statewide Health Planning and Development (OSHPD)

Two ratios were calculated for each hospital:

• Other Third Parties - Managed Care (TPMC) Allowed/Billed Ratio

Attachment A presents these ratios by hospital.

TPMC Allowed/Billed Ratio

(TPMC Gross IP Charges + TPMC Gross OP Charges

(A) (B) (C) (D=A-B+C) (E=D/A)

Cost/Charge Ratio = (Total Operating Expenses – Other Operating Revenue)

(A) (B) (C) (D=[B-C]/A)

Attachment A presents the Allowed/Billed and Cost/Charge Ratios by hospital. We excluded

• Negative or Zero Allowed/Billed Ratio

(A) (B) (C=A*B) (D) (E=A*D)

• A fixed dollar amount per day (per diem);

(A) (B) (C=A*B) (D) (E=C/D)

(Allowed Based) (Cost Based) Area Adjusted

North 114 $5,614,621,661 1.178 1.132 1.090 1.080 1.038

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

(A) (B) (C) (D) (E) (F) (G=(A-B+C)/A) (H=(E-F)/D)

CMM 10/12/2007 11:24 AM

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

2005 OSHPD Discharge Data

(A) (B) (C=A/B) (D) (E=C/D)

(A) (B) (C=A/B) (D) (E=C/D)

(A) (B) (C=A/B) (D) (E=C/D)

(A) (B) (C=A/B) (D) (E=C/D)

(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

CMM 10/12/2007 11:26 AM

(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

CMM 10/12/2007 11:26 AM

(A) (B) (C=A/B) (D=C/0.704) (E) (F=D/E)

(A) (B) (C=AB) (D) (E=AD)