CCN: 140046 NPI: 1609897339 Organization

GOOD SAMARITAN REGIONAL HLTH CENTER

1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 628642402

Contact Information

Phone 6188994600
Enumeration Date 2006-07-21
Last Updated 2023-11-27

Taxonomies

Code: 273R00000X License State: IL License: 0004705
Code: 282N00000X (Primary) License State: IL License: 0004705

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2221

uncompensatedCareAmount 426.61

vbpAdjustment 1.0047107011

hhrAdjustment 0.9973

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2221

uncompensatedCareAmount 426.61

vbpAdjustment 1.0047107011

hhrAdjustment 0.9973

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2221

uncompensatedCareAmount 327.87

vbpAdjustment 1.0027099178

hhrAdjustment 0.9959

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.301

medicaidRatio 0.2281

uncompensatedCareAmount 327.87

vbpAdjustment 1.0027099178

hhrAdjustment 0.9959

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.301

medicaidRatio 0.2281

uncompensatedCareAmount 327.87

vbpAdjustment 1.0027099178

hhrAdjustment 0.9959

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.301

medicaidRatio 0.2281

uncompensatedCareAmount 335.23

vbpAdjustment 0.9975575047

hhrAdjustment 0.9962

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2309

uncompensatedCareAmount 335.23

vbpAdjustment 0.9975575047

hhrAdjustment 0.9962

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2309

uncompensatedCareAmount 335.23

vbpAdjustment 0.9975575047

hhrAdjustment 0.9962

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.297

medicaidRatio 0.2309

uncompensatedCareAmount 338.26

hhrAdjustment 0.9989

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.275

medicaidRatio 0.2303

uncompensatedCareAmount 338.26

hhrAdjustment 0.9989

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.275

medicaidRatio 0.2303

uncompensatedCareAmount 338.26

hhrAdjustment 0.9989

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.275

medicaidRatio 0.2303

uncompensatedCareAmount 338.26

hhrAdjustment 0.9989

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.275

medicaidRatio 0.2303

uncompensatedCareAmount 308.87

hhrAdjustment 0.9985

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.311

medicaidRatio 0.216

uncompensatedCareAmount 308.87

hhrAdjustment 0.9985

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.311

medicaidRatio 0.216

uncompensatedCareAmount 308.87

hhrAdjustment 0.9985

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.311

medicaidRatio 0.216

uncompensatedCareAmount 308.87

hhrAdjustment 0.9985

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.288

medicaidRatio 0.2183

uncompensatedCareAmount 440.3

vbpAdjustment 1.0038973054

hhrAdjustment 0.9938

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.276

medicaidRatio 0.224

uncompensatedCareAmount 440.3

vbpAdjustment 1.0038973054

hhrAdjustment 0.9938

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.276

medicaidRatio 0.224

uncompensatedCareAmount 329.92

vbpAdjustment 0.9953533527

hhrAdjustment 0.9933

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.276

medicaidRatio 0.224

uncompensatedCareAmount 329.92

vbpAdjustment 0.9953533527

hhrAdjustment 0.9933

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.276

medicaidRatio 0.224

uncompensatedCareAmount 319.56

vbpAdjustment 0.9948139823

hhrAdjustment 0.9839

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.276

medicaidRatio 0.224

uncompensatedCareAmount 319.56

vbpAdjustment 0.9948139823

hhrAdjustment 0.9839

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.294

medicaidRatio 0.2195

uncompensatedCareAmount 319.56

vbpAdjustment 0.9948139823

hhrAdjustment 0.9839

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.294

medicaidRatio 0.2195

uncompensatedCareAmount 319.56

vbpAdjustment 0.9948139823

hhrAdjustment 0.9839

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.296

medicaidRatio 0.2195

uncompensatedCareAmount 284.6

vbpAdjustment 0.9990591931

hhrAdjustment 0.981

censusDivision 6

cbsaActualGeographicLocation 14

providerType 07

caseMixIndex 1.0195

operatingCostToChargeRatio 0.318

medicaidRatio 0.2426

uncompensatedCareAmount 284.6

vbpAdjustment 0.9990591931

hhrAdjustment 0.981

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.186

deviceCostToChargeRatio 0.681

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.186

deviceCostToChargeRatio 0.681

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.176

deviceCostToChargeRatio 0.572

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.176

deviceCostToChargeRatio 0.572

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.17

deviceCostToChargeRatio 0.402

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.17

deviceCostToChargeRatio 0.402

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.173

deviceCostToChargeRatio 0.262

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.173

deviceCostToChargeRatio 0.262

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.196

deviceCostToChargeRatio 0.25

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.196

deviceCostToChargeRatio 0.25

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.191

deviceCostToChargeRatio 0.319

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.336

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.336

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.224

deviceCostToChargeRatio 0.347

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.224

deviceCostToChargeRatio 0.347

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.223

deviceCostToChargeRatio 0.348

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

cbsaActualGeographicLocation 14

providerType 07

operatingCostToChargeRatio 0.229

deviceCostToChargeRatio 0.408

specialPaymentIndicator Y

costOfLivingAdjustment 0.001

carrierCode 06102

localityCode 99

GOOD SAMARITAN REGIONAL HLTH CENTER

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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