medicare_provider_charge_inpatient_drg100_fy2011 ca
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DRG DefinitionProvider IdProvider NameProvider Street AddressProvider CityProvider StateProvider Zip CodeHospital Referral Region Description Total Discharges Average Covered Charges Average Total Payments
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50732FRESNO HEART AND SURGICAL HOSPITAL15 EAST AUDUBON DRIVEFRESNOCA93720CA - Fresno66$20,227.67$6,390.26
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50290SAINT JOHN'S HEALTH CENTER2121 SANTA MONICA BLVDSANTA MONICACA90404CA - Los Angeles22$26,209.55$6,483.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50701SOUTHWEST HEALTHCARE SYSTEM25500 MEDICAL CENTER DRIVEMURRIETACA92562CA - San Diego14$26,258.00$7,244.29
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50056ANTELOPE VALLEY HOSPITAL MED CENTER1600 W AVE JLANCASTERCA93534CA - Los Angeles15$27,027.93$8,333.87
6
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50224HOAG MEMORIAL HOSPITAL PRESBYTERIANONE HOAG DRIVENEWPORT BEACHCA92663CA - Orange County34$29,350.85$6,511.29
7
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50238METHODIST HOSPITAL OF SOUTHERN CA300 W HUNTINGTON DRARCADIACA91006CA - Los Angeles11$30,027.55$7,733.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50351TORRANCE MEMORIAL MEDICAL CENTER3330 LOMITA BLVDTORRANCECA90509CA - Los Angeles17$30,510.29$6,793.65
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50057KAWEAH DELTA MEDICAL CENTER400 W MINERAL KING AVEVISALIACA93291CA - Bakersfield52$30,686.02$7,562.27
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50757ALVARADO HOSPITAL MEDICAL CENTER6655 ALVARADO ROADSAN DIEGOCA92120CA - San Diego15$31,017.07$7,199.80
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50438HUNTINGTON MEMORIAL HOSPITAL100 W CALIFORNIA BLVDPASADENACA91109CA - Los Angeles19$31,305.47$7,804.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50069ST JOSEPH HOSPITAL1100 WEST STEWART DRORANGECA92868CA - Orange County40$35,690.03$7,188.90
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50262RONALD REAGAN UCLA MEDICAL CENTER757 WESTWOOD PLAZALOS ANGELESCA90095CA - Los Angeles13$36,730.69$11,899.77
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50390HEMET VALLEY MEDICAL CENTER1117 EAST DEVONSHIREHEMETCA92543CA - San Bernardino19$36,866.32$7,513.32
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50396SANTA BARBARA COTTAGE HOSPITAL400 WEST PUEBLOSANTA BARBARACA93102CA - Santa Barbara28$37,691.96$7,533.50
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50168ST JUDE MEDICAL CENTER101 E VALENCIA MESA DRIVEFULLERTONCA92835CA - Orange County16$39,046.81$6,710.81
17
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50026GROSSMONT HOSPITAL5555 GROSSMONT CENTER DRIVE BOX 58LA MESACA91942CA - San Diego26$40,062.46$7,449.81
18
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50309SUTTER ROSEVILLE MEDICAL CENTERONE MEDICAL PLAZAROSEVILLECA95661CA - Sacramento13$41,204.23$8,964.62
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50093SAINT AGNES MEDICAL CENTER1303 E HERNDON AVEFRESNOCA93710CA - Fresno34$41,460.68$7,471.71
20
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50382CITRUS VALLEY MEDICAL CENTER-IC CAMPUS210 W SAN BERNARDINO ROADCOVINACA91723CA - Los Angeles17$42,287.47$9,044.00
21
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50039ENLOE MEDICAL CENTER1531 ESPLANADECHICOCA95926CA - Chico56$42,446.30$6,967.73
22
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50291SUTTER MEDICAL CENTER OF SANTA ROSA3325 CHANATE RDSANTA ROSACA95404CA - Santa Rosa17$43,000.12$10,671.65
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50006ST JOSEPH HOSPITAL2700 DOLBEER STEUREKACA95501CA - Redding48$44,664.46$8,227.15
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50603SADDLEBACK MEMORIAL MEDICAL CENTER24451 HEALTH CENTER DRIVELAGUNA HILLSCA92653CA - Orange County14$44,761.50$6,496.43
25
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50115PALOMAR MEDICAL CENTER555 E VALLEY PARKWAYESCONDIDOCA92025CA - San Diego12$44,775.92$6,992.33
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50133RIDEOUT MEMORIAL HOSPITAL726 4TH STMARYSVILLECA95901CA - Sacramento27$45,246.74$7,863.15
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50280MERCY MEDICAL CENTER REDDING2175 ROSALINE AVE, CLAIRMONT HGTSREDDINGCA96001CA - Redding75$48,567.23$8,668.09
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50295MERCY HOSPITAL2215 TRUXTUN AVENUEBAKERSFIELDCA93301CA - Bakersfield11$48,852.45$7,049.09
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50573EISENHOWER MEDICAL CENTER39-000 BOB HOPE DRIVERANCHO MIRAGECA92270CA - Palm Springs/Rancho M53$50,977.02$6,519.72
30
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50485LONG BEACH MEMORIAL MEDICAL CENTER2801 ATLANTIC AVELONG BEACHCA90806CA - Los Angeles23$51,813.13$8,349.61
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50007PENINSULA MEDICAL CENTER1501 TROUSDALE DRIVEBURLINGAMECA94010CA - San Mateo County16$51,950.88$7,863.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50107MARIAN MEDICAL CENTER1400 E CHURCH STSANTA MARIACA93454CA - Santa Barbara34$51,983.85$7,992.35
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50128TRI-CITY MEDICAL CENTER4002 VISTA WAYOCEANSIDECA92056CA - San Diego26$52,977.92$7,548.77
34
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50036BAKERSFIELD MEMORIAL HOSPITAL420 34TH ST BOX 1888BAKERSFIELDCA93301CA - Bakersfield21$53,334.81$8,012.24
35
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50334SALINAS VALLEY MEMORIAL HOSPITAL450 EAST ROMIE LANESALINASCA93901CA - Salinas17$53,860.18$16,744.82
36
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50516MERCY SAN JUAN MEDICAL CENTER6501 COYLE AVECARMICHAELCA95608CA - Sacramento39$54,446.46$9,882.15
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50222SHARP CHULA VISTA MEDICAL CENTER751 MEDICAL CENTER COURTCHULA VISTACA91911CA - San Diego13$55,232.69$8,104.38
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50549LOS ROBLES HOSPITAL & MEDICAL CENTER215 W JANSS RDTHOUSAND OAKSCA91360CA - Ventura11$56,328.91$7,835.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50077SCRIPPS MERCY HOSPITAL4077 5TH AVESAN DIEGOCA92103CA - San Diego13$57,187.31$8,791.69
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50179EMANUEL MEDICAL CENTER INC825 DELBON AVETURLOCKCA95382CA - Modesto15$57,258.73$7,714.13
41
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50084ST JOSEPHS MED CENTER OF STOCKTON1800 N CALIFORNIA STSTOCKTONCA95204CA - Stockton66$59,184.74$8,628.41
42
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50308EL CAMINO HOSPITAL2500 GRANT ROADMOUNTAIN VIEWCA94040CA - San Jose12$59,465.00$8,180.00
43
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50225FEATHER RIVER HOSPITAL5974 PENTZ ROADPARADISECA95969CA - Chico12$60,022.58$7,122.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50557MEMORIAL MEDICAL CENTER1700 COFFEE RDMODESTOCA95355CA - Modesto41$60,264.98$7,457.39
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50394COMMUNITY MEMORIAL HOSPITAL SAN BUENAVENTURA147 N BRENT STVENTURACA93003CA - Ventura21$60,448.48$6,967.24
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50108SUTTER GENERAL HOSPITAL2801 L STREETSACRAMENTOCA95816CA - Sacramento67$60,997.16$8,894.85
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50360MARIN GENERAL HOSPITAL250 BON AIR ROAD, PO BOX 8010GREENBRAECA94904CA - San Francisco32$62,077.72$8,526.00
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50424SCRIPPS GREEN HOSPITAL10666 NORTH TORREY PINES ROADLA JOLLACA92037CA - San Diego11$62,924.09$7,309.82
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50551LOS ALAMITOS MEDICAL CENTER3751 KATELLA AVENUELOS ALAMITOSCA90720CA - Orange County13$64,229.62$6,719.38
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50481WEST HILLS HOSPITAL & MEDICAL CENTER7300 MEDICAL CENTER DRWEST HILLSCA91307CA - Los Angeles16$64,346.69$6,770.06
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50232FRENCH HOSPITAL MEDICAL CENTER1911 JOHNSON AVESAN LUIS OBISPOCA93401CA - San Luis Obispo18$64,419.67$7,185.44
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50058GLENDALE MEM HOSPITAL & HLTH CENTER1420 S CENTRAL AVEGLENDALECA91204CA - Los Angeles11$65,099.55$11,082.18
53
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50017MERCY GENERAL HOSPITAL4001 J STSACRAMENTOCA95819CA - Sacramento27$66,207.67$10,863.22
54
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50380GOOD SAMARITAN HOSPITAL2425 SAMARITAN DRIVESAN JOSECA95124CA - San Jose17$69,223.47$11,721.65
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039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50761PROVIDENCE TARZANA MEDICAL CENTER18321 CLARK STREETTARZANACA91356CA - Los Angeles48$70,478.25$7,174.90
56
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50082ST JOHNS REGIONAL MEDICAL CENTER1600 N ROSE AVEOXNARDCA93030CA - Ventura28$72,051.89$8,009.18
57
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50464DOCTORS MEDICAL CENTER1441 FLORIDA AVENUEMODESTOCA95350CA - Modesto35$72,225.31$8,882.77
58
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50625CEDARS-SINAI MEDICAL CENTER8700 BEVERLY BLVDLOS ANGELESCA90048CA - Los Angeles40$72,784.00$9,754.93
59
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50764SHASTA REGIONAL MEDICAL CENTER1100 BUTTE STREDDINGCA96001CA - Redding13$74,093.92$7,852.00
60
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50496JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS2540 EAST STCONCORDCA94520CA - Contra Costa County20$79,033.50$8,485.00
61
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50174SANTA ROSA MEMORIAL HOSPITAL1165 MONTGOMERY DRSANTA ROSACA95405CA - Santa Rosa16$82,480.75$8,830.75
62
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50180JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS1601 YGNACIO VALLEY RDWALNUT CREEKCA94598CA - Contra Costa County20$85,165.10$12,355.85
63
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50243DESERT REGIONAL MEDICAL CENTER1150 NORTH INDIAN CANYON DRIVEPALM SPRINGSCA92262CA - Palm Springs/Rancho M12$88,175.00$8,766.83
64
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50441STANFORD HOSPITAL300 PASTEUR DRIVESTANFORDCA94305CA - San Mateo County27$90,836.48$12,396.30
65
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50197SEQUOIA HOSPITAL170 ALAMEDA DE LAS PULGASREDWOOD CITYCA94062CA - San Mateo County19$94,693.84$8,682.95
66
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50235PROVIDENCE SAINT JOSEPH MEDICAL CTR501 SOUTH BUENA VISTABURBANKCA91505CA - Los Angeles31$101,282.03$8,294.94
67
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50013ST HELENA HOSPITAL10 WOODLAND ROADSAINT HELENACA94574CA - Napa17$105,929.47$9,438.00
68
039 - EXTRACRANIAL PROCEDURES W/O CC/MCC50599UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER2315 STOCKTON BOULEVARDSACRAMENTOCA95817CA - Sacramento13$146,892.00$11,514.38
69
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50261SIERRA VIEW DISTRICT HOSPITAL465 W PUTNAM AVEPORTERVILLECA93257CA - Bakersfield11$20,552.27$7,617.64
70
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50030OROVILLE HOSPITAL2767 OLIVE HIGHWAYOROVILLECA95966CA - Chico11$21,153.09$6,728.36
71
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50701SOUTHWEST HEALTHCARE SYSTEM25500 MEDICAL CENTER DRIVEMURRIETACA92562CA - San Diego25$22,742.32$6,477.64
72
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50056ANTELOPE VALLEY HOSPITAL MED CENTER1600 W AVE JLANCASTERCA93534CA - Los Angeles19$23,186.05$7,844.63
73
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50342PIONEERS MEMORIAL HEALTHCARE DISTRICT207 WEST LEGION ROADBRAWLEYCA92227CA - San Diego12$23,502.00$7,361.83
74
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50382CITRUS VALLEY MEDICAL CENTER-IC CAMPUS210 W SAN BERNARDINO ROADCOVINACA91723CA - Los Angeles22$23,641.73$8,261.64
75
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50204PALMDALE REGIONAL MEDICAL CENTER38600 MEDICAL CENTER DRIVEPALMDALECA93552CA - Los Angeles15$24,102.80$6,984.07
76
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50327LOMA LINDA UNIVERSITY MEDICAL CENTER11234 ANDERSON STLOMA LINDACA92354CA - San Bernardino13$25,208.85$9,939.85
77
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50121ADVENTIST MEDICAL CENTER115 MALL DRIVEHANFORDCA93230CA - Fresno19$25,281.84$7,168.89
78
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50224HOAG MEMORIAL HOSPITAL PRESBYTERIANONE HOAG DRIVENEWPORT BEACHCA92663CA - Orange County15$25,761.53$5,764.87
79
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50396SANTA BARBARA COTTAGE HOSPITAL400 WEST PUEBLOSANTA BARBARACA93102CA - Santa Barbara18$25,975.17$7,028.11
80
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50111TEMPLE COMMUNITY HOSPITAL235 N HOOVER STLOS ANGELESCA90004CA - Los Angeles11$28,268.45$8,602.00
81
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50039ENLOE MEDICAL CENTER1531 ESPLANADECHICOCA95926CA - Chico12$28,830.42$6,164.92
82
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50077SCRIPPS MERCY HOSPITAL4077 5TH AVESAN DIEGOCA92103CA - San Diego41$29,651.17$8,133.32
83
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50334SALINAS VALLEY MEMORIAL HOSPITAL450 EAST ROMIE LANESALINASCA93901CA - Salinas17$30,182.12$8,171.12
84
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50191ST MARY MEDICAL CENTER1050 LINDEN AVELONG BEACHCA90813CA - Los Angeles11$30,237.36$8,308.09
85
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50112SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL1250 16TH STREETSANTA MONICACA90404CA - Los Angeles28$30,474.11$7,286.82
86
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50025UNIVERSITY OF CALIFORNIA SAN DIEGO MEDICAL CENTER200 WEST ARBOR DRIVESAN DIEGOCA92103CA - San Diego16$31,442.75$10,488.88
87
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50324SCRIPPS MEMORIAL HOSPITAL LA JOLLA9888 GENESEE AVENUELA JOLLACA92037CA - San Diego14$31,504.43$7,565.86
88
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50455SAN JOAQUIN COMMUNITY HOSPITAL2615 CHESTER AVENUEBAKERSFIELDCA93301CA - Bakersfield27$32,546.59$7,024.56
89
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50309SUTTER ROSEVILLE MEDICAL CENTERONE MEDICAL PLAZAROSEVILLECA95661CA - Sacramento16$32,757.81$6,692.88
90
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50093SAINT AGNES MEDICAL CENTER1303 E HERNDON AVEFRESNOCA93710CA - Fresno19$33,040.16$7,000.47
91
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50488EDEN MEDICAL CENTER20103 LAKE CHABOT ROADCASTRO VALLEYCA94546CA - Alameda County26$33,223.12$7,901.15
92
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50060COMMUNITY REGIONAL MEDICAL CENTER2823 FRESNO STREETFRESNOCA93715CA - Fresno25$33,403.12$10,118.56
93
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50133RIDEOUT MEMORIAL HOSPITAL726 4TH STMARYSVILLECA95901CA - Sacramento15$33,826.87$6,904.53
94
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50145COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA23625 W R HOLMAN HIGHWAYMONTEREYCA93940CA - Salinas13$34,389.38$7,929.46
95
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50057KAWEAH DELTA MEDICAL CENTER400 W MINERAL KING AVEVISALIACA93291CA - Bakersfield25$34,588.28$7,680.44
96
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50485LONG BEACH MEMORIAL MEDICAL CENTER2801 ATLANTIC AVELONG BEACHCA90806CA - Los Angeles27$34,735.37$7,540.74
97
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50276CONTRA COSTA REGIONAL MEDICAL CENTER2500 ALHAMBRA AVEMARTINEZCA94553CA - Contra Costa County23$35,616.61$19,239.30
98
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50567MISSION HOSPITAL REGIONAL MED CENTER27700 MEDICAL CENTER RDMISSION VIEJOCA92691CA - Orange County22$35,669.50$5,781.86
99
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50026GROSSMONT HOSPITAL5555 GROSSMONT CENTER DRIVE BOX 58LA MESACA91942CA - San Diego35$35,709.80$6,548.89
100
057 - DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC50752BROTMAN MEDICAL CENTER3828 DELMAS TERRACECULVER CITYCA90231CA - Los Angeles13$36,151.77$6,970.08
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