National Provider Identifier (NPI)
Provider Number
Effective Date
Fiscal Year Beginning Date
Report Date
Termination Date
PPS Waiver Indicator (Y=Not Under PPS;N=Under PPS)
Intermediary Number
Provider Type
Census Division
Change Code Wage Index Reclassification
MSA - Actual Geographic Location
MSA - Wage Index Location
MSA - Standardized Amount Location
Sole Community Hospital (SCH) Medical Dependent Hospital (MDH) Base Year
Change Code for Lugar Reclassification
Temporary Relief Indicator
Federal PPS Blend Indicator
State Code
Case Mix Adjusted Cost Per Discharge/PPS Facility Specific Rate
Cost of Living Adjustment (COLA)
Intern/Resident to Bed Ratio
Bed Size
Operating Cost to Charge Ratio
Case Mix Index
Supplemental Security Income (SSI) Ratio
Medicaid Ratio
Provider PPS Period (Not Used as of 4/1/91)
Special Provider Update Factor (Not Used as of 4/1/91)
Operating Disproportionate Share Adjustment (DSH) Percentage (Not Used as of 10/
Fiscal Year End Date - No Longer Used
Special Payment Indicator
Hospital Quality Indicator
CBSA - Actual Geographic Location
CBSA - Wage Index Location
CBSA - Standardized Amount Location
Special Wage Index
Pass Through Amount for Capital
Pass Through Amount for Durable Medical Equipment
Pass Through Amount for Organ Acquisition
Pass Through Amount for Total Including Misc.
Capital PPS Code
Hospital Specfic Capital Rate
Old Capital Hold Harmless Rate
New Capital Hold Harmless Ratio
Capital Cost to Charge Ratio
New Hospital
Capital Indirect Medical Education Ratio
Capital Exception Payment Ratio
Fiscal Year (Based on Effective date)