Health Services Development Agency
Medical Equipment Utilization Survey

Section 2 of 2: Utilization by County

Instructions

As in Section 1, enter the requested data in the form below and click the "Submit Data" button. When your information has been successfully submitted, you will receive a confirmation message and a copy of the data you entered. If you cannot report county detail, please explain why in the Comments section.

If you have problems or questions, call or e-mail Alecia Craighead , Staistical Analyst, at 615-253-2782, alecia.l.craighead@state.tn.us.


Contact Information
Facility Name (select from list)   
Facility Name (if not included in list)   
Comments:
(if you cannot report county detail)		   
Reporting Period - From:
 Month:     Year: 
Reporting Period - To:
 Month:     Year: 


Medical Equipment Utilization by County

Enter total (fixed + mobile) number of procedures for each equipment type as indicated.
For counties with no procedures, leave fields blank as appropriate.
County
 CT
 Linear
Accelerator
 Cyber
Knife
 Gamma
Knife
 Lithotripter
 MRI
 PET
Anderson
Bedford
Benton
Bledsoe
Blount
Bradley
Campbell
Cannon
Carroll
Carter
Cheatham
Chester
Claiborne
Clay
Cocke
Coffee
Crockett
Cumberland
Davidson
Decatur
DeKalb
Dickson
Dyer
Fayette
Fentress
Franklin
Gibson
Giles
Grainger
Greene
Grundy
Hamblen
Hamilton
Hancock
Hardeman
Hardin
Hawkins
Haywood
Henderson
Henry
Hickman
Houston
Humphreys
Jackson
Jefferson
Johnson
Knox
Lake
Lauderdale
Lawrence
Lewis
Lincoln
Loudon
McMinn
McNairy
Macon
Madison
Marion
Marshall
Maury
Meigs
Monroe
Montgomery
Moore
Morgan
Obion
Overton
Perry
Pickett
Polk
Putnam
Rhea
Roane
Robertson
Rutherford
Scott
Sequatchie
Sevier
Shelby
Smith
Stewart
Sullivan
Sumner
Tipton
Trousdale
Unicoi
Union
Van Buren
Warren
Washington
Wayne
Weakley
White
Williamson
Wilson

To submit, print this page with your printer and fax to Alicia Craighead, (615) 253-2782.



Procedures:
Number of billing units, e.g., ICD9 or CPT4 procedures.

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