412-17

AB 225 TRAN TRANSPORTS TO Fourth Quarter Report 2 Compiled by Clark County Dep

Total Dollar Amt Invoiced Transport Company or Government Entity Total # of Transports % of Grand Total as Fees Community Ambulance 3,770 $4,381,793

Transport Destination Transport Count Transport Charges Centennial Hills 4 $6,269.86 Clark County Detention Center 1 $1,131.78 Desert Springs Hospital 754 $837,904.53 Desert Willow Treatment Center 1 $1,076.02 Henderson Hospital 228 $248,749.37 Mountain View Hospital 4 $5,705.41 1 $1,236.45 O'Callaghan Federal Hospital 1 $1,347.97 Southern Hills Hospital 45 $58,428.60 Spring Mountain Treatment - Sahara 1 $1,271.18 Medical Center 136 $166,618.26 St Rose Dominican, San Martin Campus 306 $387,588.57 St Rose Dominican, Siena Campus 1127 $1,306,459.96 St. Rose Dominican, de Lima Campus 118 $138,586.33 Medical Center 8 $11,863.75 Sunrise Hospital 863 $988,071.57 UMC 2 $2,702.79 University Medical Center of Southern 148 $189,576.55 VA Southern Nevada Healthcare 1 $964.50 Valley Hospital Medical Center 21 $26,239.32

Grand Total 3770 $4,381,792.77 NSPORT REPORT MEDICAL FACILITIES 2016 (October-December) artment of Administrative Services

Insured Transports Uninsured Transports Transports Total # % of Total Total Dollar Total # % of Total Total Total # % of Total Total Insured Insured Amt Invoiced Uninsured Uninsured Dollar Amt Unknown Unknown Dollar Amt as Fees Invoiced as Invoiced as Fees Fees

3,213 85.23% $3,739,664 557 14.77% $642,128 Clark County AB 225 10/01/2016 - 12/31/2016 as of 01/03/2017

ALL Data To Facility Name Count of Account Number Sum of Total Current Charges Sunrise Medical Center - 17 $ 18,411.06 University Medical Center 11 $ 12,948.41 Western Arizona Regional Medical Center 11 $ 13,558.89 Desert Springs Hospital 4 $ 4,248.80 Spring Valley Hospital Medical Center 4 $ 4,537.33 Saint Rose Dominican Hospital Siena Campus 3 $ 3,904.51 Southern Hills Hospital 3 $ 3,245.12 University Med Center 3 $ 3,521.04 Summerlin Hospital 2 $ 2,343.23 Grand Total 58 $ 66,718.39 UNINSURED Data To Facility Name Count of Account Number University Medical Center 10 Sunrise Medical Center - Las Vegas 10 Western Arizona Regional Medical Center 4 University Med Center 3 Spring Valley Hospital Medical Center 3 Southern Hills Hospital 1 Desert Springs Hospital 1 Saint Rose Dominican Hospital Siena Campus 1 Summerlin Hospital 1 Grand Total 34 Sum of Total Current Charges $ 11,823.48 $ 10,798.77 $ 4,903.74 $ 3,521.04 $ 3,412.40 $ 1,041.29 $ 1,097.05 $ 1,180.69 $ 1,097.05 $ 38,875.51 Total Current Account Number Charges Primary Name 40176949 1180.69 AHCCCS Claims 40176950 1208.57 40252875 1180.69 40265851 1159.66 40288475 1180.69 Molina Healthcare of WA 40288476 1208.57 40288477 1246.18 Culinary Health Fund/ABPA 40396169 1041.29 40396170 1013.41 40396171 1243.3 40396172 1076.02 40396173 1236.45 40396174 1236.45 40411310 1292.21 Senior Dimensions 40411311 1264.33 Secure Horizons Medicare Direc 40489521 1152.81 40489522 1048.14 40503976 1180.69 40503977 1097.05 40595046 1190.42 40595047 1124.93 Blue Cross Blue Shield of NV 40634036 1106.78 Medicare - NV 40655044 1180.69 Clark County Fire Fighters Sec 40682591 1124.93 40730777 1152.81 40741893 1180.69 Medicaid/Health Plan of NV 40741894 1069.17 40741895 1013.41 VA Southern NV Healthcare Sys 40821103 1041.29 State Farm Insurance 40821104 1152.81 Aetna 40841931 1124.93 40873515 1320.09 Health Plan of Nevada 40873516 1097.05 40873519 1180.69 40897754 1124.93 Amerigroup NV Claims 40897755 1069.17 Medicaid/Health Plan of NV 40914247 1097.05 40914248 1320.09 40943867 964.5 Medicaid - NV 40943868 1106.78 Medicaid - NV 40943869 1097.05 40960242 992.38 41006841 1097.05 Amerigroup NV Claims 41006842 1320.09 Senior Dimensions 41006843 1134.66 41049496 1013.41 41066160 1103.9 41086122 1124.93 Amerigroup NV Claims 41114509 1459.49 Medicare - NV 41114510 1069.17 41167400 1274.06 41167401 1208.57 41217806 1069.17 41245386 1097.05 Medicaid - NV 41254109 1152.81 Clark County Fire Fighters Sec 41254110 1236.45 41262829 1041.29 Medicaid - NV 41342341 1236.45 To Facility Name Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas Saint Rose Dominican Hospital Siena Campus Western Arizona Regional Medical Center Western Arizona Regional Medical Center University Medical Center Summerlin Hospital Southern Hills Hospital Sunrise Medical Center - Las Vegas Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas University Medical Center University Med Center Western Arizona Regional Medical Center Saint Rose Dominican Hospital Siena Campus Spring Valley Hospital Medical Center University Med Center University Medical Center Sunrise Medical Center - Las Vegas Sunrise Medical Center - Las Vegas Spring Valley Hospital Medical Center Southern Hills Hospital Western Arizona Regional Medical Center Spring Valley Hospital Medical Center University Medical Center Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas Desert Springs Hospital Sunrise Medical Center - Las Vegas Sunrise Medical Center - Las Vegas University Medical Center Western Arizona Regional Medical Center University Medical Center Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas Sunrise Medical Center - Las Vegas Desert Springs Hospital Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas Sunrise Medical Center - Las Vegas Summerlin Hospital Sunrise Medical Center - Las Vegas Southern Hills Hospital Western Arizona Regional Medical Center Spring Valley Hospital Medical Center Sunrise Medical Center - Las Vegas University Medical Center University Medical Center Saint Rose Dominican Hospital Siena Campus Sunrise Medical Center - Las Vegas University Medical Center University Medical Center Sunrise Medical Center - Las Vegas Desert Springs Hospital Sunrise Medical Center - Las Vegas University Medical Center Desert Springs Hospital University Med Center