CCN: 520062 NPI: 1366420531 Organization

PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL

791 SUMMIT AVE
OCONOMOWOC, WI 53066

Contact Information

Phone 2629282510
Fax 2629284032
Enumeration Date 2006-01-06
Last Updated 2020-05-06

Taxonomies

Code: 282N00000X (Primary) License State: WI License: 113

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.263

medicaidRatio 0.0868

vbpAdjustment 1.0034464326

hhrAdjustment 0.9928

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.263

medicaidRatio 0.0868

vbpAdjustment 1.0034464326

hhrAdjustment 0.9928

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.263

medicaidRatio 0.0868

vbpAdjustment 1.0025980462

hhrAdjustment 0.9966

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.28

medicaidRatio 0.0827

vbpAdjustment 1.0025980462

hhrAdjustment 0.9966

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.28

medicaidRatio 0.0827

vbpAdjustment 1.0025980462

hhrAdjustment 0.9966

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.28

medicaidRatio 0.0827

vbpAdjustment 1.0060989935

hhrAdjustment 0.999

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.303

medicaidRatio 0.0621

vbpAdjustment 1.0060989935

hhrAdjustment 0.999

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.303

medicaidRatio 0.0621

vbpAdjustment 1.0060989935

hhrAdjustment 0.999

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.303

medicaidRatio 0.0621

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.283

medicaidRatio 0.0596

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.283

medicaidRatio 0.0596

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.283

medicaidRatio 0.0596

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.283

medicaidRatio 0.0596

hhrAdjustment 0.9988

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.286

medicaidRatio 0.0798

hhrAdjustment 0.9988

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.286

medicaidRatio 0.0798

hhrAdjustment 0.9988

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.286

medicaidRatio 0.0798

hhrAdjustment 0.9988

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.286

medicaidRatio 0.0798

vbpAdjustment 1.0052338437

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.305

medicaidRatio 0.0579

vbpAdjustment 1.0052338437

hhrAdjustment 0.9976

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.305

medicaidRatio 0.0579

vbpAdjustment 0.9982321063

hhrAdjustment 0.9961

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.305

medicaidRatio 0.0579

vbpAdjustment 0.9982321063

hhrAdjustment 0.9961

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.29

medicaidRatio 0.0576

vbpAdjustment 0.9982321063

hhrAdjustment 0.9961

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.29

medicaidRatio 0.0576

vbpAdjustment 1.0028016816

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.29

medicaidRatio 0.0576

vbpAdjustment 1.0028016816

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.34

medicaidRatio 0.0792

vbpAdjustment 1.0028016816

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.34

medicaidRatio 0.0792

vbpAdjustment 1.0028016816

hhrAdjustment 0.9969

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.34

medicaidRatio 0.0792

vbpAdjustment 1.0009830083

hhrAdjustment 0.9961

censusDivision 4

cbsaActualGeographicLocation 33340

providerType 00

caseMixIndex 1.2308

operatingCostToChargeRatio 0.343

medicaidRatio 0.1223

vbpAdjustment 1.0009830083

hhrAdjustment 0.9961

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.203

deviceCostToChargeRatio 0.273

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.203

deviceCostToChargeRatio 0.273

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.206

deviceCostToChargeRatio 0.275

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.206

deviceCostToChargeRatio 0.275

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.269

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.211

deviceCostToChargeRatio 0.269

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.217

deviceCostToChargeRatio 0.272

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.217

deviceCostToChargeRatio 0.272

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.23

deviceCostToChargeRatio 0.276

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.23

deviceCostToChargeRatio 0.276

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.245

deviceCostToChargeRatio 0.289

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.245

deviceCostToChargeRatio 0.289

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.229

deviceCostToChargeRatio 0.237

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.229

deviceCostToChargeRatio 0.237

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.262

deviceCostToChargeRatio 0.291

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.262

deviceCostToChargeRatio 0.291

specialPaymentIndicator

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 33340

providerType 00

operatingCostToChargeRatio 0.272

deviceCostToChargeRatio 0.302

specialPaymentIndicator

carrierCode 06302

localityCode 00

PROHEALTH OCONOMOWOC MEMORIAL HOSPITAL

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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