340B Drug Pricing Program Database


DSH360159 ADENA REGIONAL MEDICAL CENTER (Active) - information as of 6/1/2025 3:52:55 AM

Main Details
ADENA REGIONAL MEDICAL CENTER
Disproportionate Share Hospital
Yes
DSH360159
360159


Additional Details
Active
3/4/2008
4/1/2008
3/11/2008
8/20/2024

Contacts

Adena Health System
Katherine Edrington, Chief Operations Officer
(740) 779-7282

Adena Health System
Fred Yingling, Director of Pharmacy
(740) 779-7648

Addresses

272 HOSPITAL ROAD
CHILLICOTHE, OH 45601

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
3/30/09 DOC RECEIVED TO CONFIRM ELIG DSH ADJ%03/31/2009
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OH0066701,0067053,0401860,14756851902839673,1235468083,1437488558,1659647170,1013547835
AZ 1235468083,1902839673
FL 1235468083,1902839673
KY 1235468083,1902839673
LA 1235468083,1902839673
MI 1235468083,1902839673
MO 1235468083,1902839673
TN 1235468083,1902839673
TX 1235468083,1902839673
VA 1235468083,1902839673
WA 1235468083,1902839673
WV 1235468083,1902839673
Shipping Addresses

Adena Regional Medical Center
272 Hospital Road
Chillicothe, OH 45601

Safecor Health, LLC
4060 Business Park Drive
Columbus, OH 43204

Adena Pharmacy
272 Hospital Road
Chillicothe, OH 45601

Adena Cancer Center Pharmacy
4435 SR 159
Chillicothe, OH 45601

Adena Community Pharmacy Woodlands
311 Caldwell Street
Chillicothe, OH 45601

Adena Wellston Pharmacy
2 E. A Street
Wellston, OH 45692

Adena Warrior Pharmacy
169 W. High Street
Frankfort, OH 45628
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailADENA CANCER CENTER PHARMACYDBA ADENA CANCER CENTER PHARMACY 4435 STATE ROUTE 159
CHILLICOTHEOH4560102/14/201304/01/2013 05/01/202405/01/2024
Contract DetailADENA PHARMACY LLCD.B.A ADENA COMMUNITY PHARMACY - WOODLAN 311 CALDWELL ST
CHILLICOTHEOH45601-333204/15/202007/01/2020 05/01/202405/01/2024
Contract DetailADENA PHARMACY, LLC272 HOSPITAL RD
CHILLICOTHEOH45601-903112/04/201201/01/2013 05/01/202405/01/2024
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/11/201601/01/2017  10/11/2016
Contract DetailKROGER COLUMBUS CENTRAL FILL #0192270 RICKENBACKER PKWY W
COLUMBUSOH4321704/21/201607/01/2016  04/21/2016
Contract DetailKROGER PHARMACY1165 WESTERN AVENUE
CHILLICOTHEOH4560104/21/201607/01/2016  04/21/2016
Contract DetailKROGER PHARMACY220 WAVERLY PLAZA
WAVERLYOH4569007/16/201910/01/2019  10/01/2019
Contract DetailKROGER PHARMACY530 E. MAIN STREET
JACKSONOH4564007/16/201910/01/2019  10/01/2019
Contract DetailKROGER PHARMACY548 CLINTON AVENUE
WASHINGTON CHOH4316007/16/201910/01/2019  10/01/2019
Contract DetailKROGER PHARMACY N-348887 N BRIDGE STREET
CHILLICOTHEOH4560104/21/201607/01/2016  04/21/2016
Contract DetailKROGER PHARMACY N-844175 LANCASTER PIKE
CIRCLEVILLEOH4311307/16/201910/01/2019  10/01/2019
Contract DetailOHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 06195 205 EAST MAIN ST
CIRCLEVILLEOH4311304/15/201907/01/2019  07/01/2019
Contract DetailOHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 06189 11 CENTENNIAL BLVD.
CHILLICOTHEOH4560104/15/201907/01/2019  07/01/2019
Contract DetailOHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 06190 1021 NORTH BRIDGE ST.
CHILLICOTHEOH4560104/15/201907/01/2019  07/01/2019
Contract DetailOHIO CVS STORES, L.L.C.DBA: CVS/PHARMACY # 03419 353 E. MAIN ST.
JACKSONOH4564004/15/201907/01/2019  07/01/2019
Contract DetailONCOMED THE ONCOLOGY PHARMACY OF BUFFALOD/B/A ONCO360 140 JOHN JAMES AUDUBON PKWY STE 101
AMHERSTNY1422807/16/202110/01/2021  10/01/2021
Contract DetailSENDERRA RX PHARMACYSENDERRA RX PARTNERS, LLC 3712 E PLANO PKWY STE 200
PLANOTX7507410/14/202001/01/2021  01/01/2021
Contract DetailSINA DRUG LLCD/B/A ONCO 360 13410 EASTPOINT CENTRE DR
STE 101 		LOUISVILLEKY4022307/16/202110/01/2021  10/01/2021
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/18/201804/01/2018  01/18/2018
Contract DetailWAL-MART PHARMACY 10-14271470 SO. COURT ST.
CIRCLEVILLEOH4311307/16/201910/01/2019  10/01/2019
Contract DetailWAL-MART PHARMACY 10-1519100 WAL-MART DRIVE
JACKSONOH4564007/16/201910/01/2019  10/01/2019
Contract DetailWAL-MART PHARMACY 10-240085 RIVER TRACE LANE
CHILLICOTHEOH4560104/21/201607/01/2016  04/21/2016
Contract DetailWAL-MART PHARMACY 10-2572990 WEST EMMITT AVENUE
WAVERLYOH4569010/11/201901/01/2020  01/01/2020
Contract DetailWAL-MART PHARMACY 10-32511397 LEESBURG AVENUE
WASHINGTON COURT HOUSEOH4316007/16/201910/01/2019  10/01/2019
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/18/201804/01/2018  01/18/2018
Contract DetailWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275607/17/202310/01/2023  10/01/2023
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH360159AChildDSHADENA REGIONAL MEDICAL CENTERADENA CANCER CENTER4435 SR 159CHILLICOTHEOHActive
DSH360159AAChildDSHADENA REGIONAL MEDICAL CENTERAdena Internal Medicine4439 St. Rt. 159ChillicotheOHTerminated
DSH360159ABChildDSHADENA REGIONAL MEDICAL CENTERAdena Occupational Health4457 State Route 159ChillicotheOHActive
DSH360159ACChildDSHADENA REGIONAL MEDICAL CENTERAdena Family Medicine Oak Hill315 Washington StreetOak HillOHTerminated
DSH360159ADChildDSHADENA REGIONAL MEDICAL CENTERAdena Interventional Pain Management4437 St. Rt. 159, Suite G15ChillicotheOHTerminated
DSH360159AEChildDSHADENA REGIONAL MEDICAL CENTERADENA RHEUMATOLOGY - Rheumatology4437 STATE ROUTE 159CHILLICOTHEOHTerminated
DSH360159AFChildDSHADENA REGIONAL MEDICAL CENTERAdena Counseling Center - Counseling Center455 Shawnee LaneChillicotheOHActive
DSH360159AGChildDSHADENA REGIONAL MEDICAL CENTERADENA SURGERY CENTER - Outpatient Surgery Center4437 STATE ROUTE 159CHILLICOTHEOHTerminated
DSH360159AHChildDSHADENA REGIONAL MEDICAL CENTERADENA HEALTH CENTER - WOODLANDS - Family Medicine Clinic311 CALDWELL STCHILLICOTHEOHActive
DSH360159AJChildDSHADENA REGIONAL MEDICAL CENTERADENA FAMILY MEDICINE MAIN CAMPUS C - Family Medicine Residency Clinic4461 STATE ROUTE 159CHILLICOTHEOHActive
DSH360159BChildDSHADENA REGIONAL MEDICAL CENTERADENA URGENT CARE - WESTERN55 CENTENNIAL BOULEVARDCHILLICOTHEOHTerminated
DSH360159DChildDSHADENA REGIONAL MEDICAL CENTERADENA URGENT CARE - WAVERLY12340 ST RT 104WAVERLYOHTerminated
DSH360159EChildDSHADENA REGIONAL MEDICAL CENTERAdena Family Medicine Washington C.H.308 Highland Avenue, Suite CWashington C.H.OHActive
DSH360159FChildDSHADENA REGIONAL MEDICAL CENTERAdena Endocrinology and Diabetes Care4439 St. Rt. 159, Suite 150ChillicotheOHTerminated
DSH360159GChildDSHADENA REGIONAL MEDICAL CENTERAdena Surgical4439 St. Rt. 159, Suite 270ChillicotheOHTerminated
DSH360159HChildDSHADENA REGIONAL MEDICAL CENTERAdena Pickaway Ross Family Physicians100 North WalnutChillicotheOHActive
DSH360159JChildDSHADENA REGIONAL MEDICAL CENTERAdena Cardiothoracic & Vascular4437 St. Rt. 159, Suite 115ChillicotheOHTerminated
DSH360159KChildDSHADENA REGIONAL MEDICAL CENTERAdena Cardiology4437 St. Rt. 159, Suite 125ChillicotheOHTerminated
DSH360159LChildDSHADENA REGIONAL MEDICAL CENTERAdena Bone and Joint Center4437 St. Rt. 159, Suite G15ChillicotheOHTerminated
DSH360159MChildDSHADENA REGIONAL MEDICAL CENTERAdena Gastroenterology4439 St. Rt. 159, Suite 210ChillicotheOHTerminated
DSH360159NChildDSHADENA REGIONAL MEDICAL CENTERAdena Urology4439 St. Rt. 159, Suite 260ChillicotheOHTerminated
DSH360159PChildDSHADENA REGIONAL MEDICAL CENTERAdena Pediatrics4439 St. Rt. 159, Suite G10ChillicotheOHTerminated
DSH360159QChildDSHADENA REGIONAL MEDICAL CENTERAdena Dermatology4437 St. Rt. 159, Suite G15ChillicotheOHTerminated
DSH360159RChildDSHADENA REGIONAL MEDICAL CENTERAdena Pulmonology Critical Care & Sleep Associates4439 St. Rt. 159, Suite 210ChillicotheOHTerminated
DSH360159SChildDSHADENA REGIONAL MEDICAL CENTERAdena Family Medicine Jackson1000 Veterans DriveJacksonOHActive
DSH360159TChildDSHADENA REGIONAL MEDICAL CENTERAdena ENT and Allergy4439 St. Rt. 159, Suite G70ChillicotheOHTerminated
DSH360159UChildDSHADENA REGIONAL MEDICAL CENTERAdena Family Medicine of Chillicothe626 Central CenterChillicotheOHTerminated
DSH360159VChildDSHADENA REGIONAL MEDICAL CENTERAdena OB/GYN4439 St. Rt. 159, Suite 120ChillicotheOHTerminated
DSH360159WChildDSHADENA REGIONAL MEDICAL CENTERAdena Family Medicine Circleville140 Morris RoadCirclevilleOHActive
DSH360159XChildDSHADENA REGIONAL MEDICAL CENTERAdena Chillicothe Family Physicians60 Capital DriveChillicotheOHActive
DSH360159YChildDSHADENA REGIONAL MEDICAL CENTERAdena Infectious Disease4439 St. Rt. 159 Suite 150ChillicotheOHTerminated
DSH360159ZChildDSHADENA REGIONAL MEDICAL CENTERAdena Nephrology4437 St. Rt. 159, Suite G35ChillicotheOHTerminated
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertChange Request Adena Wellston Pharmacy 2 E. A Street Wellston, OH 456921/30/2025 1:37 PM
AddressesShipping AddressInsertChange Request Adena Warrior Pharmacy 169 W. High Street Frankfort, OH 456281/30/2025 1:37 PM
DetailsLast Recertification DateUpdateRecertification9/1/2023 12:43:05 PM8/20/2024 3:18:28 PM8/20/2024 3:18 PM
AddressesShipping AddressInsertChange Request Adena Pharmacy 272 Hospital Road Chillicothe, OH 456014/5/2024 7:22 AM
AddressesShipping AddressInsertChange Request Adena Cancer Center Pharmacy 4435 SR 159 Chillicothe, OH 456014/5/2024 7:22 AM
AddressesShipping AddressInsertChange Request Adena Community Pharmacy Woodlands 311 Caldwell Street Chillicothe, OH 456014/5/2024 7:22 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False4/5/2024 7:22 AM
Medicaid BillingMedicaid: NumberInsertChange Request 00667014/5/2024 7:22 AM
Medicaid BillingMedicaid: StateInsertChange Request OH4/5/2024 7:22 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False4/5/2024 7:22 AM
Medicaid BillingMedicaid: NumberInsertChange Request 00670534/5/2024 7:22 AM
Medicaid BillingMedicaid: StateInsertChange Request OH4/5/2024 7:22 AM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False4/5/2024 7:22 AM
Medicaid BillingMedicaid: NumberInsertChange Request 04018604/5/2024 7:22 AM
Medicaid BillingMedicaid: StateInsertChange Request OH4/5/2024 7:22 AM
Medicaid BillingNPI: NumberInsertChange Request 14374885584/5/2024 7:22 AM
Medicaid BillingNPI: StateInsertChange Request OH4/5/2024 7:22 AM
Medicaid BillingNPI: NumberInsertChange Request 16596471704/5/2024 7:22 AM
Medicaid BillingNPI: StateInsertChange Request OH4/5/2024 7:22 AM
Medicaid BillingNPI: NumberInsertChange Request 10135478354/5/2024 7:22 AM
Medicaid BillingNPI: StateInsertChange Request OH4/5/2024 7:22 AM
DetailsLast Recertification DateUpdateRecertification9/12/2022 1:17:27 PM9/1/2023 12:43:05 PM9/1/2023 12:43 PM
DetailsLast Recertification DateUpdateRecertification8/27/2021 12:11:30 PM9/12/2022 1:17:27 PM9/12/2022 1:17 PM
ContactsAuthorizing OfficialUpdateChange RequestCarlson, Lisa Marie CFO Adena Health System 7407797582Edrington, Katherine Chief Operations Officer Adena Health System 74077972824/8/2022 1:22 PM
AddressesShipping AddressInsertChange Request Adena Regional Medical Center 272 Hospital Road Chillicothe, OH 456011/24/2022 9:53 AM
AddressesShipping AddressInsertChange Request Safecor Health, LLC 4060 Business Park Drive Columbus, OH 432041/24/2022 9:53 AM
DetailsLast Recertification DateUpdateRecertification9/3/2020 4:45:58 PM8/27/2021 12:11:30 PM8/27/2021 12:11 PM
Medicaid BillingNPI: StateUpdateRecertification OH9/3/2020 4:45 PM
Medicaid BillingNPI: StateUpdateRecertification OH9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification AZ9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification AZ9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification FL9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification FL9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification KY9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification KY9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification LA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification LA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification MI9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification MI9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification MO9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification MO9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification TN9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification TN9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification TX9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification TX9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification VA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification VA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification WA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification WA9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 12354680839/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification WV9/3/2020 4:45 PM
Medicaid BillingNPI: NumberInsertRecertification 19028396739/3/2020 4:45 PM
Medicaid BillingNPI: StateInsertRecertification WV9/3/2020 4:45 PM
DetailsLast Recertification DateUpdateRecertification9/2/2019 7:07:24 PM9/3/2020 4:45:58 PM9/3/2020 4:45 PM
DetailsLast Recertification DateUpdateRecertification9/12/2018 1:53:52 PM9/2/2019 7:07:24 PM9/2/2019 7:07 PM
Medicaid BillingNPI: NumberInsertChange Request 19028396734/12/2019 12:24 PM
Medicaid BillingNPI: NumberInsertChange Request 12354680834/12/2019 12:24 PM
DetailsLast Recertification DateUpdateRecertification11/15/2017 10:56:47 AM9/12/2018 1:53:52 PM9/12/2018 1:53 PM
DetailsLast Recertification DateUpdateRecertification8/31/2016 12:00:00 AM11/15/2017 10:56:47 AM11/15/2017 10:56 AM
ContactsAuthorizing OfficialUpdate Carlson, Lisa CFO 7407797582Carlson, Lisa Marie CFO Adena Health System 740779758210/5/2017 4:05 PM
ContactsPrimary ContactUpdate Yingling, Fred Director of Pharmacy 7407797648Yingling, Fred Director of Pharmacy Adena Health System 740779764810/4/2017 1:15 PM
ContactsPrimary ContactUpdate Henson, Judith CNO 7407797151Yingling, Fred Director of Pharmacy 74077976488/2/2017 2:03 PM
ContactsAuthorizing OfficialUpdate GRAHAM, JEFF HOSPITAL OPERATIONS OFFICER 7407797584Carlson, Lisa CFO 74077975828/2/2017 2:03 PM
AddressesMain AddressInsert   272 HOSPITAL ROAD CHILLICOTHE, OH 456018/2/2017 1:55 PM
DetailsLast Recertification DateUpdate 8/12/2015 12:00:00 AM8/31/2016 12:00:00 AM8/31/2016 12:35 PM
ContactsPrimary ContactUpdate DIENER, MIKE SYSTEM DIRECTOR AMBULATORY SERVICES 7407798572Henson, Judith CNO 74077971511/28/2016 3:10 PM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse8/12/2015 11:11 AM
DetailsLast Recertification DateUpdate 8/14/2014 12:00:00 AM8/12/2015 12:00:00 AM8/12/2015 11:11 AM
DetailsLast Recertification DateUpdate 9/9/2013 12:00:00 AM8/14/2014 12:00:00 AM8/14/2014 3:21 PM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM9/9/2013 12:00:00 AM9/9/2013 2:50 PM
ContactsPrimary ContactUpdate HANNA, JOHN L. PHARMACY DIRECTOR 7407797648DIENER, MIKE SYSTEM DIRECTOR AMBULATORY SERVICES 740779857212/20/2012 4:12 PM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM4/30/2012 12:26 PM
ContactsAuthorizing OfficialInsert  GRAHAM, JEFF HOSPITAL OPERATIONS OFFICER 74077975844/4/2012 1:30 PM
ContactsPrimary ContactInsert  HANNA, JOHN L. PHARMACY DIRECTOR 74077976483/31/2009 9:54 AM
DetailsLast Recertification DateInsert   3/31/2009 9:54 AM
DetailsGrant NumberInsert   3/31/2009 9:54 AM
Details340B IDInsert  DSH3601593/31/2009 9:54 AM
DetailsIs Authorizing Official EHB DataInsert   3/31/2009 9:54 AM
DatesLast Date That 340B Drugs PurchasedInsert   3/31/2009 9:54 AM
DetailsMedicare Provider NumberInsert  3601593/31/2009 9:54 AM
DetailsEntity NameInsert  ADENA REGIONAL MEDICAL CENTER3/31/2009 9:54 AM
DetailsProgram CodeInsert  DSH3/31/2009 9:54 AM
DetailsEntity SubnameInsert   3/31/2009 9:54 AM
DatesParticipating Approval DateInsert  3/11/2008 12:00:00 AM3/31/2009 9:54 AM
DetailsStateInsert  Active3/31/2009 9:54 AM
DatesRegistration DateInsert  3/4/2008 12:00:00 AM3/31/2009 9:54 AM
DatesSigned By DateInsert  2/29/2008 12:00:00 AM3/31/2009 9:54 AM
DatesStart DateInsert  4/1/2008 12:00:00 AM3/31/2009 9:54 AM
TerminationsTermination CommentsInsert   3/31/2009 9:54 AM
TerminationsTermination DateInsert   3/31/2009 9:54 AM
TerminationsTermination Effective DateInsert   3/31/2009 9:54 AM
TerminationsTermination ReasonInsert   3/31/2009 9:54 AM
DetailsComments PublicInsert  3/30/09 DOC RECEIVED TO CONFIRM ELIG DSH ADJ%3/31/2009 9:54 AM
Medicaid BillingMedicaid: Is PrimaryInsert  True3/4/2008 12:20 PM
Medicaid BillingMedicaid: NumberInsert  14756853/4/2008 12:20 PM
Medicaid BillingMedicaid: StateInsert  OH3/4/2008 12:20 PM