CCN: 463301 NPI: 1235148594 Organization

INTERMOUNTAIN HEALTH PRIMARY CHILDREN'S HOSPITAL

100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 841131103

Contact Information

Phone 8016621000
Enumeration Date 2006-08-05
Last Updated 2025-07-01

Taxonomies

Code: 273R00000X License State: UT License: 2010-HOSP-439
Code: 273Y00000X
Code: 322D00000X License State: UT License: 2006-HOSP-439
Code: 282NC2000X (Primary) License State: UT License: 2006-HOSP-439

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

censusDivision 8

providerType 05

operatingCostToChargeRatio 0.571

medicaidRatio 0.1777

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.522

deviceCostToChargeRatio 0.471

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.522

deviceCostToChargeRatio 0.47

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.522

deviceCostToChargeRatio 0.47

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.398

deviceCostToChargeRatio 0.259

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.398

deviceCostToChargeRatio 0.259

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.489

deviceCostToChargeRatio 0.38

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.489

deviceCostToChargeRatio 0.38

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.379

deviceCostToChargeRatio 0.377

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.379

deviceCostToChargeRatio 0.377

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.427

deviceCostToChargeRatio 0.317

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.427

deviceCostToChargeRatio 0.317

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.422

deviceCostToChargeRatio 0.279

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.422

deviceCostToChargeRatio 0.279

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.431

deviceCostToChargeRatio 0.294

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.43

deviceCostToChargeRatio 0.294

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.43

deviceCostToChargeRatio 0.294

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.381

deviceCostToChargeRatio 0.521

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.381

deviceCostToChargeRatio 0.521

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.539

deviceCostToChargeRatio 0.543

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.539

deviceCostToChargeRatio 0.543

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.621

deviceCostToChargeRatio 0.537

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.621

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.55

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.55

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

cbsaActualGeographicLocation 41620

providerType 05

operatingCostToChargeRatio 0.566

specialPaymentIndicator

costOfLivingAdjustment 0.878

carrierCode 03502

localityCode 09

INTERMOUNTAIN HEALTH PRIMARY CHILDREN'S HOSPITAL

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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