No-fault reimbursement schedules for hospital: (A) Inpatient services rendered on and after January 1, 1986 to patients admitted prior to January 1, 1988; and (B) Outpatient services rendered on and after July 1, 1988.

October 5, 1988 SUBJECT: INSURANCE Circular Letter No. 22 (1988) WITHDRAWN TO: ALL AUTOMOBILE SELF-INSURERS & INSURERS LICENSED TO WRITE AUTOMOBILE INSURANCE IN NEW YORK STATE RE: NO-FAULT REIMBURSEMENT SCHEDULES FOR HOSPITAL (A) INPATIENT SERVICES RENDERED ON & AFTER JANUARY 1, 1986 TO PATIENTS ADMITTED PRIOR TO JANUARY 1, 1988; AND (B) OUTPATIENT SERVICES RENDERED ON & AFTER JULY 1, 1988. Pursuant to Regulation No. 83, 11 NYCRR 68.2, the no-fault rate schedules for reimbursing hospital services provided under § 5102(a)(1) of the Insurance Law shall be those established for workers compensation by the Chair of the Workers Compensation Board (WCB), which has now established rates for hospital: (A). inpatient services, in conformity with Chapter 767 of the Laws of 1977, as amended, and § 2807-a of the Public Health Law, as amended; and (B) outpatient services, in conformity with Chapter 453 of the Laws of 1984. Attached are the four rate schedules duly established by the WCB Chair. Thus No-Fault payors shall use: (a) the first two revised per diem schedules to reimburse hospitals for inpatient services rendered during the past periods: (1) January 1, 1986 through December 31, 1986; and (2) January 1, 1987 through December 31, 1987; (b) the third per diem schedule to reimburse hospitals for inpatient services rendered on and after January 1, 1988 to patients admitted prior to January 1, 1988; and (c) the fourth schedule to reimburse hospitals for outpatient services from July 1, 1988 through June 30, 1989. Please note that the Health Department has determined that inpatient hospital admissions prior to January 1, 1988 shall be reimbursed on a per diem. basis, rather than by the Diagnosis-Related Group (DRG) approach, effective January 1, 1988 for inpatient reimbursement as discussed in Circular Letter Nos. 11 and 18 (1988). Very truly yours, [SIGNATURE] JAMES P. CORCORAN SUPERINTENDENT OF INSURANCE REVISED HOSPITAL FEE SCHEDULE Effective 1/1/86-12/31/86 The inpatient Hospital Fee Schedule was recommended and certified by the State Commissioner of Health. These rates were developed in accordance with amendments to Articles 2803 and 2807 of the Public Health Law as set forth in Chapter 807 of the Laws of 1986, as amended by Chapter 906 of the Laws of 1985, Chapters 266, 267 and 268 of the Laws of 1986 and Part 86 of the Commissioner of Health's Administrative Rules and Regulations. The rates for outpatient services were prepared and established pursuant to Chapter 453 Laws of 1984 and will be filed in the office of the Department of State. This schedule will constitute Sections 329.6 and 329.7 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York. These charges are for use in payment of claims under the Workers' Compensation Law and the Volunteer Fire fighters Benefit Law. WORKERS' COMPENSATION SCHEDULE OF RATES FOR OUTPATIENT HOSPITAL SERVICES Effective 1/1/87 - 6/30/88 Room other than operating room when used for minor surgery or emergency treatment For the medical service provided whether by employed staff, attending staff or by contractual arrangement with the physician groups, the fee for this service is the fee indicated in the Schedule of Medical Fees. For the hospital providing intern or resident staffing or by physician group contractual coverage, the total fee is the fee for physician services as indicated in the Schedule of Medical Fees plus the fee for use of the Emergency Service Room as shown in this schedule. When the care is provided by an attending physician, the hospital fee is the Emergency Service Room fee as shown in this schedule, with the physician billing separately. Note: These fees include common or ordinary medications Crutches, mechanical splints and appliances Rental or Sale at Cost. Plaster Cast and/or Splint Cost of Plaster E.K.G., E.E.G., X-ray, P.T., and laboratory Charges Rates in Schedule of Medical Fees Promulgated by the Chairman, Workers' Compensation Board Materials supplied by the Emergency Room (i.e. sterile trays, medications, etc.) over and above those usually included with the Emergency Room visit may be charged for separately. Itemize these on the bill submitted COMMON OR ORDINARY DRUGS COVERED BY THE EMERGENCY ROOM HOSPITAL RATES A study was undertaken to determine the low-cost drugs which a large number of hospitals in New York State regard as fairly common or ordinary and for which no charges are made apart from the inclusive Emergency Room rates. A partial list of such drugs is furnished below. It is expected that the list will be enlarged or augmented from time to time. In the meanwhile, the drugs shown below or on any future similar list or heretofore regarded as common or ordinary or any additional drugs so regarded should be considered as covered by the applicable Emergency Room rate. No charge should be made for any drugs, whether or not listed hereunder, in connection with hospitalized patients. Current List of "No Charge" Drugs and Pharmaceutical Supplies Acetaminophen 325 mg tablet Lidocaine 2 percent with/ without Epinephrine Alcohol 70 percent Lidocaine 5 percent ointment Alcohol swabs Lindane lotion (e.g. Kwell) Antacid (e.g. Mylanta, Maalox, etc.) Lubricating jelly Aspirin 325 mg. tablet Magnesium Sulfate Aromatic Spirits of Ammonia Meperidine injection (e.g. Demerol) Atropine 2 percent Ophthalmic Solution Merthiolate Atropine 0.4 mg/ml Neomycin and Polympcin B Sulfates Bacitracin ointment w/Hydrocortisone ophthalmic suspension Castor Oil (e.g. Cortisporin) Calamine lotion Nitroglycerin 0.4 mg. s. 1. tablet Collodion Flexible Nitroglycerin 0.6 mg. s. 1. tablet Id Cream Peppermint Spirit unitest tablets Petrolatum Dibucaine 1 percent ointment Providone-Iodine solution (e.g. Nupercainal) (e.g. Betadine) Epinephrine Injection Pralidoxime Chloride (e.g. Protopam) Ethyl Chloride spray Silver Nitrate Sticks Gelfoam Silver Sulfadiazine cream (e.g. Savadene) Glycerin suppository Sodium Chloride - injection Hematest tablets Sodium Chloride for irrigation Hydrocortisone 1 percent ointment Sterile Water for irrigation Hydrogen Peroxide Talcum powder Iodine Tetanus Toxoid Ipecac Syrup Tuberculin PPD (1st and 2nd strength) Lidocaine 2 percent viscous (e.g. Xylocaine) Witch Hazel Lidocaine 1 percent with/ without Epinephrine Zinc Oxide ointment WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE WESTERN NEW YORK REGION EFFECTIVE 1/1/86-12/31/86 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE ALLEGANY CUBA MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 389.13 $ 388.95 Z $ 55.00 MEMORIAL HOSPITAL OF WM F & GERTRUDE F JONES A/K/A JONES MEMORIAL INPATIENT ACUTE CARE $ 349.82 Z $ 35.00 CATTARAUGUS OLEAN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 333.46 A.E.R. $ 45.00 PHYSICIANS, RADIOLOGYx PHYSICIANS, SALAMANCA HOSPITAL DISTRICT AUTHORITY INPATIENT ACUTE CARE $ 299.77 B $ 28.00 REHAB $ 170.27 ST FRANCIS HOSPITAL OF OLEAN INPATIENT ACUTE CARE $ 328.40 B $ 35.00 TRI-COUNTY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 289.73 A.B.I.L $ 35.00 CHAUTAUQUA BROOKS MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 659.29 $ 707.46 A.B $ 35.00 JAMESTOWN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 348.46 A.B.C.D $ 35.00 LAKE SHORE HOSPITAL INC INPATIENT ACUTE CARE $ 278.34 $ 279.19 A.B.C.D.E $ 35.00 WESTFIELD MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 336.86 $ 338.48 B $ 45.00 WOMANS CHRISTIAN ASSOCIATION INPATIENT ACUTE CARE $ 335.82 A.B $ 35.00 ERIE BERTRAND CHAFFEE HOSPITAL INPATIENT ACUTE CARE $ 322.75 $ 333.84 A.C 28.00 BUFFALO COLUMBUS HOSPITAL INPATIENT ACUTE CARE $ 491.64 Z $ 55.00 BUFFALO GENERAL HOSPITAL INPATIENT ACUTE CARE $ 564.46 $ 574.95 A.B.E.G.H.K $ 55.00 ANGIO. ECHO CHILDRENS HOSPITAL OF BUFFALO INPATIENT ACUTE CARE $ 439.10 A $ 35.00 ERIE COUNTY MEDICAL CENTER INPATIENT ACUTE CARE $ 518.52 $ 518.84 A.B.C.D $ 55.00 DETOX UNIT $ 315.77 A.B.C.D KENMORE MERCY HOSPITAL INPATIENT ACUTE CARE $ 275.88 A.E $ 45.00 LAFAYETTE GENERAL HOSPITAL INPATIENT ACUTE CARE $ 292.18 $ 213.02 MERCY HOSPITAL OF BUFFALO INPATIENT ACUTE CARE $ 301.79 $ 301.79 A.B $ 28.00 MILLARD FILLMORE HOSPITAL INPATIENT ACUTE CARE $ 370.41 A.B $ 45.00 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE ERIE(CONT'D) OUR LADY OF VICTORY HOSPITAL OF LACKAWANNA INPATIENT ACUTE CARE $ 300.17 A,B,F,L, $ 55.00 ENDOSC, SONO, ELECTROMY, ENDOC ROSWELL PARK MEMORIAL INSTITUTE INPATIENT ACUTE CARE $ 644.74 Z NO E.R. SERVICE SAINT FRANCIS HOSPITAL OF BUFFALO INPATIENT ACUTE CARE $ 273.34 A $ 55.00 SHEEHAN MEMORIAL EMERGENCY HOSPITAL INC INPATIENT ACUTE CARE $ 445.99 $ 447.29 B $ 55.00 SHERIDAN PARK HOSPITAL INC INPATIENT ACUTE CARE $ 658.55 C $ 55.00 SISTERS OF CHARITY HOSPITAL INPATIENT ACUTE CARE $ 307.05 A,B $ 55.00 ST JOSEPH INTERCOMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 287.75 A $ 45.00 GENESEE GENESEE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 323.09 A.B $ 35.00 ST JEROME HOSPITAL INPATIENT ACUTE CARE $ 277.61 B $ 35.00 NIMARA OFF MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 343.46 A,B $ 35.00 INTER-COMMUNITY MEMORIAL HOSPITAL AT NEWFANE INC INPATIENT ACUTE CARE $ 315.70 A $ 35.00 LOCKPORT MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 377.90 A,E,F,G $ 55.00 MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS INPATIENT ACUTE CARE $ 379.65 $ 381.28 A $ 45.00 NIAGARA FALLS MEMORIAL MEDICAL CENTER INPATIENT ACUTE CARE $ 344.10 $ 342.38 A $ 45.00 ORLEANS ARNOLD GREGORY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 352.07 $ 355.94 A $ 35.00 MEDINA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 280.62 $ 281.98 A,B $ 45.00 WYOMING WYOMING COUNTY COMMUNITY HOSPITAL $ 55.00 INPATIENT ACUTE CARE $ 354.90 A,B,E,L $ 55.00 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE CHEMUNG ARNOT-OGOEN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 473.37 $ 477.75 A,B,F $ 55.00 ST JOSEPHS HOSPITAL OF ELMIRA INPATIENT ACUTE CARE $ 481.37 $ 700.62 A,B $ 55.00 LIVINGSTON NICHOLAS H NOYES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 327.32 $ 329.36 A,B $ 55.00 MONROE GENESEE HOSPITAL OF ROCHESTER INPATIENT ACUTE CARE $ 480.36 $ 484.83 A,B $ 55.00 HIGHLAND HOSPITAL OF ROCHESTER INPATIENT ACUTE CARE $ 483.44 $ 486.56 A,B $ 55.00 LAKESIDE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 459.00 $ 462.92 A,B $ 45.00 MONROE COMMUNITY OSPITAL INPATIENT ACUTE CARE $ 526.92 OR NO PHYSICIANS E.R. PARK RIDGE HOSPITAL INPATIENT ACUTE CARE $ 468.63 $ 471.35 A,B,O $ 55.00 ROCHESTER GENERAL HOSPITAL INPATIENT ACUTE CARE $ 472.44 A,B $ 55.00 ST MARYS HOSPITAL OF ROCHESTER INPATIENT ACUTE CARE $ 624.73 A,B,C,N $ 55.00 STRONG MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 559.76 $ 559.97 A,B $ 55.00 ONTARIO CLIFTON SPRINGS HOSPITAL AND CLINIC INPATIENT ACUTE CARE $ 405.60 $ 408.89 A,B,O 55.00 F F THOMPSON HOSPITAL INPATIENT ACUTE CARE $ 277.96 B,G,I $ 35.00 GENEVA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 378.88 A $ 35.00 SCHUYLER SCHUYLER HOSPITAL INPATIENT ACUTE CARE $ 345.64 $ 346.00 A,B,C $ 45.00 SENECA SENECA FALLS HOSPITAL INPATIENT ACUTE CARE $ 424.49 B,D,E,M $ 55.00 WATERLOO MEMORIAL HOSPITAL INC D/B/A TAYLOR-BROWN MEMORIAL HOSP INPATIENT ACUTE CARE $ 382.04 $ 385.04 A $ 55.00 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE JBEN BETHESDA HOSPITAL INPATIENT ACUTE CARE $ 291.49 Z $ 35.00 CORNING HOSPITAL INPATIENT ACUTE CARE $ 353.02 A,B $ 55.00 IRA DAVENPORT MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 317.48 A $ 45.00 ST JAMES MERCY HOSPITAL INPATIENT ACUTE CARE $ 274.04 A,B,C,D $ 35.00 WAYNE MYERS COMMUNITY HOSPITAL FOUNDATION INC INPATIENT ACUTE CARE $ 339.91 $ 340.24 A,B $ 45.00 NEWARK-WAYNE COMMUNITY HOSPITAL INC INPATIENT ACUTE CARE $ 345.34 $ 347.00 A,B $ 45.00 YATES SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY INC INPATIENT ACUTE CARE $ 370.29 $ 372.59 A $ 45.00 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE BROOME OUR LADY OF LOURDES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 369.26 $ 369.64 A,B,G $ 45.00 UNITED HEALTH SERVICES INC INPATIENT ACUTE CARE $ 478.98 A.B.C. $ 45.00 REHABILITATION $ 176.10 A,B,C CAYUGA AUBURN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 280.42 A,E $ 35.00 CHENANGO INPATIENT ACUTE CARE $ 415.60 $ 415.98 A,B $ 45.00 CORTLAND CORTLAND MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 446.69 $ 476.92 B $ 45.00 HERKIMER LITTLE FALLS HOSPITAL INPATIENT ACUTE CARE $ 264.47 A,B $ 35.00 MOHAWK VALLEY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 289.11 A,B $ 28.00 JEFFERSON CARTHAGE AREA HOSPITAL INC INPATIENT ACUTE CARE $ 310.17 B $ 45.00 EDWARD JOHN NOBLE HOSPITAL OF ALEXANDRIA BAY INPATIENT ACUTE CARE $ 259.57 $ 268.23 B $ 45.00 HOUSE OF THE GOOD SAMARITAN INPATIENT ACUTE CARE $ 320.19 A,B,C $ 45.00 MERCY HOSPITAL OF WATERTOWN INPATIENT ACUTE CARE $ 497.66 $ 537.98 A,B $ 45.00 LEWIS LEWIS COUNTY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 371.69 $ 386.61 B $ 55.00 MADISON COMMUNITY MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 343.01 347.80* A,B $ 45.00 ONEIDA CITY HOSPITAL INPATIENT ACUTE CARE $ 296.74 A,B,D,O, $ 35.00 ONEIDA CHILDRENS HOSPITAL AND REHABILITATION CENTER REHABILITATION $ 384.62 $ 383.89 A NO E.R. SERVICE FAXTON HOSPITAL INPATIENT ACUTE CARE $ 357.56 A,B,H,I,O $ 28.00 *EFFECTIVE DATE: 4/1/86 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE [ILLEGIBLE TEXT] ROME HOSPITAL AND MURPHY MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 299.38 $ 299.96 A,B,C,D $ 35.00 ST ELIZABETH HOSPITAL INPATIENT ACUTE CARE $ 491.68 $ 503.63 A,B,C $ 55.00 FAMILY PRACTICE FACILITY ST LUKES MEMORIAL HOSPITAL CENTER INPATIENT. ACUTE CARE $ 362.06 A,B,C,E $ 45.00 ONONDAGA COMMUNITY GENERAL HOSPITAL OF GREATER SYRACUSE INPATIENT ACUTE CARE $ 382.12 A,B,G $ 55.00 NON- INVASIVE VASCULAR LAB CROUSE - IRVING MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 497.06 $ 498.57 A,B,C,D, $ 55.00 E,G ST JOSEPHS HOSPITAL HEALTH CENTER INPATIENT ACUTE CARE $ 433.14 $ 418.79 A.B,C $ 45.00 PERIPHERAL VASCULAR LAB, PATH FROZEN SECT, CARDIOVASCULAR LAB, PULMONARY FUNCTION LAB [ILLEGIBLE TEXT] INPATIENT ACUTE CARE $ 538.74 554.43* A,B,C,H, $ 55.00 I,K,0 OSWEGO ALBERT LINDLEY LEE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 378.42 $ 380.21 A,B $ 28.00 OSWEGO HOSPITAL INPATIENT ACUTE CARE $ 267.43 A,B $ 45.00 ST LAWRENCE A.BARTON HEPBURN HOSPITAL INPATIENT ACUTE CARE $ 399.22 $ 400.48 A,B,C $ 45.00 CANTON-POTSDAM HOSPITAL INPATIENT ACUTE CARE $ 397.36 $ 400.14 A,B,C $ 35.00 CLIFTON-FINE HOSPITAL INPATIENT ACUTE CARE $ 352.11 B $ 28.00 EDWARD JOHN NOBLE HOSPITAL OF GOUVERNEUR INPATIENT ACUTE CARE $ 330.83 $ 344.42 A,B $ 35.00 *EFFECTIVE DATE: 3/18/86 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE ST LAWRENCE MASSENA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 420.12 A $ 55.00 TIOGA TIOGA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 359.21 $ 360.95 A,B,D,N 35.00 TOMPKINS TOMPKINS COUNTY HOSPITAL INPATIENT ACUTE CARE $ 363.36 A,B,C,E,F $ 45.00 HOSPITAL RATE SCHEDULE CENTRAL NEW YORK REGION EFFECTIVE 1/1/86 - 12/31/86 DAILY DAILY DAILY EMERGENCY RATE RATE RATE SERVICE 1-1-86 7-1-86 OTHER EXCLUSIONS: ROOM RATE ALBANY ALBANY MEDICAL CENTER HOSPITAL INPATIENT ACUTE CARE $ 492.79 $ 498.10 A,B,I,K $ 55.00 CHILDS HOSPITAL INPATIENT ACUTE CARE $ 485.09 A,B,C NO E.R. SERVICE COHOES MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 291.61 A,B,C $ 45.00 MEMORIAL HOSPITAL OF ALBANY INPATIENT ACUTE CARE $ 355.58 $ 356.27 A,B,C,D, $ 45.00 E,F,I,O,R ST PETERS HOSPITAL INPATIENT ACUTE CARE $ 355.96 A,B,C,F, $ 55.00 H,I,K,O,R CARDIO PULMONARY CLINTON CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 266.42 A,B,E $ 45.00 COLUMBIA COLUMBIA MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 351.01 B $ 45.00 DELAWARE A LINDSAY 8 OLIVE B OCONNOR HOSPITAL INPATIENT ACUTE CARE $ 320.65 $ 321.25 A $ 28.00 COMMUNITY HOSPITAL OF STAMFORD INPATIENT ACUTE CARE $ 365.61 $ 367.86 Z $ 45.00 VARE VALLEY HOSPITAL INC INPATIENT ACUTE CARE $ 423.80 $ 429.04 B $ 35.00 MARGARETVILLE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 425.62 $ 429.44 B $ 35.00 THE HOSPITAL INPATIENT ACUTE CARE $ 354.83 A, B $ 45.00 ESSEX ELIZABETHTOWN COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 335.35 $ 335.48 B $ 55.00 MOSES-LUDINGTON HOSPITAL INPATIENT ACUTE CARE $ 457.09 Z $ 55.00 PLACID MEMORIAL HOSPITAL INC INPATIENT ACUTE CARE $ 353.38 B,D $ 55.00 FRANKLIN ALICE HYDE MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 267.01 $ 267.88 B $ 35.00 GENERAL HOSPITAL OF SARANAC LAKE INPATIENT ACUTE CARE $ 239.07 A,B,D $ 35.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER FULTON JOHNSTOWN HOSPITAL INPATIENT ACUTE CARE $ 297.95 $ 298.13 NATHAN LITTAUER HOSPITAL INPATIENT ACUTE CARE $ 483.06 $ 510.52 GREENE MEMORIAL HOSPITAL AND NURSING HOME OF GREENE COUNTY INPATIENT ACUTE CARE $ 438.50 $ 439.48 MONTGOMERY LAMSTERDAM MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 278.16 ST MARYS HOSPITAL AT AMSTERDAM INPATIENT ACUTE CARE $ 287.60 OTSEGO AURELIA OSBORN FOX MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 343.24 MARY IMOGENE BASSM HOSPITAL INPATIENT ACUTE CARE $ 531.79 RENSSELAER LEONARD HOSPITAL INPATIENT ACUTE CARE $ 326.15 REHABILITATION $ 181.76 SAMARITAN HOSPITAL OF TROY INPATIENT ACUTE CARE $ 280.80 ST MARYS HOSPITAL OF TROY INPATIENT ACUTE CARE $ 299.70 SARATOGA ADIRONDACK REGIONAL HOSPITAL INPATIENT ACUTE CARE $ 404.42 SARATOGA HOSPITAL INPATIENT ACUTE CARE $ 342.98 SCHENECTADY BELLEVUE MATERNITY HOSPITAL INC INPATIENT ACUTE CARE $ 425.35 ELLIS HOSPITAL INPATIENT ACUTE CARE $ 397.76 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE FULTON JOHNSTOWN HOSPITAL INPATIENT ACUTE CARE A,C $ 45.00 NATHAN LITTAUER HOSPITAL INPATIENT ACUTE CARE A,B $ 35.00 GREENE MEMORIAL HOSPITAL AND NURSING HOME OF GREENE COUNTY INPATIENT ACUTE CARE A,B $ 45.00 MONTGOMERY AMSTERDAM MEMORIAL HOSPITAL INPATIENT ACUTE CARE A.B,C,D,N $ 45.00 ST MARYS HOSPITAL AT AMSTERDAM INPATIENT ACUTE CARE A,B,C,D $ 45.00 OTSEGO AURELIA OSBORN FOX MEMORIAL HOSPITAL INPATIENT ACUTE CARE A,B,F $ 55.00 MARY IMOGENE BASSM HOSPITAL INPATIENT ACUTE CARE A,B,C,D.K $ 55.00 OPHTHALMOLOGY, GEN. PRACTITIONER, SURGERY, OB-GYN, PEDIATRICS, OPTOMETRY, PSYCHIATRY, OTOLARYNGOLOGY RENSSELAER LEONARD HOSPITAL INPATIENT ACUTE CARE A,B,C,F $ 55.00 REHABILITATION A,B,C,F SAMARITAN HOSPITAL OF TROY INPATIENT ACUTE CARE A,B,C,E,F,G,I,J,M $ 45.00 ST MARYS HOSPITAL OF TROY INPATIENT ACUTE CARE A,B,D,F,L,P $ 45.00 PULMON. FUNCT. STUDIES SARATOGA ADIRONDACK REGIONAL HOSPITAL INPATIENT ACUTE CARE B,D $ 35.00 SARATOGA HOSPITAL INPATIENT ACUTE CARE A,B,D,F.J $ 45.00 VASCULAR LAB SCHENECTADY BELLEVUE MATERNITY HOSPITAL INC INPATIENT ACUTE CARE A,B ALL INCLUSIVE ELLIS HOSPITAL INPATIENT ACUTE CARE A,B,C,D $ 55.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER SCHENECTADY ST CLARES HOSPITAL OF SCHENECTADY INPATIENT ACUTE CARE $ 670.33 $ 723.27 SUNNYVIEW HOSPITAL AND REHABILITATION CENTER INPATIENT ACUTE CARE $ 267.31 $ 267.90 SCHOHARIE COMMUNITY HOSPITAL OF SCHOHARIE COUNTY INC INPATIENT ACUTE CARE $ 345.69 WARREN GLENS FALLS HOSPITAL INPATIENT ACUTE CARE $ 332.31 WASHINGTON EMMA LAING STEVENS HOSPITAL INPATIENT ACUTE CARE $ 462.44 $ 480.94 MARY MCCLELLAN HOSPITAL INPATIENT ACUTE CARE $ 362.18 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE SCHENECTADY ST CLARES HOSPITAL OF SCHENECTADY INPATIENT ACUTE CARE A,B,C,D,G $ 4500 GASTRO, PROCTOLOGY SUNNYVIEW HOSPITAL AND REHABILITATION CENTER INPATIENT ACUTE CARE A,B,C,D,J NO E.R. SERVICE CYSTOMETRY SCHOHARIE COMMUNITY HOSPITAL OF SCHOHARIE COUNTY INC INPATIENT ACUTE CARE Z $ 55.00 WARREN GLENS FALLS HOSPITAL INPATIENT ACUTE CARE A,B,D,N $ 35.00 WASHINGTON EMMA LAING STEVENS HOSPITAL INPATIENT ACUTE CARE B $ 55.00 MARY MCCLELLAN HOSPITAL INPATIENT ACUTE CARE B,0 $ 55.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER DUTCHESS NORTHERN DUTCHESS HOSPITAL INPATIENT ACUTE CARE $ 332.90 $ 334.61 ST FRANCIS HOSPITAL OF BEACON (HIGHLAND) INPATIENT ACUTE CARE $ 290.06 ST FRANCIS HOSPITAL OF POUGHKEEPSIE INPATIENT ACUTE CARE $ 423.06 $ 422.82 VASSAR BROTHERS HOSPITAL INPATIENT. ACUTE CARE $ 390.80 ORANGE ARDEN HILL HOSPITAL INPATIENT ACUTE CARE $ 319.43 CORNWALL HOSPITAL INPATIENT ACUTE CARE $ 359.51 E A HORTON MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 360.06 ST ANTHONY COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 410.62 $ 414.90 ST FRANCIS - MERCY COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 389.72 ST LUKES HOSPITAL OF NEWBURGH INPATIENT ACUTE CARE $ 321.97 PUTNAM JULIA BUTTERFIELD MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 335.57 $ 336.59 PUTNAM COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 367.40 $ 376.12 ROCKLAND GOOD SAMARITAN HOSPITAL OF SUFFERN INPATIENT ACUTE CARE $ 477.50 HELEN HAYES HOSPITAL INPATIENT ACUTE CARE $ 557.62 NYACK HOSPITAL INPATIENT ACUTE CARE $ 474.05 SUMMIT PARK HOSPITAL- ROCKLAND COUNTY. INFIRMARY INPATIENT ACUTE CARE $ 290.21 PSYCHIATRIC CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE DUTCHESS NORTHERN DUTCHESS HOSPITAL INPATIENT ACUTE CARE A,D $ 35.00 ST FRANCIS HOSPITAL OF BEACON (HIGHLAND) INPATIENT ACUTE CARE A,B $ 55.00 ST FRANCIS HOSPITAL OF POUGHKEEPSIE INPATIENT ACUTE CARE A,B $ 55.00 VASSAR BROTHERS HOSPITAL INPATIENT. ACUTE CARE A,B,D $ 55.00 RADIATION ONCOLOGY ORANGE ARDEN HILL HOSPITAL INPATIENT ACUTE CARE A,B,D,J $ 55.00 CORNWALL HOSPITAL INPATIENT ACUTE CARE A,B,G,H,I,L $ 55.00 HOLTER MONITOR E A HORTON MEMORIAL HOSPITAL INPATIENT ACUTE CARE A,B,C,D,E,F $ 55.00 RENAL, CARDIOPULMONARY ST ANTHONY COMMUNITY HOSPITAL INPATIENT ACUTE CARE A,B $ 35.00 ST FRANCIS - MERCY COMMUNITY HOSPITAL INPATIENT ACUTE CARE A,B,D $ 45.00 ST LUKES HOSPITAL OF NEWBURGH INPATIENT ACUTE CARE A,B $ 35.00 PUTNAM JULIA BUTTERFIELD MEMORIAL HOSPITAL INPATIENT ACUTE CARE A,B,D $ 45.00 PUTNAM COMMUNITY HOSPITAL INPATIENT ACUTE CARE A,B $ 45.00 ROCKLAND GOOD SAMARITAN HOSPITAL OF SUFFERN INPATIENT ACUTE CARE A,B $ 55.00 HELEN HAYES HOSPITAL INPATIENT ACUTE CARE Z NO E.R. SERVICE NYACK HOSPITAL INPATIENT ACUTE CARE AB,D $ 55.00 SUMMIT PARK HOSPITAL- ROCKLAND COUNTY. INFIRMARY INPATIENT ACUTE CARE Z NO E.R. SERVICE PSYCHIATRIC CARE Z NO E.R. SERVICE DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER SUWAN COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY - HARRIS DIV INPATIENT ACUTE CARE $ 661.72 $ 729.98 COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY G HERMAN DIV INPATIENT ACUTE CARE $ 335.34 JLSTER BENEDICTINE HOSPITAL INPATIENT ACUTE CARE $ 338.13 ELLENVILLE COMMUNITY HOSPITAL INPATIENT ACUTE CARE $ 290.58 $ 293.51 KINGSTON HOSPITAL INPATIENT ACUTE CARE $ 322.08 WESTCHESTER BLYTHEDALE CHILDRENS HOSPITAL INPATIENT ACUTE CARE $ 332.07 $ 332.43 BURKE REHABILITATION CENTER INPATIENT ACUTE CARE $ 450.19 $ 451.53 DOBBS FERRY HOSPITAL INPATIENT ACUTE CARE $ 476.17 $ 482.57 LAWRENCE HOSPITAL INPATIENT ACUTE CARE $ 425.77 MMT VERNON HOSPITAL PATIENT ACUTE CARE $ 460.95 $ 467.81 IROCHELLE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 514.02 NEW YORK HOSPITAL-CORNELL MEDICAL CENTER WESTCHESTER DIVISION PSYCHIATRIC CARE $ 386.97 NORTHERN WESTCHESTER HOSPITAL INPATIENT ACUTE CARE $ 455.14 $ 459.04 PEEKSKILL HOSPITAL INPATIENT ACUTE CARE $ 415.66 $ 438.45 PHELPS MEMORIAL HOSPITAL ASSOCIATION INPATIENT ACUTE CARE $ 473.84 $ 483.83 ST AGNES HOSPITAL INPATIENT ACUTE CARE $ 422.01 ST JOHNS RIVERSIDE HOSPITAL INPATIENT ACUTE CARE $ 560.47 $ 569.04 ST JOSEPHS HOSPITAL YONKERS INPATIENT ACUTE CARE $ 453.65 $ 456.94 ST VINCENTS HOSP AND MEDICAL CTR OF NY WESTCHESTER BRANCH PSYCHIATRIC CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE SUWAN COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY - HARRIS DIV INPATIENT ACUTE CARE A,B $ 55.00 COMMUNITY GENERAL HOSPITAL OF SULLIVAN COUNTY G HERMAN DIV INPATIENT ACUTE CARE A,B $ 55.00 JLSTER BENEDICTINE HOSPITAL INPATIENT ACUTE CARE A,B $ 45.00 ELLENVILLE COMMUNITY HOSPITAL INPATIENT ACUTE CARE Z $ 28.00 KINGSTON HOSPITAL INPATIENT ACUTE CARE A,B $ 35.00 WESTCHESTER BLYTHEDALE CHILDRENS HOSPITAL INPATIENT ACUTE CARE A,D NO E.R. SERVICE BURKE REHABILITATION CENTER INPATIENT ACUTE CARE A NO E.R. SERVICE DOBBS FERRY HOSPITAL INPATIENT ACUTE CARE Z $ 35.00 LAWRENCE HOSPITAL INPATIENT ACUTE CARE A $ 55.00 MMT VERNON HOSPITAL PATIENT ACUTE CARE A,B $ 55.00 IROCHELLE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE A,B,C,D $ 55.00 NEW YORK HOSPITAL-CORNELL MEDICAL CENTER WESTCHESTER DIVISION PSYCHIATRIC CARE Z NO E.R. SERVICE NORTHERN WESTCHESTER HOSPITAL INPATIENT ACUTE CARE A,B,H,I,K $ 55.00 PEEKSKILL HOSPITAL INPATIENT ACUTE CARE B $ 35.00. PHELPS MEMORIAL HOSPITAL ASSOCIATION INPATIENT ACUTE CARE A,B $ 55.00 ST AGNES HOSPITAL INPATIENT ACUTE CARE A,C,K $ 55.00 ANATOMICAL PATHOLOGY ST JOHNS RIVERSIDE HOSPITAL INPATIENT ACUTE CARE A,B,C,J $ 45.00 ST JOSEPHS HOSPITAL YONKERS INPATIENT ACUTE CARE Z $ 45.00 ST VINCENTS HOSP AND MEDICAL CTR OF NY WESTCHESTER BRANCH PSYCHIATRIC CARE Z NO E.R. SERVICE DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER ESTCHESTER UNITED HOSPITAL INPATIENT ACUTE CARE $ 461.27 $ 462.01 WESTCHESTER COUNTY MEDICAL CENTER INPATIENT ACUTE CARE $ 636.13 WHITE PLAINS HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 416.39 $ 412.27 YONKERS GENERAL HOSPITAL INPATIENT ACUTE CARE $ 375.34 EFFECTIVE 5-1-86 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE ESTCHESTER UNITED HOSPITAL INPATIENT ACUTE CARE A,B,D $ 45.00 WESTCHESTER COUNTY MEDICAL CENTER INPATIENT ACUTE CARE A,B,C,D,E,F,G $ 55.00 CYSTOSCOPY WHITE PLAINS HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE A,C $ 55.00 ELECTRO-DIAGNOSTIC STUDIES YONKERS GENERAL HOSPITAL INPATIENT ACUTE CARE A,K $ 35.00 EFFECTIVE 5-1-86 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE LONG ISLAND REGION EFFECTIVE 1/1/86 - 12/31/86 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER NASSAU CENTRAL GENERAL HOSPITAL INPATIENT ACUTE CARE $ 392.73 $ 393.28 COMMUNITY HOSPITAL AT GLEN COVE INPATIENT ACUTE CARE $ 438.89 $ 448.26 FRANKLIN GENERAL HOSPITAL INPATIENT ACUTE CARE $ 480.89 $ 617.90 HEMPSTEAD.GENERAL HOSPITAL INPATIENT ACUTE CARE $ 448.62 LONG BEACH MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 443.12 LONG ISLAND JEWISH - HILLSIDE MEDICAL CENTER (MANHASSET DIV.) INPATIENT ACUTE CARE $ 675.67 $ 676.26 MASSAPEOUA GENERAL HOSPITAL INPATIENT ACUTE CARE $ 521.50 MERCY HOSPITAL OF ROCKVILLE CENTER INPATIENT ACUTE CARE $ 469.94 $ 470.05 MID-ISLAND HOSPITAL INPATIENT ACUTE CARE $ 462.95 $ 467.07 NASSAU COUNTY MEDICAL CENTER MEADOW DIV INPATIENT ACUTE CARE $ 629.00 NORTH SHORE UNIVERSITY HOSPITAL INPATIENT ACUTE CARE $ 579.09 SOUTH NASSAU COMMUNITIES HOSPITAL INPATIENT ACUTE CARE $ 338.31 ST FRANCIS HOSPITAL OF ROSLYN INPATIENT ACUTE CARE $ 1210.47 $ 1252.48 SYOSSET COMMUNITY HOSPITAL (HIP HOSPITAL OF L.I.) INPATIENT ACUTE CARE $ 625.85 WINTHROP UNIVERSITY HOSPITAL (NASSAU HOSP) INPATIENT ACUTE CARE $ 440.85 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE NASSAU CENTRAL GENERAL HOSPITAL INPATIENT ACUTE CARE A,B,E,F $ 55.00 COMMUNITY HOSPITAL AT GLEN COVE INPATIENT ACUTE CARE Z $ 28.00 FRANKLIN GENERAL HOSPITAL INPATIENT ACUTE CARE A $ 55.00 HEMPSTEAD.GENERAL HOSPITAL INPATIENT ACUTE CARE A,B,C,D,E,F $ 55.00 LONG BEACH MEMORIAL HOSPITAL INPATIENT ACUTE CARE A $ 28.00 LONG ISLAND JEWISH - HILLSIDE MEDICAL CENTER (MANHASSET DIV.) INPATIENT ACUTE CARE A,B $ 55.00 CARDIAC CATHERIZATION MASSAPEOUA GENERAL HOSPITAL INPATIENT ACUTE CARE A,B,E $ 55.00 MERCY HOSPITAL OF ROCKVILLE CENTER INPATIENT ACUTE CARE Z $ 55.00 MID-ISLAND HOSPITAL INPATIENT ACUTE CARE A,B,C,D,E,F $ 45.00 NASSAU COUNTY MEDICAL CENTER MEADOW DIV INPATIENT ACUTE CARE Z $ 55.00 NORTH SHORE UNIVERSITY HOSPITAL INPATIENT ACUTE CARE A,B,C,D,E,F,G,M $ 55.00 SPEECH THERAPY SOUTH NASSAU COMMUNITIES HOSPITAL INPATIENT ACUTE CARE A,L $ 45.00 ECHOCARDIOGRAM ST FRANCIS HOSPITAL OF ROSLYN INPATIENT ACUTE CARE A $ 55.00 SYOSSET COMMUNITY HOSPITAL (HIP HOSPITAL OF L.I.) INPATIENT ACUTE CARE A $ 55.00 WINTHROP UNIVERSITY HOSPITAL (NASSAU HOSP) INPATIENT ACUTE CARE A,B, $ 45.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER SUFFOLK BROOKHAVEN MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 461.02 BRUNSWICK HOSPITAL CENTER INC INPATIENT ACUTE CARE $ 485.42 $ 524.62 REHABILITATION $ 356.23 CENTRAL SUFFOLK HOSPITAL ASSOCIATION INPATIENT ACUTE CARE $ 806.19 $ 810.50 CHURCH CHARITY FOUNDATION - SEE ST JOHNS EPISCOPAL HOSP-SMITHTOWN COMMUNITY HOSP OF WESTERN SUFFOLK (SMITHTOWN GENERAL HOSP) INPATIENT ACUTE CARE $ 1214.26 $ 1330.83 EASTERN LONG ISLAND HOSPITAL INPATIENT ACUTE CARE $ 423.10 GOOD SAMARITAN HOSPITAL OF WEST ISLIP. INPATIENT ACUTE CARE $ 525.63 $ 563.44 HUNTINGTON HOSPITAL INPATIENT ACUTE CARE $ 399.12 JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON NEW YORK INC INPATIENT ACUTE CARE $ 469.86 $ 467.26 SMITHTOWN GENERAL HOSPITAL (SEE COMM HOSP OF WESTERN SUFFOLK) SOUTHAMPTON HOSPITAL INPATIENT ACUTE CARE $ 416.59 SOUTHSIOE HOSPITAL INPATIENT ACUTE CARE $ 402.60 ST CHARLES HOSPITAL INPATIENT ACUTE CARE $ 394.37 ST JOHNS EPISCOPAL HOSPITAL SMITHTOWN (CHURCH CHARITY FOUNDATION) INPATIENT ACUTE CARE $ 524.43 UNIVERSITY HOSPITAL OF STONY BROOK INPATIENT ACUTE CARE $ 775.88 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE SUFFOLK BROOKHAVEN MEMORIAL HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 BRUNSWICK HOSPITAL CENTER INC INPATIENT ACUTE CARE A,B,E,F $ 55.00 REHABILITATION A,B,E,F CENTRAL SUFFOLK HOSPITAL ASSOCIATION INPATIENT ACUTE CARE A $ 35.00 CHURCH CHARITY FOUNDATION - SEE ST JOHNS EPISCOPAL HOSP-SMITHTOWN COMMUNITY HOSP OF WESTERN SUFFOLK (SMITHTOWN GENERAL HOSP) INPATIENT ACUTE CARE A $ 55.00 EASTERN LONG ISLAND HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 GOOD SAMARITAN HOSPITAL OF WEST ISLIP. INPATIENT ACUTE CARE A,C $ 45.00 HUNTINGTON HOSPITAL INPATIENT ACUTE CARE A,D,M $ 45.00 DIALYSIS, CHEMOTHERAPY JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON NEW YORK INC INPATIENT ACUTE CARE A,B,E,F $ 55.00 SMITHTOWN GENERAL HOSPITAL (SEE COMM HOSP OF WESTERN SUFFOLK) SOUTHAMPTON HOSPITAL INPATIENT ACUTE CARE Z $ 45.00 SOUTHSIDE HOSPITAL INPATIENT ACUTE CARE A,B,C $ 55.00 ST CHARLES HOSPITAL INPATIENT ACUTE CARE A $ 45.00 ST JOHNS EPISCOPAL HOSPITAL SMITHTOWN (CHURCH CHARITY FOUNDATION) INPATIENT ACUTE CARE A,B,C $ 55.00 UNIVERSITY HOSPITAL OF STONY BROOK INPATIENT ACUTE CARE A,B,C $ 55.00 WORKERS' COMPENSATION HOSPITAL RATE SCHEDULE NEW YORK CITY REGION EFFECTIVE 1/1/86 - 12/31/86 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER GENERAL HOSPITAL INPATIENT ACUTE CARE $ 412.30 $ 421.56 BAPTIST MEDICAL CENTER OF NEW YORK INPATIENT ACUTE CARE $ 441.53 $ 440.24 BAYLEY SETON HOSPITAL INPATIENT ACUTE CARE $ 595.21 $ 598.61 BETH ISRAEL MEDICAL CENTER INPATIENT ACUTE CARE $ 670.07 DETOXIFICATION UNIT $ 303.61 BOOTH MEMORIAL MEDICAL CENTER INPATIENT ACUTE CARE $ 1412.89 $ 1457.19 BRONX-LEBANON HOSPITAL CENTER INPATIENT ACUTE CARE $ 702.50 $ 723.09 BROOKDALE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE $ 511.96 $ 516.68 BROOKLYN/CALEDONIAN HOSPITAL INPATIENT ACUTE CARE $ 524.98 CABRINI HEALTH CARE CTR INPATIENT ACUTE CARE $ 508.45 CALVARY HOSPITAL INPATIENT ACUTE CARE $ 470.56 MEDICAL CENTER* INPATIENT ACUTE CARE $ 585.40 $ 577.12 ST MARYS HOSP - SEE SEPARATE LISTING CHURCH CHARITY FOUNDATION - SEE ST JOHNS EPISCOPAL HOSPITAL COMMUNITY HOSPITAL OF BROOKLYN INC INPATIENT ACUTE CARE $ 393.53 DEEPDALE GENERAL HOSPITAL INPATIENT ACUTE CARE $ 439.15 DOCTORS HOSPITAL INC INPATIENT ACUTE CARE $ 594.74 $ 600.27 DOCTORS HOSPITAL OF STATEN ISLAND INPATIENT ACUTE CARE $ 481.68 $ 491.87 FLATBUSH GENERAL HOSPITAL INPATIENT ACUTE CARE $ 371.02 FLUSHING HOSPITAL AND MEDICAL CENTER INPATIENT ACUTE CARE $ 469.28 $ 468.42 HILLCREST GEN HOSP - SEE CATHOLIC MEDICAL CENTER HOSSPITAL INC (LA GUARDIA) INPATIENT ACUTE CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE GENERAL HOSPITAL INPATIENT ACUTE CARE A,B,F,G $ 35.00 BAPTIST MEDICAL CENTER OF NEW YORK INPATIENT ACUTE CARE A $ 28.00 BAYLEY SETON HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 BETH ISRAEL MEDICAL CENTER INPATIENT ACUTE CARE A,B $ 55.00 DETOXIFICATION UNIT A,B BOOTH MEMORIAL MEDICAL CENTER INPATIENT ACUTE CARE A,B,D,N,P, VASCULAR $ 55.00 BRONX-LEBANON HOSPITAL CENTER INPATIENT ACUTE CARE A,C,E,H,K $ 45.00 BROOKDALE HOSPITAL MEDICAL CENTER INPATIENT ACUTE CARE A,C,D $ 55.00 BROOKLYN/CALEDONIAN HOSPITAL INPATIENT ACUTE CARE A $ 45.00 CABRINI HEALTH CARE CTR INPATIENT ACUTE CARE A.B $ 55.00 CALVARY HOSPITAL INPATIENT ACUTE CARE Z NO E.R. SERVICE MEDICAL CENTER* INPATIENT ACUTE CARE A $ 55.00 ST MARYS HOSP - SEE SEPARATE LISTING CHURCH CHARITY FOUNDATION - SEE ST JOHNS EPISCOPAL HOSPITAL COMMUNITY HOSPITAL OF BROOKLYN INC INPATIENT ACUTE CARE A.B,C,D $ 45.00 DEEPDALE GENERAL HOSPITAL INPATIENT ACUTE CARE A,B,C,D,E $ 45.00 DOCTORS HOSPITAL INC INPATIENT ACUTE CARE A $ 55.00 DOCTORS HOSPITAL OF STATEN ISLAND INPATIENT ACUTE CARE A,B $ 28.00 FLATBUSH GENERAL HOSPITAL INPATIENT ACUTE CARE A,C,F,H,I, ECHO $ 35.00 FLUSHING HOSPITAL AND MEDICAL CENTER INPATIENT ACUTE CARE A,B $ 55.00 HILLCREST GEN HOSP - SEE CATHOLIC MEDICAL CENTER HOSSPITAL INC (LA GUARDIA) INPATIENT ACUTE CARE A $ 55.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER HOSPITAL FOR JOINT DISEASES AND MEDICAL CENTER ORTHOPEDIC INSTITUTE INPATIENT ACUTE CARE $ 912.65 $ 899.86 HOSPITAL FOR SPECIAL SURGERY INPATIENT ACUTE CARE $ 686.82 INSTITUTE OF REHAB MEDICINE NY UNIVERSITY SEE RUSK INST-NYU INTERFAITH MEDICAL CENTER INPATIENT ACUTE CARE $ 566.47 JAMAICA HOSPITAL INPATIENT ACUTE CARE $ 524.16 JOINT DISEASES NORTH GENERAL HOSPITAL INPATIENT ACUTE CARE $ 501.79 KINGS HIGHWAY HOSPITAL INPATIENT ACUTE CARE $ 371.24 KINGSBROOK JEWISH MEDICAL CENTER INPATIENT ACUTE CARE $ 530.22 LAGUARDIA HOSP - SEE HIP. HOSP LENOX HILL HOSPITAL INPATIENT ACUTE CARE $ 628.92 $ 631.99 LONG ISLAND COLLEGE HOSPITAL INPATIENT ACUTE CARE $ 644.82 $ 638.43 LONG ISLAND JEWISH-HILLSIDE MED CTR INPATIENT ACUTE CARE $ 675.67 $ 676.26 PSYCHIATRIC $ 339.48 REHABILITATION $ 930.44 LUTHERAN MEDICAL CENTER INPATIENT ACUTE CARE $ 481.78 MAIMONIDES MEDICAL CENTER INPATIENT ACUTECARE $ 580.77 MANHATTAN EYE EAR AND THROAT HOSPITAL INPATIENT ACUTE CARE $ 795.77 MEDICAL ARTS CENTER HOSPITAL INPATIENT ACUTE CARE $ 454.42 MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES INPATIENT ACUTE CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE HOSPITAL FOR JOINT DISEASES AND MEDICAL CENTER ORTHOPEDIC INSTITUTE INPATIENT ACUTE CARE A,B,C,D NO E.R. SERVICE HOSPITAL FOR SPECIAL SURGERY INPATIENT ACUTE CARE A,B, P NO E.R. SERVICE INSTITUTE OF REHAB MEDICINE NY UNIVERSITY SEE RUSK INST-NYU INTERFAITH MEDICAL CENTER INPATIENT ACUTE CARE A $ 55.00 JAMAICA HOSPITAL INPATIENT ACUTE CARE A,B,C,E $ 55.00 JOINT DISEASES NORTH GENERAL HOSPITAL INPATIENT ACUTE CARE Z $ 55.00 KINGS HIGHWAY HOSPITAL INPATIENT ACUTE CARE A,B,E $ 35.00 KINGSBROOK JEWISH MEDICAL CENTER INPATIENT ACUTE CARE A.B.C,E,F,O, AUDIOLOGY $ 55.00 LAGUARDIA HOSP - SEE HIP. HOSP LENOX HILL HOSPITAL INPATIENT ACUTE CARE A,J $ 55.00 LONG ISLAND COLLEGE HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 LONG ISLAND JEWISH-HILLSIDE MED CTR INPATIENT ACUTE CARE A,B CARDIAC- $ 55.00 CATHETERIZATION PSYCHIATRIC SAME REHABILITATION SAME LUTHERAN MEDICAL CENTER INPATIENT ACUTE CARE A,B,C,G,H,I,K. $ 55.00 ELECTROCARDIOLOGY MAIMONIDES MEDICAL CENTER INPATIENT ACUTECARE A,B,C,D,E,P $ 55.00 MANHATTAN EYE EAR AND THROAT HOSPITAL INPATIENT ACUTE CARE A,B,C,E $ 45.00 MEDICAL ARTS CENTER HOSPITAL INPATIENT ACUTE CARE B,D $ 45.00 MEMORIAL HOSPITAL FOR CANCER AND ALLIED DISEASES INPATIENT ACUTE CARE z NO E.R. SERVICE DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE $ 598.96 $ 598.10 MISERICORDIA HOSPITAL MEDICAL CENTER - SEE OUR LADY OF MERCY MED CTR MONTEFIORE HOSPITAL & MEDICAL CENTER INPATIENT ACUTE CARE $ 943.83 $ 960.91 REHABILITATION $ 204.91 MOUNT SINAI HOSPITAL INPATIENT ACUTE CARE $ 766.59 NY EYE AND EAR INFIRMARY INPATIENT ACUTE CARE $ 510.97 NEW YORK HOSPITAL AND PAYNE WHITNEY PSYCHIATRIC CLINIC INPATIENT ACUTE CARE $ 745.15 NY INFIRMARY BEEKMAN DOWNTOWN HOSPITAL INPATIENT ACUTE CARE $ 876.20 $ 1132.34 NY UNIVERSITY MEDICAL CENTER INPATIENT ACUTE CARE $ 724.00 $ 730.91* OSTEOPATHIC HOSPITAL AND CLINIC OF NEW YORK D/B/A HILLCREST GENERAL HOSPITAL - SEE CATHOLIC MEDICAL CENTER OF MERCY MED CTR (MISERICORDIA HOSP) INPATIENT ACUTE CARE $ 582.56 PARKWAY HOSPITAL INPATIENT ACUTE CARE $ 427.72 PARSONS HOSPITAL INPATIENT ACUTE CARE $ 546.24 PELHAM BAY GENERAL HOSPITAL INPATIENT ACUTE CARE $ 407.55 PENINSULA HOSPITAL CENTER INPATIENT ACUTE CARE $ 550.57 $ 606.10 PHYSICIANS HOSPITAL INPATIENT ACUTE CARE $ 456.90 $ 457.14 PRESBYTERIAN HOSPITAL IN THE CITY OF NY INPATIENT ACUTE CARE $ 615.80 EMERGENCY SERVICE EXCLUSIONS: ROOM RATE HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE Z MISERICORDIA HOSPITAL MEDICAL CENTER - SEE OUR LADY OF MERCY MED CTR MONTEFIORE HOSPITAL & MEDICAL CENTER INPATIENT ACUTE CARE A,B,G $ 55.00 REHABILITATION MOUNT SINAI HOSPITAL INPATIENT ACUTE CARE A,B,E,F,G,J $ 55.00 NY EYE AND EAR INFIRMARY INPATIENT ACUTE CARE A $ 28.00 NEW YORK HOSPITAL AND PAYNE WHITNEY PSYCHIATRIC CLINIC INPATIENT ACUTE CARE A,B,D CYTOLOGY $ 55.00 NY INFIRMARY BEEKMAN DOWNTOWN HOSPITAL INPATIENT ACUTE CARE Z $ 55.00 NY UNIVERSITY MEDICAL CENTER INPATIENT ACUTE CARE A,B,C $ 55.00 OSTEOPATHIC HOSPITAL AND CLINIC OF NEW YORK D/B/A HILLCREST GENERAL HOSPITAL - SEE CATHOLIC MEDICAL CENTER OF MERCY MED CTR (MISERICORDIA HOSP) INPATIENT ACUTE CARE A,B.C,E $ 45.00 PARKWAY HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 PARSONS HOSPITAL INPATIENT ACUTE CARE Z $ 45.00 PELHAM BAY GENERAL HOSPITAL INPATIENT ACUTE CARE A,B $ 55.00 PENINSULA HOSPITAL CENTER INPATIENT ACUTE CARE A,B,G $ 55.00 PHYSICIANS HOSPITAL INPATIENT ACUTE CARE Z $ 28.00 PRESBYTERIAN HOSPITAL IN THE CITY OF NY INPATIENT ACUTE CARE A,B.D $ 55.00 DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER RICHMOND MEMORIAL HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE $ 581.51 $ 577.63 ROCKEFELLER UNIVERSITY HOSPITAL INPATIENT ACUTE CARE $ 294.86 RUSK INSTITUTE - NYU INPATIENT ACUTE CARE $ 497.98 ST BARNABAS HOSPITAL INPATIENT ACUTE CARE $ 492.82 ST CLARES HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE $ 471.37 ST JOHNS EPISCOPAL HOSPITAL (CHURCH CHARITY FOUNDATION) INPATIENT ACUTE CARE $ 524.43 ST JOSEPHS HOSPITAL SEE CATHOLIC MEDICAL CENTER ST LUKES - ROOSEVELT HOSPITAL CENTER INPATIENT ACUTE CARE $ 603.95 $ 602.67 DETOXIFICATION UNIT. $ 168.82 ST MARYS HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE $ 598.37 $ 598.29 ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY INPATIENT ACUTE CARE $ 658.35 $ 658.39 ST VINCENTS MEDICAL CENTER OF RICHMON INPATIENT ACUTE CARE $ 498.47 B,E STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL CENTER $ 659.54 $ 665.58 INPATIENT ACUTE CAR STATEN ISLAND HOSPITAL INPATIENT ACUTE CARE $ 520.55 $ 523.53 UNION HOSPITAL OF THE BRONX INPATIENT ACUTE CARE $ 435.54 VICTORY MEMORIAL HOSPITAL $ 380.95 $ 382.65 INPATIENT ACUTE CARE WESTCHESTER SQUARE HOSPITAL $ 475.76 $ 491.19 INPATIENT ACUTE CARE WYCKOFF HEIGHTS HOSPITAL INPATIENT ACUTE CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE RICHMOND MEMORIAL HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE A,B $ 55.00 ROCKEFELLER UNIVERSITY HOSPITAL INPATIENT ACUTE CARE Z NO E.R. SERVICE RUSK INSTITUTE - NYU INPATIENT ACUTE CARE A,B,D NO E.R. SERVICE ST BARNABAS HOSPITAL INPATIENT ACUTE CARE A,B,C.E,H $ 55.00 ST CLARES HOSPITAL AND HEALTH CENTER INPATIENT ACUTE CARE A,B,C,E,F $ 55.00 ST JOHNS EPISCOPAL HOSPITAL (CHURCH CHARITY FOUNDATION) INPATIENT ACUTE CARE A,B,C $ 55.00 ST JOSEPHS HOSPITAL SEE CATHOLIC MEDICAL CENTER ST LUKES - ROOSEVELT HOSPITAL CENTER INPATIENT ACUTE CARE A $ 55.00 DETOXIFICATION UNIT. A ST MARYS HOSPITAL OF BROOKLYN INPATIENT ACUTE CARE Z $ 55.00 ST VINCENTS HOSPITAL AND MEDICAL CENTER OF NY INPATIENT ACUTE CARE A,I, DIAG. RADIO OGY $ 55.00 ST VINCENTS MEDICAL CENTER OF RICHMON INPATIENT ACUTE CARE $ 55.00 STATE UNIVERSITY HOSPITAL DOWNSTATE MEDICAL CENTER A,B NO E.R. SERVICE INPATIENT ACUTE CAR STATEN ISLAND HOSPITAL INPATIENT ACUTE CARE A,B,C,D,EI, J,K,L,M,N,O,P,R $ 55.00 UNION HOSPITAL OF THE BRONX A,C $ 28.00 INPATIENT ACUTE CARE VICTORY MEMORIAL HOSPITAL A $ 55.00 INPATIENT ACUTE CARE WESTCHESTER SQUARE HOSPITAL A,B,C $ 55.00 INPATIENT ACUTE CARE WYCKOFF HEIGHTS HOSPITAL A,C $ 45.00 INPATIENT ACUTE CARE DAILY DAILY DAILY RATE RATE RATE 1-1-86 7-1-86 OTHER HEALTH AND HOSPITAL CORPORATION BELLEVUE HOSPITAL CENTER INPATIENT ACUTE CARE $ 628.71 BRONX MUNICIPAL HOSPITAL CENTER INPATIENT ACUTE CARE $ 626.28 CITY HOSPITAL CENTER AT ELMHURST INPATIENT ACUTE CARE $ 543.19 COLER MEMORIAL HOSPITAL AND HOME INPATIENT ACUTE CARE $ 369.72 CONEY ISLAND HOSPITAL INPATIENT ACUTE CARE $ 574.55 GOLDWATER MEMORIAL HOSPITAL INPATIENT ACUTE CARE $ 294.25 HARLEM HOSPITAL CENTER INPATIENT ACUTE CARE $ 659.98 KINGS COUNTY HOSPITAL CENTER INPATIENT ACUTE CARE $ 547.09 LINCOLN MEDICAL & MENTAL HEALTH CENTER INPATIENT ACUTE CARE $ 665.33 MSM 3LITAN HOSPITAL CENTER INPATIENT ACUTE CARE $ 637.47 NORTH CENTRAL BRONX HOSPITAL INPATIENT ACUTE CARE $ 839.06 QUEENS HOSPITAL CENTER INPATIENT ACUTE CARE $ 648.43 WOODHULL MEDICAL AND MENTAL HEALTH CENTER INPATIENT ACUTE CARE EMERGENCY SERVICE EXCLUSIONS: ROOM RATE HEALTH AND HOSPITAL CORPORATION BELLEVUE HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 55.00 BRONX MUNICIPAL HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 55.00 CITY HOSPITAL CENTER AT ELMHURST INPATIENT ACUTE CARE Z $ 45.00 COLER MEMORIAL HOSPITAL AND HOME INPATIENT ACUTE CARE Z NO E.R. SERVICE CONEY ISLAND HOSPITAL INPATIENT ACUTE CARE A,B.D,G,H $ 55.00 GOLDWATER MEMORIAL HOSPITAL INPATIENT ACUTE CARE Z NO E.R. SERVICE HARLEM HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 55.00 KINGS COUNTY HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 35.00 LINCOLN MEDICAL & MENTAL HEALTH CENTER INPATIENT ACUTE CARE Z $ 55.00 MSM 3LITAN HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 555.00 NORTH CENTRAL BRONX HOSPITAL INPATIENT ACUTE CARE Z $ 55.00 QUEENS HOSPITAL CENTER INPATIENT ACUTE CARE Z $ 55.00 WOODHULL MEDICAL AND MENTAL HEALTH CENTER INPATIENT ACUTE CARE Z $ 55.00