CCN: 520088 NPI: 1346228541 Organization

SSM HEALTH ST AGNES HOSPITAL-FOND DU LAC

430 E DIVISION ST
FOND DU LAC, WI 549354560

Contact Information

Phone 9209292300
Fax 9209268885
Enumeration Date 2006-01-06
Last Updated 2024-06-05

Taxonomies

Code: 261QA0600X
Code: 275N00000X
Code: 282N00000X (Primary)

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 17

caseMixIndex 1.2649

operatingCostToChargeRatio 0.331

medicaidRatio 0.1761

uncompensatedCareAmount 850.21

vbpAdjustment 1.0194221882

hhrAdjustment 0.9982

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 17

caseMixIndex 1.2649

operatingCostToChargeRatio 0.331

medicaidRatio 0.1761

uncompensatedCareAmount 850.21

vbpAdjustment 1.0194221882

hhrAdjustment 0.9982

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 17

caseMixIndex 1.2649

operatingCostToChargeRatio 0.331

medicaidRatio 0.1761

uncompensatedCareAmount 668.6

vbpAdjustment 1.0171413433

hhrAdjustment 0.9991

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 17

caseMixIndex 1.2649

operatingCostToChargeRatio 0.328

medicaidRatio 0.2084

uncompensatedCareAmount 668.6

vbpAdjustment 1.0171413433

hhrAdjustment 0.9991

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 17

caseMixIndex 1.2649

operatingCostToChargeRatio 0.328

medicaidRatio 0.2084

uncompensatedCareAmount 668.6

vbpAdjustment 1.0171413433

hhrAdjustment 0.9991

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.328

medicaidRatio 0.2084

uncompensatedCareAmount 668.6

vbpAdjustment 1.0171413433

hhrAdjustment 0.9991

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.328

medicaidRatio 0.2084

uncompensatedCareAmount 546.95

vbpAdjustment 1.0096579472

hhrAdjustment 0.9997

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.348

medicaidRatio 0.2067

uncompensatedCareAmount 546.95

vbpAdjustment 1.0096579472

hhrAdjustment 0.9997

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.348

medicaidRatio 0.2067

uncompensatedCareAmount 546.95

vbpAdjustment 1.0096579472

hhrAdjustment 0.9997

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.348

medicaidRatio 0.2067

uncompensatedCareAmount 546.53

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.332

medicaidRatio 0.1835

uncompensatedCareAmount 546.53

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.332

medicaidRatio 0.1835

uncompensatedCareAmount 546.53

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.332

medicaidRatio 0.1835

uncompensatedCareAmount 546.53

hhrAdjustment 1.0

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.332

medicaidRatio 0.1835

uncompensatedCareAmount 323.99

hhrAdjustment 0.9949

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.273

medicaidRatio 0.2069

uncompensatedCareAmount 323.99

hhrAdjustment 0.9949

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.273

medicaidRatio 0.2069

uncompensatedCareAmount 323.99

hhrAdjustment 0.9949

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.273

medicaidRatio 0.2069

uncompensatedCareAmount 323.99

hhrAdjustment 0.9949

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.276

medicaidRatio 0.1035

uncompensatedCareAmount 323.99

hhrAdjustment 0.9949

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.276

medicaidRatio 0.1035

uncompensatedCareAmount 573.15

vbpAdjustment 1.0021330748

hhrAdjustment 0.997

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1628

uncompensatedCareAmount 573.15

vbpAdjustment 1.0021330748

hhrAdjustment 0.997

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1628

uncompensatedCareAmount 563.82

vbpAdjustment 1.0066343222

hhrAdjustment 0.9964

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1628

uncompensatedCareAmount 563.82

vbpAdjustment 1.0066343222

hhrAdjustment 0.9964

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1628

uncompensatedCareAmount 482.95

vbpAdjustment 1.0083717389

hhrAdjustment 0.9993

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1628

uncompensatedCareAmount 482.95

vbpAdjustment 1.0083717389

hhrAdjustment 0.9993

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.285

medicaidRatio 0.1388

uncompensatedCareAmount 482.95

vbpAdjustment 1.0083717389

hhrAdjustment 0.9993

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.285

medicaidRatio 0.1388

uncompensatedCareAmount 482.95

vbpAdjustment 1.0083717389

hhrAdjustment 0.9993

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1455

uncompensatedCareAmount 482.95

vbpAdjustment 1.0083717389

hhrAdjustment 0.9993

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1455

uncompensatedCareAmount 400.99

vbpAdjustment 0.9992037373

hhrAdjustment 0.9971

censusDivision 4

cbsaActualGeographicLocation 22540

providerType 16

caseMixIndex 1.2649

operatingCostToChargeRatio 0.275

medicaidRatio 0.1455

uncompensatedCareAmount 400.99

vbpAdjustment 0.9992037373

hhrAdjustment 0.9971

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 22540

providerType 17

operatingCostToChargeRatio 0.267

deviceCostToChargeRatio 0.435

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 17

operatingCostToChargeRatio 0.267

deviceCostToChargeRatio 0.435

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 17

operatingCostToChargeRatio 0.204

deviceCostToChargeRatio 0.435

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.204

deviceCostToChargeRatio 0.435

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.217

deviceCostToChargeRatio 0.452

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.217

deviceCostToChargeRatio 0.452

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.242

deviceCostToChargeRatio 0.484

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.242

deviceCostToChargeRatio 0.484

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.201

deviceCostToChargeRatio 0.734

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.201

deviceCostToChargeRatio 0.734

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.247

deviceCostToChargeRatio 0.722

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.223

deviceCostToChargeRatio 0.712

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.223

deviceCostToChargeRatio 0.712

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.228

deviceCostToChargeRatio 0.636

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.238

deviceCostToChargeRatio 0.535

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.238

deviceCostToChargeRatio 0.535

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

cbsaActualGeographicLocation 22540

providerType 16

operatingCostToChargeRatio 0.245

specialPaymentIndicator Y

costOfLivingAdjustment 0.8

carrierCode 06302

localityCode 00

SSM HEALTH ST AGNES HOSPITAL-FOND DU LAC

Contact Information

Taxonomies

Inpatient Payment Attributes (IPSF) View Dictionary →

Outpatient Payment Attributes (OPSF) View Dictionary →

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