107 Regional Hosp. 4/8/13 5/29/13 A 109 Northeast Health Sys - Addison 4/8/13 4/18/13 A 110 Northeast Health Sys - Beverly 4/8/13 4/18/13 A 116 Med. Ctr. / Hosp & Union 4/8/13 4/19/13 A 112 Hosp. 4/8/13 4/22/13 A 127 Saint Vincent Hosp @ Med Ctr 4/8/13 4/23/13 A 6963 for Children - 4/8/13 5/3/13 A 11718 for Children - 4/8/13 4/18/13 A 25 Signature Healthcare Hosp 4/8/13 4/18/13 A 122 Hosp. 4/8/13 4/26/13 A 123 Southcoast Health - Charlton Memorial 5/31/13 Data not verified 124 Southcoast Health - Lukes 5/31/13 Data not verified 145 Southcoast Health - Campus 5/31/13 Data not verified 42 4/8/13 5/13/13 A 62 4/8/13 5/13/13 A 4460 Steward Good Sam Med Ctr - Norcap Lodge 4/8/13 5/12/13 A 75 4/8/13 5/12/13 A 41 4/8/13 5/13/13 A 114 Steward Saint Anne's Hospital 4/8/13 5/12/13 A 126 Steward St. Elizabeth's 4/8/13 5/13/13 A 129 4/8/13 4/22/13 A 104 Med. Ctr. 4/8/13 4/22/13 A 131 U / Memorial Health - U. Mass Campus 4/8/13 4/29/13 B 139 U Mass / Wing Memorial Hosp. 4/8/13 data not verified 138 Hosp. & Family Med. Ctr. 4/8/13 4/13/13 A Individual Hospital Discrepancy Documentation
Transport Ambulance Run Number (delayed indefinitely) Medical Record Number Stated Reason for (effective 10/1/02) End of Line Items Indicator Number of ED Treatment Beds at Site Number of ED-based Observation Beds at Site Total Number of ED-based Beds at Site ED Visits – Admitted to Inpatient at Site ED Visits – Admitted to Outpatient Observation at Site ED Visits – All Other Outpatient ED Visits at Site ED Visits – Total Registered at Site End of Record Indicator Number of Outpatient ED Visits Total Charges for Batch TYPE ‘B’ ERRORS: Mother’s Social Security Number Patient Race Patient Zip Code Discharge Time (effective 10/1/02) Type of Visit Source of Visit Secondary Source of Visit Other Physician Number ED Physician Number Other Caregiver Code Emergency Severity Index Homeless Indicator (effective 10/1/02) Service Line Item Race 1, 2 & Other Race Hispanic Indicator Ethnicity 1, 2 & Other Ethnicity Condition Present on Admission Primary Diagnosis, Associate Diagnoses I – XIV, & Primary E-Code Significant Procedure Date Operating Physician for Significant Procedure Permanent Patient Street Address, City/Town, State, Zip Code Patient Country Temporary Patient Street Address, City/Town, State, Zip Code
79 79 79 Jordan Hospital 275 Sandwich Street Plymouth MA 02360 136 136 136 Kindred Hospital Boston 1515 Commonwealth Avenue Boston MA 135 135 135 Kindred Hospital Boston North Shore 15 King Street Peabody MA 01960 81 81 81 Clinic - Burlington Campus 41 Mall Road Burlington MA 01805 *** 4448 4448 Lahey Clinic North Shore One Essex Center Drive Peabody MA 83 83 83 Lawrence General Hospital One General Street Lawrence MA 01842 85 85 85 Lowell General Hospital 295 Varnum Avenue Lowell MA 133 133 133 Marlborough Hospital 157 Union Street MA 88 88 88 Martha's Vineyard Hospital One Hospital Road P.O. Box 1477 Oak Bluffs MA 02557 89 89 89 Massachusetts Eye and Ear Infirmary 243 Charles Street Boston MA 02114 91 91 91 Massachusetts General Hospital 55 Street Boston MA 02114 118 118 118 Mercy Medical Center - Providence Behavioral Health Hospital Campus 1233 Main Street Holyoke MA 01040 119 119 119 Medical Center - Springfield Campus 271 Carew Street Springfield MA 01102 11466 11466 Merrimack Valley Hospital, A Steward Family Hospital, Inc. 140 Lincoln Avenue Haverhill MA 01830 49 49 3110 MetroWest Medical Center - Framingham Campus 115 Lincoln Street MA 01701 *** 457 457 MetroWest Medical Center - Leonard Morse Campus 67 Union Street Natick MA 01760 97 97 97 Milford Regional Medical Center 14 Prospect Street Milford MA 01757 99 99 99 Morton Hospital, A Steward Family Hospital, Inc. 88 Washington Street Taunton MA 02780 100 100 100 Mount Auburn Hospital 330 Mount Auburn Street Cambridge MA 101 101 101 Nantucket Cottage Hospital 57 Prospect Street Nantucket MA 02554 11467 11467 11467 Nashoba Valley Medical Center, A Steward Family Hospital, Inc. 200 Groton Road Ayer MA 01432 103 103 103 New England Baptist Hospital 125 Parker Hill Avenue Boston MA 02120 105 105 105 Newton-Wellesley Hospital 2014 Washington Street Newton MA 02462 106 106 106 Noble Hospital PO Box 1634 Westfield MA 01086
107 107 107 North Adams Regional Hospital 71 Hospital Avenue Adams MA 01247 116 116 116 North Shore Medical Center - Salem Campus 81 Highland Avenue Salem MA 01970 *** 3 3 North Shore Medical Center - Union Campus 500 Lynnfield Street Lynn MA 01904 109 109 109 Northeast Hospital - Addison Gilbert Campus 298 Washington Street Gloucester MA 110 110 110 Northeast Hospital - Beverly Campus 85 Herrick Street Beverly MA 112 112 112 Quincy Medical Center, A Steward Family Hospital, Inc. 114 Whitwell Street Quincy MA 02169 127 127 127 Saint Vincent Hospital 123 Summer Street Worcester MA 01608 115 115 115 Saints Medical Center One Hospital Drive Lowell MA 01852 6963 6963 6963 Shriners Hospitals for Children Boston 51 Blossom Street Boston MA 02114 11718 11718 Shriners Hospitals for Children Springfield 516 Street Springfield MA 01104 25 25 25 Signature Healthcare Brockton Hospital 680 Centre Street Brockton MA 02302 122 122 122 South Shore Hospital 55 Fogg Road South Weymouth MA 02190 123 123 123 Southcoast Hospitals Group - Charlton Memorial Campus 363 Highland Avenue Fall MA 02720 124 124 124 Southcoast Hospitals Group - St. Luke's Campus 101 Page Street New Bedford MA 02740 145 145 145 Southcoast Hospitals Group - Tobey Hospital Campus 43 High Street Wareham MA 02571 42 42 42 Steward Carney Hospital, Inc. 2100 Dorchester Avenue Dorchester MA 02124 62 62 62 Steward Good Samaritan Medical Center - Brockton Campus 235 North Pearl Street Brockton MA 02301 4460 4460 4460 Steward Good Samaritan Medical Center - NORCAP Lodge Campus 71 Walnut Street Foxboro MA 02035 75 75 75 Steward Holy Family Hospital, Inc. 70 East Street Methuen MA 01844 41 41 41 Steward Norwood Hospital, Inc. 800 Washington Street Norwood MA 02062 114 114 114 Steward Saint Anne's Hospital, Inc. 795 Middle Street Fall River MA 02721 126 126 126 Steward St. Elizabeth's Medical Center 736 Cambridge Street Boston MA 02135 129 129 129 Sturdy Memorial Hospital 211 Park Street P.O. Box 2963 Attleboro MA 02703 104 104 104 Tufts Medical Center 800 Washington Street Boston MA 02111