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TABLE OF CONTENTS	SUBMITTING APPLICABLE

SCHEDULES V1A, V1B, V1C, V1D-INPATIENT AND PATIENT DAYS
SCHEDULES V2A, V2B, - OUTPATIENT VISITS
SCHEDULES V3A, V3D-ANCILLARY SERVICE UNITS
SCHEDULE V5-EQUIVALENT INPATIENT DAYS AND ADMISSIONS
SCHEDULE OADP–ALLOOCATION EXPENSES (CAFETERIA,PARKING,DATA PROCESSING)
SCHEDULE UA-UNASSIGNED EXPENSES
SCHEDULES P1A, P1B-HOSPITAL BASED PHYSICIANS ALLOCATION
SCHEDULES P2A TO P2I - MEDICAL STAFF SERVICES
SCHEDULES P3 - PHYSICIAN SUPPORT SERVICES
SCHEDULES P4A TO P4I-RESIDENTS, INTERNS SERVICES-ELIGIBLE
SCHEDULES P5A TO P5I-RESIDENTS, INTERNS SERVICES-INELIGIBLE
SCHEDULE C -GENERAL SERVICE CENTERS
SCHEDULES D -PATIENT CARE CENTERS
SCHEDULES E1 TO E9-AUXILIARY ENTERPRISES
SCHEDULES F1 TO F4-OTHER INSTITUTIONAL PROGRAMS
SCHEDULE RC – RECONCILIATION OF BASE YR & BUDGET YR EXPENSES TO SCHEDULE RE
SCHEDULE RE – STATEMENT OF REVENUE AND EXPENSES
SCHEDULE RE-R – RECONCILATION OF THE AUDITED FINANCIALS TO RE SCHEDULE
SCHEDULE AHA-R – RECONCILIATION OF FINANCIAL STATEMENTS TO AHA SUBMISSIOIN
SCHEDULES J1, J2-OVERHEAD EXPENSE APPORTIONMENT
SCHEDULES J3, J4-OVERHEAD EXPENSE APPORTIONMENT (PSYCH HOSPITALS)
SCHEDULES JS1, JS2-OVERHEAD STATISTICAL APPORTIONMENT
SCHEDULES JS3, JS4-OVERHEAD STATISTICAL APPORTIONMENT (PSYCH HOSPITALS)
SCHEDULE H1-BUILDING FACILITY ALLOWANCE
SCHEDULE H2 - DEPARTMENTAL EQUIPMENT ALLOWANCE
SCHEDULES H3A, H3B-DISTRIBUTION OF CAPITAL FACILITIES ALLOWANCE
SCHEDULE H4-CAPITAL FACILITY ALLOWANCE SUMMARY
SCHEDULE H4A-EQUIPMENT PURCHASES AND LEASES
SCHEDULE G-OTHER FINANCIAL CONSIDERATIONS
SCHEDULE GR-CASH AND MARKETABLE ASSETS
SCHEDULE PDA-THIRD PARTY DIFFERENTIAL
SCHEDULES M, MA- PART A COST ACCUMULATINS LEVELS I – IV
SCHEDULE MC, MD – PART A COST ACCUMULATINS LEVELS I – IV (PSYCH HOSPITALS)
SCHEDULE OES – OVERHEAD EXPENSE SUMMARY – PART B
SCHEDULE UR1 TO UR9 – UNREGUALTED SERVICES
SCHEDULE URS - UNREGULATED SERVICES SUMMARY
SCHEDULE ACS-ANNUAL COST SURVEY
SCHEDULE TRE-TRANSACTIONS WITH RELATED ENTITIES
SCHEDULE D21A – OUTPATIENT SURGERY PROCEDURE BASED
SCHEUDULE SB – SUPPLEMENTAL BIRTHS
SCHEDULE SBCI, SBCII – STANDBY COSTS-TRAUMA PHYSICIANS
SCHEDULE MTC – MIEMMS REGULATORY TRAUMA COST SUMMARY
SCHEUDULES MTC-A TO MTC-F – REGULATORY TRAUMA COSTS
SUPPLEMENTAL SCHEDULE 1 –SUMMARY OF OTHER & NON-OPERATING REVENUE (RE)
SUPPLEMENTAL SCHEDULE 2 – RECONCILIATION OF DEPRECIATION & LEASE/RENTALS (UA)
SUPPLEMENTAL SCHEDULE 3 - RECONCILIATION OF UCC (PDA)
SUPPLEMENTAL SCHEDULE 4 – DETAIL OF MCO REGULATED REVENUE (PDA)
SUPPLEMENTAL SCHEDULE 5 – SUPPLEMENT TO FS AND RE SCHEDULES TO DISCLOSE NON-OPERATING REVENUE AND EXPENSE (RE)
SUPPLEMENTAL SCHEDULES 6 – STANDBY COSTS (SBC-I & SBC-II)

*I HEREBY CERTIFY THAT I HAVE REVIEWED THIS LIST OF ANNUAL REPORT SCHEDULES AND AM SUBMITTING ALL SCHEDULE APPLICABLE TO ______________________ HOSPITAL.

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