SNFData - 675364 - 12/1997

CANTERBURY VILLA OF BAIRD
BAIRD, TX 79504

Medicare Provider Number: 675364

Cost report status: Settled Without Audit

[Record Code 100165 - 1996]

Excel

PDF

You are not logged in or you have not purchased this report. This report has had its actual values replaced with dummy text ('###').

If you would like to become a subscriber, please look at our subscription details.

If you are already a subscriber, please login.

RATIO OF COST TO CHARGES		PROVIDER NO: 675364	PERIOD: FROM 01/01/1997 TO 12/31/1997	WORKSHEET C
Cost Center		TOTAL (From Wkst B, Pt. I, Col. 18)	Total Charges	Ratio (col. 1 ÷ col. 2)
Cost Center		1	2	3
ANCILLARY SERVICE COST CENTERS
21	Radiology	###	###	###	21
22	Laboratory				22
23	Intravenous Therapy	###	###	###	23
24	Oxygen ( Inhalation ) Therapy	###	###	###	24
25	Physical Therapy	###	###	###	25
26	Occupational Therapy	###	###	###	26
27	Speech Pathology	###	###	###	27
28	Electrocardiology				28
29	Medical Supplies Charged	###	###	###	29
30	Drugs Charged to Patients	###	###	###	30
31	Dental Care - Title XIX only				31
32	Support Surfaces				32
33	Other Ancillary Service Cost				33
OUTPATIENT SERVICE COST CENTERS
34	Clinic				34
35	R H C				35
36	Other Outpatient Service Cost				36
48	Ambulance				48
75	Total	###	###		75

Worksheet C