CCN: 360032 NPI: 1639133002 Organization

GRAND LAKE HEALTH SYSTEM

200 SAINT CLAIR AVE
SAINT MARYS, OH 458852400

Contact Information

Phone 4193943335
Fax 4193948485
Enumeration Date 2006-04-13
Last Updated 2024-02-06

Taxonomies

Code: 3336I0012X License State: OH License: HOS020623650
Code: 282N00000X (Primary) License State: OH

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.446

medicaidRatio 0.1272

uncompensatedCareAmount 992.78

vbpAdjustment 0.9950179765

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.446

medicaidRatio 0.1272

uncompensatedCareAmount 992.78

vbpAdjustment 0.9950179765

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.446

medicaidRatio 0.1272

uncompensatedCareAmount 992.78

vbpAdjustment 0.9950179765

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.446

medicaidRatio 0.1272

uncompensatedCareAmount 992.78

vbpAdjustment 0.9950179765

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.446

medicaidRatio 0.1272

uncompensatedCareAmount 760.62

vbpAdjustment 1.0087882701

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.461

medicaidRatio 0.1305

uncompensatedCareAmount 760.62

vbpAdjustment 1.0087882701

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.461

medicaidRatio 0.1305

uncompensatedCareAmount 760.62

vbpAdjustment 1.0087882701

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.461

medicaidRatio 0.1305

uncompensatedCareAmount 760.62

vbpAdjustment 1.0087882701

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.461

medicaidRatio 0.1305

uncompensatedCareAmount 828.89

vbpAdjustment 1.0070480478

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.468

medicaidRatio 0.1442

uncompensatedCareAmount 828.89

vbpAdjustment 1.0070480478

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.468

medicaidRatio 0.1442

uncompensatedCareAmount 828.89

vbpAdjustment 1.0070480478

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.468

medicaidRatio 0.1442

uncompensatedCareAmount 828.89

vbpAdjustment 1.0070480478

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.468

medicaidRatio 0.1442

uncompensatedCareAmount 744.18

hhrAdjustment 0.9933

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.453

medicaidRatio 0.1611

uncompensatedCareAmount 744.18

hhrAdjustment 0.9933

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.453

medicaidRatio 0.1611

uncompensatedCareAmount 744.18

hhrAdjustment 0.9933

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.453

medicaidRatio 0.1611

uncompensatedCareAmount 744.18

hhrAdjustment 0.9933

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.453

medicaidRatio 0.1611

uncompensatedCareAmount 744.18

hhrAdjustment 0.9933

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.453

medicaidRatio 0.1611

uncompensatedCareAmount 670.98

hhrAdjustment 0.9948

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.478

medicaidRatio 0.1448

uncompensatedCareAmount 670.98

hhrAdjustment 0.9948

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.478

medicaidRatio 0.1448

uncompensatedCareAmount 670.98

hhrAdjustment 0.9948

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.478

medicaidRatio 0.1448

uncompensatedCareAmount 670.98

hhrAdjustment 0.9948

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.478

medicaidRatio 0.1448

uncompensatedCareAmount 670.98

hhrAdjustment 0.9948

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.478

medicaidRatio 0.1448

uncompensatedCareAmount 552.92

vbpAdjustment 1.0063030744

hhrAdjustment 0.9982

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.488

medicaidRatio 0.1337

uncompensatedCareAmount 552.92

vbpAdjustment 1.0063030744

hhrAdjustment 0.9982

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.488

medicaidRatio 0.1337

uncompensatedCareAmount 552.92

vbpAdjustment 1.0063030744

hhrAdjustment 0.9982

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.488

medicaidRatio 0.1337

uncompensatedCareAmount 632.77

vbpAdjustment 1.0082960418

hhrAdjustment 0.9965

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 632.77

vbpAdjustment 1.0082960418

hhrAdjustment 0.9965

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 632.77

vbpAdjustment 1.0082960418

hhrAdjustment 0.9965

censusDivision 4

cbsaActualGeographicLocation 36

providerType 00

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 632.77

vbpAdjustment 1.0082960418

hhrAdjustment 0.9965

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 632.77

vbpAdjustment 1.0082960418

hhrAdjustment 0.9965

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 3885.77

vbpAdjustment 1.0046030618

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.456

medicaidRatio 0.1348

uncompensatedCareAmount 3885.77

vbpAdjustment 1.0046030618

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.495

medicaidRatio 0.1463

uncompensatedCareAmount 3885.77

vbpAdjustment 1.0046030618

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.495

medicaidRatio 0.1463

uncompensatedCareAmount 3885.77

vbpAdjustment 1.0046030618

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.495

medicaidRatio 0.1463

uncompensatedCareAmount 3885.77

vbpAdjustment 1.0046030618

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.495

medicaidRatio 0.1463

uncompensatedCareAmount 1235.21

vbpAdjustment 1.0116551928

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.559

medicaidRatio 0.141

uncompensatedCareAmount 1235.21

vbpAdjustment 1.0116551928

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.559

medicaidRatio 0.141

uncompensatedCareAmount 1235.21

vbpAdjustment 1.0116551928

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.559

medicaidRatio 0.141

uncompensatedCareAmount 1235.21

vbpAdjustment 1.0116551928

hhrAdjustment 0.9999

censusDivision 4

cbsaActualGeographicLocation 36

providerType 14

caseMixIndex 1.1394

operatingCostToChargeRatio 0.559

medicaidRatio 0.141

uncompensatedCareAmount 1235.21

vbpAdjustment 1.0116551928

hhrAdjustment 0.9999

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.302

deviceCostToChargeRatio 0.586

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.302

deviceCostToChargeRatio 0.586

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.302

deviceCostToChargeRatio 0.586

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.305

deviceCostToChargeRatio 0.639

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.305

deviceCostToChargeRatio 0.639

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.306

deviceCostToChargeRatio 0.58

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.306

deviceCostToChargeRatio 0.58

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.322

deviceCostToChargeRatio 0.571

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.322

deviceCostToChargeRatio 0.571

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.328

deviceCostToChargeRatio 0.581

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.328

deviceCostToChargeRatio 0.581

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.322

deviceCostToChargeRatio 0.61

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.322

deviceCostToChargeRatio 0.61

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.306

deviceCostToChargeRatio 0.575

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.306

deviceCostToChargeRatio 0.575

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.339

deviceCostToChargeRatio 0.645

specialPaymentIndicator Y

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.339

deviceCostToChargeRatio 0.645

specialPaymentIndicator

carrierCode 15202

localityCode 00

cbsaActualGeographicLocation 36

providerType 00

operatingCostToChargeRatio 0.332

deviceCostToChargeRatio 0.674

specialPaymentIndicator

carrierCode 15202

localityCode 00

GRAND LAKE HEALTH SYSTEM

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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