"hospital_PHC Meadowwood, LLC" last_updated_ 2023-12-31 version_1 "hospital_New Castle, Delaware" hospital_address 575 South Dupont Highway license_ HSPTL-010C "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file" description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL] standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]|percent standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL] standard_charge |[payer_AETNA]|[plan_HMO/PPO] standard_charge |[payer_AETNA]|[plan_HMO/PPO]|percent standard_charge |[payer_AETNA]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AETNA]|[plan_HMO/PPO] standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|percent standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|contracting_method additional_payer_notes |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO] standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AETNA PHP]|[plan_HMO/PPO] standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL] standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]|percent standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL] standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO] standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]|percent standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AMERICHOICE]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AMERIHEALTH]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]|percent standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]|percent standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]|contracting_method additional_payer_notes |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]|percent standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]|contracting_method additional_payer_notes |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]|percent standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO] standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL] standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]|percent standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_APS HEALTHCARE]|[plan_COMMERCIAL] standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]|percent standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]|contracting_method additional_payer_notes |[payer_BCBS DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS] standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|percent standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|contracting_method additional_payer_notes |[payer_BCBS FEDERAL]|[plan_BLUE CROSS] standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]|percent standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]|contracting_method additional_payer_notes |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]|percent standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO] standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL] standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]|percent standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL] standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]|percent standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_COMP PSYCH]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_COMP PSYCH PHP]|[plan_HMO/PPO] standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]|percent standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]|contracting_method additional_payer_notes |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]|percent standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]|contracting_method additional_payer_notes |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID] standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID] standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]|percent standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]|contracting_method additional_payer_notes |[payer_DELAWARE MEDICAID]|[plan_MEDICAID] standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT] standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]|percent standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]|contracting_method additional_payer_notes |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT] standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE] standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]|percent standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]|contracting_method additional_payer_notes |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE] standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO] standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]|percent standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_GEISINGER/UBH]|[plan_HMO/PPO] standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE] standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]|percent standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]|contracting_method additional_payer_notes |[payer_HUMANA]|[plan_MANAGED MEDICARE] standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE] standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]|percent standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]|contracting_method additional_payer_notes |[payer_HUMANA MILITARY]|[plan_TRICARE] standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]|percent standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]|percent standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_INDEPENDENCE BC]|[plan_HMO/PPO] standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL] standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]|percent standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL] standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO] standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]|percent standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]|percent standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|percent standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]|percent standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]|contracting_method additional_payer_notes |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO] standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]|percent standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO] standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MEDICARE]|[plan_MEDICARE] standard_charge |[payer_MEDICARE]|[plan_MEDICARE]|percent standard_charge |[payer_MEDICARE]|[plan_MEDICARE]|contracting_method additional_payer_notes |[payer_MEDICARE]|[plan_MEDICARE] standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL] standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]|percent standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL] standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]|percent standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]|contracting_method additional_payer_notes |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]|percent standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]|contracting_method additional_payer_notes |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_STATE]|[plan_LOCAL GOVT] standard_charge |[payer_STATE]|[plan_LOCAL GOVT]|percent standard_charge |[payer_STATE]|[plan_LOCAL GOVT]|contracting_method additional_payer_notes |[payer_STATE]|[plan_LOCAL GOVT] standard_charge |[payer_TCN]|[plan_HMO/PPO] standard_charge |[payer_TCN]|[plan_HMO/PPO]|percent standard_charge |[payer_TCN]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_TCN]|[plan_HMO/PPO] standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO] standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]|percent standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO] standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO] standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]|percent standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO] standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]|percent standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]|contracting_method additional_payer_notes |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO] standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]|percent standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]|percent standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|percent standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO] standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|percent standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|contracting_method additional_payer_notes |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]|percent standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_VALUE OPTIONS]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]|percent standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]|contracting_method additional_payer_notes |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO] R & B - PSY ADULT 124 RC facility inpatient "2,400.00" 850 600 "2,200.00" 750.00 per diem "1,034.00 " per diem "1,034.00 " per diem "1,034.00 " per diem 900.00 per diem 620.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 712.00 per diem 964.69 per diem 964.69 per diem 940.00 per diem 940.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 797.57 per diem 954.45 per diem 867.68 per diem 750.00 per diem 725.00 per diem 800.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 766.31 per diem 782.00 per diem 815.70 per diem 812.54 per diem 650.00 per diem 885.00 per diem 692.00 per diem 725.00 per diem 995.61 per diem 800.00 per diem 800.00 per diem 810.00 per diem 600.00 per diem "1,004.00 " per diem 725.00 per diem 725.00 per diem 725.00 per diem 725.00 per diem 950.00 per diem R & B - PSY ADOL 124 RC facility inpatient "2,400.00" 850 757 "1,000.00" 750.00 per diem "1,034.00 " per diem "1,034.00 " per diem "1,034.00 " per diem 900.00 per diem 620.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 964.69 per diem 964.69 per diem 957.00 per diem 957.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 797.57 per diem 954.45 per diem 867.68 per diem 750.00 per diem 725.00 per diem 800.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 766.31 per diem 782.00 per diem 815.70 per diem 812.54 per diem 650.00 per diem 885.00 per diem 692.00 per diem 725.00 per diem 995.61 per diem 800.00 per diem 830.00 per diem 600.00 per diem "1,004.00 " per diem 725.00 per diem 725.00 per diem 725.00 per diem 725.00 per diem "1,000.00 " per diem R & B - PSY GERI 124 RC facility inpatient "2,400.00" 850 600 "2,200.00" 750.00 per diem "1,034.00 " per diem "1,034.00 " per diem "1,034.00 " per diem 900.00 per diem 620.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 712.00 per diem 964.69 per diem 964.69 per diem 940.00 per diem 940.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 797.57 per diem 954.45 per diem 867.68 per diem 750.00 per diem 725.00 per diem 800.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 766.31 per diem 782.00 per diem 815.70 per diem 812.54 per diem 650.00 per diem 885.00 per diem 692.00 per diem 725.00 per diem 995.61 per diem 800.00 per diem 800.00 per diem 810.00 per diem 600.00 per diem "1,004.00 " per diem 725.00 per diem 725.00 per diem 725.00 per diem 725.00 per diem 950.00 per diem R & B-CD/DETOX 126 RC facility inpatient "2,400.00" 850 600 "2,200.00" 650.00 per diem 800.00 per diem "1,034.00 " per diem 800.00 per diem 600.00 per diem 510.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 712.00 per diem 964.69 per diem 964.69 per diem 755.00 per diem 755.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 725.00 per diem 954.45 per diem 867.68 per diem 650.00 per diem 693.00 per diem 641.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 766.31 per diem 641.00 per diem 815.70 per diem 812.54 per diem 575.00 per diem 637.00 per diem 692.00 per diem 693.00 per diem 995.61 per diem 800.00 per diem 800.00 per diem 650.00 per diem 350.00 per diem 776.00 per diem 650.00 per diem 693.00 per diem 693.00 per diem 693.00 per diem 906.50 per diem R & B-GERI CD/DETOX 126 RC facility inpatient "2,400.00" 850 350 "2,200.00" 650.00 per diem 800.00 per diem 800.00 per diem 600.00 per diem 510.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 563.00 per diem 964.69 per diem 964.69 per diem 755.00 per diem 755.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 725.00 per diem 954.45 per diem 867.68 per diem 650.00 per diem 693.00 per diem 641.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 641.00 per diem 815.70 per diem 812.54 per diem 575.00 per diem 637.00 per diem 693.00 per diem 800.00 per diem 650.00 per diem 350.00 per diem 776.00 per diem 650.00 per diem 693.00 per diem 693.00 per diem 693.00 per diem 906.50 per diem R & B - GERI REHAB 128 RC facility inpatient "2,400.00" 850 350 "2,200.00" 650.00 per diem 742.00 per diem 742.00 per diem 600.00 per diem 510.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 563.00 per diem 964.69 per diem 964.69 per diem 710.00 per diem 710.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 630.36 per diem 954.45 per diem 867.68 per diem 650.00 per diem 567.00 per diem 641.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 641.00 per diem 815.70 per diem 812.54 per diem 575.00 per diem 637.00 per diem 567.00 per diem 800.00 per diem 650.00 per diem 315.00 per diem 721.00 per diem 650.00 per diem 567.00 per diem 555.00 per diem 555.00 per diem 906.50 per diem R & B C/D REHAB 128 RC facility inpatient "2,400.00" 850 315 964.69 650.00 per diem 742.00 per diem 742.00 per diem 600.00 per diem 510.00 per diem "1,050.00 " per diem "1,050.00 " per diem 831.39 per diem 831.39 per diem "1,050.00 " per diem 563.00 per diem 964.69 per diem 964.69 per diem 710.00 per diem 710.00 per diem "2,200.00 " per diem 742.12 per diem 757.00 per diem 965.00 per diem 630.36 per diem 954.45 per diem 867.68 per diem 650.00 per diem 567.00 per diem 641.00 per diem "1,050.00 " per diem "1,050.00 " per diem 741.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 955.00 per diem 641.00 per diem 815.70 per diem 812.54 per diem 575.00 per diem 637.00 per diem 567.00 per diem 800.00 per diem 650.00 per diem 315.00 per diem 721.00 per diem 650.00 per diem 567.00 per diem 555.00 per diem 555.00 per diem 906.50 per diem IOP MH PROGRAM 905 RC facility outpatient 500 240 190 247.2 247.20 per diem 247.20 per diem 247.20 per diem 190.00 per diem IOP CD PROGRAM 906 RC facility outpatient 500 240 227 247.2 242.00 per diem 247.20 per diem 247.20 per diem 247.20 per diem 227.00 per diem 227.00 per diem 227.00 per diem ADOL PARTIAL PSYCH 912 RC facility outpatient "1,200.00" 350 220.52 500 325.00 per diem 394.00 per diem 394.00 per diem 250.00 per diem 400.00 per diem 400.00 per diem 287.00 per diem 313.00 per diem 355.40 per diem 355.40 per diem 355.40 per diem 470.00 per diem 470.00 per diem 447.00 per diem - - 500.00 per diem 305.88 per diem 303.41 per diem 253.76 per diem 275.83 per diem 334.00 per diem 238.02 per diem 375.00 per diem 375.00 per diem 375.00 per diem 287.00 per diem 375.00 per diem 300.00 per diem 220.52 per diem 233.52 per diem 221.47 per diem 250.00 per diem 334.00 per diem 305.00 per diem 410.00 per diem 383.00 per diem 334.00 per diem 334.00 per diem 334.00 per diem 421.43 per diem ADULT PARTIAL PSYCH 912 RC facility outpatient "1,200.00" 350 220.52 500 325.00 per diem 394.00 per diem 394.00 per diem 250.00 per diem 400.00 per diem 400.00 per diem 287.00 per diem 313.00 per diem 355.40 per diem 355.40 per diem 355.40 per diem 447.00 per diem 470.00 per diem 447.00 per diem - - 500.00 per diem 305.88 per diem 303.41 per diem 253.76 per diem 275.83 per diem 334.00 per diem 238.02 per diem 375.00 per diem 375.00 per diem 375.00 per diem 287.00 per diem 375.00 per diem 300.00 per diem 220.52 per diem 233.52 per diem 250.00 per diem 334.00 per diem 305.00 per diem 410.00 per diem 383.00 per diem 334.00 per diem 334.00 per diem 334.00 per diem 421.43 per diem TELE PARTIAL PSYCH 912 RC facility outpatient "1,200.00" 350 220.52 500 325.00 per diem 394.00 per diem 394.00 per diem 250.00 per diem 400.00 per diem 400.00 per diem 287.00 per diem 313.00 per diem 355.40 per diem 355.40 per diem 355.40 per diem 447.00 per diem 470.00 per diem 447.00 per diem - - 500.00 per diem 305.88 per diem 303.41 per diem 253.76 per diem 275.83 per diem 334.00 per diem 238.02 per diem 375.00 per diem 375.00 per diem 375.00 per diem 287.00 per diem 375.00 per diem 300.00 per diem 220.52 per diem 233.52 per diem 250.00 per diem 334.00 per diem 305.00 per diem 410.00 per diem 383.00 per diem 334.00 per diem 334.00 per diem 334.00 per diem ADULT PARTIAL PSYCH 913 RC facility outpatient "1,200.00" 425 220.52 500 394.00 per diem 394.00 per diem 355.40 per diem 355.40 per diem 355.40 per diem - - 500.00 per diem 305.88 per diem 303.41 per diem 253.76 per diem 275.83 per diem 238.02 per diem 375.00 per diem 287.00 per diem 375.00 per diem 220.52 per diem 233.52 per diem 334.00 per diem 305.00 per diem 410.00 per diem 383.00 per diem GROUP THERAPY 915 RC facility outpatient 465 165 220.52 500 394.00 per diem 394.00 per diem 355.40 per diem 355.40 per diem 355.40 per diem - - 500.00 per diem 305.88 per diem 303.41 per diem 253.76 per diem 275.83 per diem 238.02 per diem 375.00 per diem 287.00 per diem 375.00 per diem 220.52 per diem 233.52 per diem 334.00 per diem 305.00 per diem 410.00 per diem 383.00 per diem IOP PROCESS GROUP 1 915 RC facility outpatient 175 62 221.47 394 394.00 per diem 221.47 per diem 238.02 per diem 375.00 per diem 221.47 per diem IOP PROCESS GROUP 2 915 RC facility outpatient 175 62 221.47 394 394.00 per diem 221.47 per diem 238.02 per diem 375.00 per diem 221.47 per diem IOP PROCESS GROUP 3 915 RC facility outpatient 150 54 221.47 394 394.00 per diem 221.47 per diem 238.02 per diem 375.00 per diem 221.47 per diem INITIAL HOSP/PHP LOW 99221 RC professional outpatient 200 0 83.53 83.53 83.53 fee schedule Rates based on patient diagnose INITIAL HOSP/PHP MOD 99222 RC professional outpatient 200 0 111.23 111.23 111.23 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP LOW 99233 RC professional outpatient 200 0 130.86 130.86 130.86 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP MOD 99232 RC professional outpatient 200 0 79.57 79.57 79.57 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP HIGH 99231 RC professional outpatient 200 0 49.93 49.93 49.93 fee schedule Rates based on patient diagnose DISCH HOSP/PHP LOW 99238 RC professional outpatient 200 0 81.3 81.3 81.30 fee schedule Rates based on patient diagnose