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UT_Fee_IPH3_New_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_IPH3_New_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_IPH2_Renewal_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_IPH2_Renewal_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_IPH1_Renewal_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_IPH1_Renewal_20230701-20240630
Approval Date
Effective Date
Payment Type
Fee schedule
Provider Class
Inpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH6_New_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH6_New_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH5_New_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH5_New_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH4_New_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH4_New_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH3_New_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH3_New_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
New
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH2_Renewal_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH2_Renewal_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date

UT_Fee_OPH1_Renewal_20230701-20240630

Submitted by tomoe.koketsu@… on
File - Approval Letter Media
UT_Fee_OPH1_Renewal_20230701-20240630
Approval Date
Effective Date
State
Utah
Payment Type
Fee schedule
Provider Class
Outpatient hospital service
Review Type
Renewal
State Rating Period Start Date
Approval Period
Single Rating Period
State Rating Period End Date
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