Medicaid SFY 2019 Quarterly Provider Fee As of September 27, 2018 Annual 1st Qtr Due 2nd Qtr Due 3rd Qtr Due 4th Qtr Due UID Facility Name SFY 2019 Fee 9/30/18 12/31/18 3/31/19 6/30/19 Amount HOSP301 Appling Hospital $231,847 $57,962 $57,962 $57,962 $57,961 HOSP306 Burke Medical Center $112,385 $28,096 $28,096 $28,096 $28,097 HOSP626 Candler Hospital $3,778,633 $944,658 $944,658 $944,658 $944,659 HOSP542 Cartersville Medical Center $2,876,065 $719,016 $719,016 $719,016 $719,017 HOSP416 Children's Healthcare of at Egleston $8,534,972 $2,133,743 $2,133,743 $2,133,743 $2,133,743 HOSP612 Children's Healthcare of Atlanta at Hughes Spalding $481,728 $120,432 $120,432 $120,432 $120,432 HOSP518 Children's Healthcare of Atlanta at Scottish Rite $7,463,889 $1,865,972 $1,865,972 $1,865,972 $1,865,973 HOSP406 Coffee Regional Medical Center $1,238,898 $309,724 $309,724 $309,725 $309,725 HOSP636 Coliseum Medical Centers $3,346,647 $836,662 $836,662 $836,662 $836,661 HOSP266 Coliseum $1,303,303 $325,826 $325,826 $325,826 $325,825 HOSP524 Colquitt Regional Medical Center $1,288,415 $322,104 $322,104 $322,104 $322,103 HOSP922 Columbus Specialty Hospital $134,306 $33,577 $33,577 $33,576 $33,576 HOSP317 Cook Medical Center- A Campus of Tift Regional Medical Center $127,846 $31,961 $31,961 $31,962 $31,962 HOSP623 Cornerstone Medical Center $61,993 $15,498 $15,498 $15,498 $15,499 HOSP405 Crisp Regional Hospital $721,478 $180,369 $180,369 $180,370 $180,370 HOSP552 Decatur Hospital $242,147 $60,537 $60,537 $60,537 $60,536 HOSP720 DeKalb Medical Center $4,418,098 $1,104,525 $1,104,525 $1,104,524 $1,104,524 HOSP902 DeKalb Medical Center at Hillandale $928,167 $232,042 $232,042 $232,042 $232,041 HOSP726 Doctor's Hospital of Augusta $6,677,227 $1,669,307 $1,669,307 $1,669,307 $1,669,306 HOSP309 Dodge County Hospital $265,284 $66,321 $66,321 $66,321 $66,321 HOSP310 Donalsonville Hospital, Inc. $231,434 $57,858 $57,858 $57,859 $57,859 HOSP501 Dorminy Medical Center $272,058 $68,014 $68,014 $68,015 $68,015 HOSP502 East Georgia Regional Medical Center $3,117,268 $779,317 $779,317 $779,317 $779,317 HOSP534 Eastside Medical Center $3,585,259 $896,315 $896,315 $896,315 $896,314 HOSP407 Elbert Memorial Hospital $123,263 $30,816 $30,816 $30,816 $30,815 HOSP408 Emanuel Medical Center $132,531 $33,133 $33,133 $33,133 $33,132 HOSP901 Emory Johns Creek Hospital $2,014,255 $503,564 $503,564 $503,564 $503,563 HOSP778 Emory Rehabilitation Hospital $341,788 $85,447 $85,447 $85,447 $85,447 HOSP706 Emory University Hospital $11,746,691 $2,936,673 $2,936,673 $2,936,673 $2,936,672 HOSP705 Emory University Hospital Midtown $10,623,974 $2,655,994 $2,655,994 $2,655,993 $2,655,993 HOSP368 Emory University Orthopaedics & Spine Hospital $1,210,351 $302,588 $302,588 $302,588 $302,587 HOSP448 Evans Memorial Hospital $129,188 $32,297 $32,297 $32,297 $32,297 HOSP510 Fairview Park Hospital $1,906,253 $476,563 $476,563 $476,563 $476,564 HOSP413 Fannin Regional Hospital $487,472 $121,868 $121,868 $121,868 $121,868 HOSP329 Flint River Community Hospital $136,339 $34,085 $34,085 $34,085 $34,084 HOSP606 $4,380,748 $1,095,187 $1,095,187 $1,095,187 $1,095,187 HOSP412 Gordon Hospital $1,970,750 $492,688 $492,688 $492,687 $492,687 HOSP351 Grady General Hospital $307,481 $76,870 $76,870 $76,870 $76,871 HOSP710 $8,074,584 $2,018,646 $2,018,646 $2,018,646 $2,018,646 HOSP366 $7,338,699 $1,834,675 $1,834,675 $1,834,675 $1,834,674 HOSP226 Gwinnett Medical Center - Duluth $2,042,478 $510,619 $510,619 $510,620 $510,620 HOSP414 Habersham County Medical Center $499,357 $124,839 $124,839 $124,839 $124,840 HOSP415 Hamilton Medical Center $2,999,756 $749,939 $749,939 $749,939 $749,939 HOSP927 HealthSouth Rehabilitation Hospital of Newnan $238,100 $59,525 $59,525 $59,525 $59,525 HOSP730 HealthSouth Walton Rehabilitation Hospital $279,247 $69,812 $69,812 $69,812 $69,811 HOSP439 Houston Medical Center $2,840,327 $710,082 $710,082 $710,082 $710,081 HOSP314 Irwin County Hospital $168,282 $42,070 $42,070 $42,071 $42,071 HOSP417 Jefferson Hospital $77,066 $19,267 $19,267 $19,266 $19,266 HOSP614 John D. Archbold Memorial Hospital $3,542,901 $885,725 $885,725 $885,725 $885,726 HOSP907 Kindred Hospital Rome $271,956 $67,989 $67,989 $67,989 $67,989 HOSP909 Landmark Hospital of Athens $268,095 $67,024 $67,024 $67,024 $67,023 HOSP776 Landmark Hospital of Savannah $228,402 $57,100 $57,100 $57,101 $57,101 HOSP443 Meadows Regional Medical Center $1,618,937 $404,734 $404,734 $404,734 $404,735 HOSP703 Memorial Health University Medical Center, Inc. $6,410,326 $1,602,581 $1,602,581 $1,602,582 $1,602,582 HOSP539 Memorial Hospital of Bainbridge $304,423 $76,106 $76,106 $76,106 $76,105 HOSP627 Memorial Satilla Health $1,966,017 $491,504 $491,504 $491,504 $491,505 HOSP320 Murray Medical Center $346,989 $86,747 $86,747 $86,747 $86,748 HOSP528 $799,535 $199,884 $199,884 $199,884 $199,883 HOSP611 Northeast Georgia Medical Center $11,861,866 $2,965,467 $2,965,467 $2,965,466 $2,965,466 HOSP303 Northeast Georgia Medical Center Barrow $286,993 $71,748 $71,748 $71,748 $71,749 HOSP440 Northridge Medical Center $255,293 $63,823 $63,823 $63,823 $63,824 HOSP634 Northside Hospital $24,964,683 $6,241,171 $6,241,171 $6,241,171 $6,241,170 HOSP541 Northside Hospital Cherokee $2,672,063 $668,016 $668,016 $668,016 $668,015 HOSP346 Northside Hospital Forsyth $6,113,262 $1,528,316 $1,528,316 $1,528,315 $1,528,315 HOSP450 Perry Hospital $356,127 $89,032 $89,032 $89,032 $89,031 HOSP616 Phoebe Putney Memorial Hospital $6,459,198 $1,614,799 $1,614,799 $1,614,800 $1,614,800 Georgia Medicaid SFY 2019 Quarterly Hospital Provider Fee As of September 27, 2018 Annual 1st Qtr Due 2nd Qtr Due 3rd Qtr Due 4th Qtr Due UID Facility Name SFY 2019 Fee 9/30/18 12/31/18 3/31/19 6/30/19 Amount HOSP602 Phoebe Sumter Medical Center $789,728 $197,432 $197,432 $197,432 $197,432 HOSP603 Medical Center $5,319,743 $1,329,936 $1,329,936 $1,329,936 $1,329,935 HOSP704 Piedmont Columbus Regional Midtown $3,940,116 $985,029 $985,029 $985,029 $985,029 HOSP125 Piedmont Columbus Regional Northside $950,107 $237,527 $237,527 $237,527 $237,526 HOSP318 Piedmont Fayette Hospital $4,145,695 $1,036,424 $1,036,424 $1,036,424 $1,036,423 HOSP532 , Inc $3,380,620 $845,155 $845,155 $845,155 $845,155 HOSP617 $12,187,961 $3,046,990 $3,046,990 $3,046,990 $3,046,991 HOSP451 Piedmont Mountainside Medical Center $1,021,846 $255,462 $255,462 $255,461 $255,461 HOSP629 $2,637,573 $659,393 $659,393 $659,393 $659,394 HOSP322 Piedmont Newton Hospital $465,835 $116,459 $116,459 $116,459 $116,458 HOSP240 Piedmont Rockdale Hospital $1,796,311 $449,078 $449,078 $449,078 $449,077 HOSP340 Piedmont Walton Hospital $1,054,773 $263,693 $263,693 $263,693 $263,694 HOSP637 Redmond Regional Medical Center $3,216,652 $804,163 $804,163 $804,163 $804,163 HOSP906 Regency Hospital Company of Macon $443,517 $110,879 $110,879 $110,879 $110,880 HOSP917 Regency Hospital of South Atlanta $199,421 $49,855 $49,855 $49,855 $49,856 HOSP707 Rehabilitation Hospital of Savannah $201,328 $50,332 $50,332 $50,332 $50,332 HOSP731 Rehabilitation Hospital, Navicent Health $222,591 $55,648 $55,648 $55,648 $55,647 HOSP619 Saint Francis Hospital $3,782,255 $945,564 $945,564 $945,564 $945,563 HOSP621 Saint Joseph's Hospital $2,957,986 $739,496 $739,496 $739,497 $739,497 HOSP714 Saint Joseph's Hospital of Atlanta $4,625,902 $1,156,476 $1,156,476 $1,156,475 $1,156,475 HOSP544 Select Specialty Hospital - Midtown Atlanta, LLC $92,440 $23,110 $23,110 $23,110 $23,110 HOSP923 Select Specialty Hospital - Savannah $187,315 $46,829 $46,829 $46,829 $46,828 HOSP904 Select Specialty Hospital of Augusta $424,307 $106,077 $106,077 $106,077 $106,076 HOSP228 $2,631,917 $657,979 $657,979 $657,979 $657,980 HOSP618 South Georgia Medical Center $4,287,038 $1,071,759 $1,071,759 $1,071,760 $1,071,760 HOSP445 South Georgia Medical Center - Berrien Campus $103,060 $25,765 $25,765 $25,765 $25,765 HOSP441 Southeast Georgia Health System - Camden Campus $643,847 $160,962 $160,962 $160,962 $160,961 HOSP507 Southeast Georgia Health System-Brunswick Campus $3,695,924 $923,981 $923,981 $923,981 $923,981 HOSP916 Southeastern Regional Medical Center, Inc $8,433,808 $2,108,452 $2,108,452 $2,108,452 $2,108,452 HOSP919 Southern Crescent Hospital for Specialty Care $115,700 $28,925 $28,925 $28,925 $28,925 HOSP547 Southern Regional Medical Center $2,030,127 $507,532 $507,532 $507,532 $507,531 HOSP622 St Mary's Hospital $2,526,491 $631,623 $631,623 $631,623 $631,622 HOSP915 St. Mary's Sacred Heart Hospital $347,526 $86,881 $86,881 $86,882 $86,882 HOSP545 Stephens County Hospital $465,840 $116,460 $116,460 $116,460 $116,460 HOSP244 Tanner Medical Center Villa Rica $1,603,799 $400,950 $400,950 $400,950 $400,949 HOSP435 Tanner Medical Center-Carrollton $3,918,656 $979,664 $979,664 $979,664 $979,664 HOSP519 Taylor Regional Hospital $277,030 $69,258 $69,258 $69,257 $69,257 HOSP712 The Medical Center, Navicent Health $7,805,302 $1,951,326 $1,951,326 $1,951,325 $1,951,325 HOSP521 Tift Regional Medical Center $3,848,501 $962,125 $962,125 $962,125 $962,126 HOSP248 $592,618 $148,154 $148,154 $148,155 $148,155 HOSP716 University Hospital $6,588,206 $1,647,052 $1,647,052 $1,647,051 $1,647,051 HOSP321 University Hospital McDuffie $244,367 $61,092 $61,092 $61,092 $61,091 HOSP620 University Hospital Summerville $755,806 $188,951 $188,951 $188,952 $188,952 HOSP523 Upson Regional Medical Center $971,808 $242,952 $242,952 $242,952 $242,952 HOSP540 Washington County Regional Medical Center $172,005 $43,001 $43,001 $43,001 $43,002 HOSP538 Wayne Memorial Hospital $735,529 $183,882 $183,882 $183,882 $183,883 HOSP709 WellStar $2,295,225 $573,806 $573,806 $573,806 $573,807 HOSP546 WellStar Cobb Hospital $5,047,712 $1,261,928 $1,261,928 $1,261,928 $1,261,928 HOSP312 WellStar Douglas Hospital $1,928,796 $482,199 $482,199 $482,199 $482,199 HOSP615 WellStar Kennestone Hospital $12,945,152 $3,236,288 $3,236,288 $3,236,288 $3,236,288 HOSP327 WellStar North Fulton Hospital $1,166,908 $291,727 $291,727 $291,727 $291,727 HOSP151 WellStar Paulding Hospital $1,640,254 $410,063 $410,063 $410,064 $410,064 HOSP508 WellStar Spalding Regional Hospital $908,241 $227,060 $227,060 $227,060 $227,061 HOSP605 WellStar West Georgia Medical Center $1,623,923 $405,981 $405,981 $405,981 $405,980 HOSP640 WellStar Windy Hill Hospital $990,539 $247,635 $247,635 $247,635 $247,634