hospital_name last_updated_on version hospital_location hospital_address license_number|DE "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated." "PHC Meadowwood, LLC" 5/31/2024 2.0.0 "New Castle, Delaware" 575 South Dupont Highway license_ HSPTL-010C|DE TRUE description code |1 code|1|type setting drug_unit_of_measurement drug_type_of_measurement standard_charge | gross standard_charge|discounted_cash modifiers standard_charge|min standard_charge | max standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL] standard_charge |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_AARP HEALTHCARE OPTIONS]|[plan_COMMERCIAL] standard_charge |[payer_AETNA]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AETNA]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AETNA]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AETNA]|[plan_HMO/PPO] standard_charge |[payer_AETNA]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AETNA]|[plan_HMO/PPO] standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_AETNA BETTER HEALTH KIDS]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]| negotiated_dollar standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_percentage standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_algorithm estimated_amount |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|methodology additional_payer_notes |[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AETNA PHP]|[plan_HMO/PPO] standard_charge |[payer_AETNA PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AETNA PHP]|[plan_HMO/PPO] standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL] standard_charge |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_ALLIED TRADES ASSIST PRGM]|[plan_COMMERCIAL] standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AMERICHOICE]|[plan_HMO/PPO] standard_charge |[payer_AMERICHOICE]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AMERICHOICE]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AMERIHEALTH]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AMERIHEALTH ADMIN]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AMERIHEALTH ADMIN PHP]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]| negotiated_dollar standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]|negotiated_percentage standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID]|methodology additional_payer_notes |[payer_AMERIHEALTH CARITAS DE]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]| negotiated_dollar standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]|negotiated_percentage standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID]|methodology additional_payer_notes |[payer_AMERIHEALTH CARITAS NEXT]|[plan_MANAGED MEDICAID] standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO] standard_charge |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_AMERIHEALTH PPO]|[plan_HMO/PPO] standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_APS HEALTHCARE]|[plan_COMMERCIAL] standard_charge |[payer_APS HEALTHCARE]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_APS HEALTHCARE]|[plan_COMMERCIAL] standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]| negotiated_dollar standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]|negotiated_percentage standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]|negotiated_algorithm estimated_amount |[payer_BCBS DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS DELAWARE]|[plan_BLUE CROSS]|methodology additional_payer_notes |[payer_BCBS DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]| negotiated_dollar standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|negotiated_percentage standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|negotiated_algorithm estimated_amount |[payer_BCBS FEDERAL]|[plan_BLUE CROSS] standard_charge |[payer_BCBS FEDERAL]|[plan_BLUE CROSS]|methodology additional_payer_notes |[payer_BCBS FEDERAL]|[plan_BLUE CROSS] standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]| negotiated_dollar standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]|negotiated_percentage standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]|negotiated_algorithm estimated_amount |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS]|methodology additional_payer_notes |[payer_BCBS OF DELAWARE]|[plan_BLUE CROSS] standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_CIGNA BEHAV HLTH HMO PHP]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO] standard_charge |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_CIGNA BEHAVIORAL HLTH PPO]|[plan_HMO/PPO] standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL] standard_charge |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_COMM MISC-ENTER NAME]|[plan_COMMERCIAL] standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_COMMUNITY BEHAV HEALTH]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_COMMUNITY CARE BHO]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_COMP PSYCH]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_COMP PSYCH]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_COMP PSYCH PHP]|[plan_HMO/PPO] standard_charge |[payer_COMP PSYCH PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_COMP PSYCH PHP]|[plan_HMO/PPO] standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]| negotiated_dollar standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]|negotiated_percentage standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]|negotiated_algorithm estimated_amount |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID]|methodology additional_payer_notes |[payer_DE BCBSD HEALTH OPTIONS]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]| negotiated_dollar standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]|negotiated_percentage standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]|negotiated_algorithm estimated_amount |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID] standard_charge |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID]|methodology additional_payer_notes |[payer_DE FIRST HEALTH]|[plan_MANAGED MEDICAID] standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]| negotiated_dollar standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]|negotiated_percentage standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]|negotiated_algorithm estimated_amount |[payer_DELAWARE MEDICAID]|[plan_MEDICAID] standard_charge |[payer_DELAWARE MEDICAID]|[plan_MEDICAID]|methodology additional_payer_notes |[payer_DELAWARE MEDICAID]|[plan_MEDICAID] standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]| negotiated_dollar standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]|negotiated_percentage standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]|negotiated_algorithm estimated_amount |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT] standard_charge |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT]|methodology additional_payer_notes |[payer_DSCYF-CHILD MENTAL HEALTH]|[plan_LOCAL GOVT] standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]| negotiated_dollar standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]|negotiated_percentage standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]|negotiated_algorithm estimated_amount |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE] standard_charge |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE]|methodology additional_payer_notes |[payer_GATEWAY HEALTH PLAN]|[plan_MANAGED MEDICARE] standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_GEISINGER/UBH]|[plan_HMO/PPO] standard_charge |[payer_GEISINGER/UBH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_GEISINGER/UBH]|[plan_HMO/PPO] standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]| negotiated_dollar standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]|negotiated_percentage standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]|negotiated_algorithm estimated_amount |[payer_HUMANA]|[plan_MANAGED MEDICARE] standard_charge |[payer_HUMANA]|[plan_MANAGED MEDICARE]|methodology additional_payer_notes |[payer_HUMANA]|[plan_MANAGED MEDICARE] standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]| negotiated_dollar standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]|negotiated_percentage standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]|negotiated_algorithm estimated_amount |[payer_HUMANA MILITARY]|[plan_TRICARE] standard_charge |[payer_HUMANA MILITARY]|[plan_TRICARE]|methodology additional_payer_notes |[payer_HUMANA MILITARY]|[plan_TRICARE] standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_INDEPENDENCE ADMINISTRATO]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_INDEPENDENCE BC]|[plan_HMO/PPO] standard_charge |[payer_INDEPENDENCE BC]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_INDEPENDENCE BC]|[plan_HMO/PPO] standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL] standard_charge |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_KEYSTONEFIRST VIP CHOICE]|[plan_COMMERCIAL] standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO] standard_charge |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_KHPE KHP65 MAGELLAN]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_MAGELLAN BC OF NJ]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_MAGELLAN MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]| negotiated_dollar standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_percentage standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_algorithm estimated_amount |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE]|methodology additional_payer_notes |[payer_MAGELLAN MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_MAGELLAN NORTHAMPTON]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO] standard_charge |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_MANAGED HEALTH NETWORK]|[plan_HMO/PPO] standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_MD MEDICAID OPTUM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_MD MEDICAL ASST PROGRAM]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_MEDICARE]|[plan_MEDICARE]| negotiated_dollar standard_charge |[payer_MEDICARE]|[plan_MEDICARE]|negotiated_percentage standard_charge |[payer_MEDICARE]|[plan_MEDICARE]|negotiated_algorithm estimated_amount |[payer_MEDICARE]|[plan_MEDICARE] standard_charge |[payer_MEDICARE]|[plan_MEDICARE]|methodology additional_payer_notes |[payer_MEDICARE]|[plan_MEDICARE] standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL] standard_charge |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_MENTAL HEALTH CONSULTANT]|[plan_COMMERCIAL] standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge |[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_NEW JERSEY MEDICAID]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]| negotiated_dollar standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_percentage standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_algorithm estimated_amount |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE]|methodology additional_payer_notes |[payer_OPTUM MEDICARE]|[plan_MANAGED MEDICARE] standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_PENN BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]| negotiated_dollar standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]|negotiated_percentage standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]|negotiated_algorithm estimated_amount |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA]|methodology additional_payer_notes |[payer_PERFORMCARE CLAIMS DEPT]|[plan_MEDICAID: OUT OF STA] standard_charge |[payer_STATE]|[plan_LOCAL GOVT]| negotiated_dollar standard_charge |[payer_STATE]|[plan_LOCAL GOVT]|negotiated_percentage standard_charge |[payer_STATE]|[plan_LOCAL GOVT]|negotiated_algorithm estimated_amount |[payer_STATE]|[plan_LOCAL GOVT] standard_charge |[payer_STATE]|[plan_LOCAL GOVT]|methodology additional_payer_notes |[payer_STATE]|[plan_LOCAL GOVT] standard_charge |[payer_TCN]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_TCN]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_TCN]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_TCN]|[plan_HMO/PPO] standard_charge |[payer_TCN]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_TCN]|[plan_HMO/PPO] standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO] standard_charge |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_TOTAL CARE NETWORK]|[plan_HMO/PPO] standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO] standard_charge |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_TRI STATE HEALTH & WLFRE]|[plan_HMO/PPO] standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]| negotiated_dollar standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]|negotiated_percentage standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]|negotiated_algorithm estimated_amount |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL]|methodology additional_payer_notes |[payer_TRUSTMARK HEALTH BENEFITS]|[plan_COMMERCIAL] standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UMR/COMPASS ROSE HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO] standard_charge |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UNISON HEALTH PLAN OF DE]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UNITED BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UNITED BEHAVL HEALTH PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UNITED HEALTHCARE]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO] standard_charge |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_UNITED HEALTHCARE PHP]|[plan_HMO/PPO] standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]| negotiated_dollar standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|negotiated_percentage standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|negotiated_algorithm estimated_amount |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] standard_charge |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN]|methodology additional_payer_notes |[payer_VA CCN OPTUM]|[plan_VETERANS ADMIN] standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_VALUE OPTIONS]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_VALUE OPTIONS]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]| negotiated_dollar standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]|negotiated_percentage standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO] standard_charge |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO]|methodology additional_payer_notes |[payer_VALUE OPTIONS PHP]|[plan_HMO/PPO] additional_generic_notes R & B - PSY ADULT 124 RC inpatient 2400 850 600 2200 750 per diem 1034 per diem 1034 per diem 1034 per diem 900 per diem 620 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 712 per diem 965 per diem 965 per diem 940 per diem 940 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 798 per diem 954 per diem 868 per diem 750 per diem 725 per diem 800 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 766 per diem 782 per diem 816 per diem 813 per diem 650 per diem 885 per diem 692 per diem 725 per diem 996 per diem 800 per diem 800 per diem 810 per diem 600 per diem 1004 per diem 725 per diem 725 per diem 725 per diem 725 per diem 950 per diem R & B - PSY ADOL 124 RC inpatient 2400 850 757 1000 750 per diem 1034 per diem 1034 per diem 1034 per diem 900 per diem 620 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 965 per diem 965 per diem 957 per diem 957 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 798 per diem 954 per diem 868 per diem 750 per diem 725 per diem 800 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 766 per diem 782 per diem 816 per diem 813 per diem 650 per diem 885 per diem 692 per diem 725 per diem 996 per diem 800 per diem 830 per diem 600 per diem 1004 per diem 725 per diem 725 per diem 725 per diem 725 per diem 1000 per diem R & B - PSY GERI 124 RC inpatient 2400 850 600 2200 750 per diem 1034 per diem 1034 per diem 1034 per diem 900 per diem 620 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 712 per diem 965 per diem 965 per diem 940 per diem 940 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 798 per diem 954 per diem 868 per diem 750 per diem 725 per diem 800 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 766 per diem 782 per diem 816 per diem 813 per diem 650 per diem 885 per diem 692 per diem 725 per diem 996 per diem 800 per diem 800 per diem 810 per diem 600 per diem 1004 per diem 725 per diem 725 per diem 725 per diem 725 per diem 950 per diem R & B-CD/DETOX 126 RC inpatient 2400 850 600 2200 650 per diem 800 per diem 1034 per diem 800 per diem 600 per diem 510 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 712 per diem 965 per diem 965 per diem 755 per diem 755 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 725 per diem 954 per diem 868 per diem 650 per diem 693 per diem 641 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 766 per diem 641 per diem 816 per diem 813 per diem 575 per diem 637 per diem 692 per diem 693 per diem 996 per diem 800 per diem 800 per diem 650 per diem 350 per diem 776 per diem 650 per diem 693 per diem 693 per diem 693 per diem 907 per diem R & B-GERI CD/DETOX 126 RC inpatient 2400 850 350 2200 650 per diem 800 per diem 800 per diem 600 per diem 510 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 563 per diem 965 per diem 965 per diem 755 per diem 755 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 725 per diem 954 per diem 868 per diem 650 per diem 693 per diem 641 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 641 per diem 816 per diem 813 per diem 575 per diem 637 per diem 693 per diem 800 per diem 650 per diem 350 per diem 776 per diem 650 per diem 693 per diem 693 per diem 693 per diem 907 per diem R & B - GERI REHAB 128 RC inpatient 2400 850 350 2200 650 per diem 742 per diem 742 per diem 600 per diem 510 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 563 per diem 965 per diem 965 per diem 710 per diem 710 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 630 per diem 954 per diem 868 per diem 650 per diem 567 per diem 641 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 641 per diem 816 per diem 813 per diem 575 per diem 637 per diem 567 per diem 800 per diem 650 per diem 315 per diem 721 per diem 650 per diem 567 per diem 555 per diem 555 per diem 907 per diem R & B C/D REHAB 128 RC inpatient 2400 850 315 965 650 per diem 742 per diem 742 per diem 600 per diem 510 per diem 1050 per diem 1050 per diem 831 per diem 831 per diem 1050 per diem 563 per diem 965 per diem 965 per diem 710 per diem 710 per diem 2200 per diem 742 per diem 757 per diem 965 per diem 630 per diem 954 per diem 868 per diem 650 per diem 567 per diem 641 per diem 1050 per diem 1050 per diem 741 per diem 955 per diem 955 per diem 955 per diem 955 per diem 641 per diem 816 per diem 813 per diem 575 per diem 637 per diem 567 per diem 800 per diem 650 per diem 315 per diem 721 per diem 650 per diem 567 per diem 555 per diem 555 per diem 907 per diem IOP MH PROGRAM 905 RC outpatient 500 240 190 247 247 per diem 247 per diem 247 per diem 190 per diem IOP CD PROGRAM 906 RC outpatient 500 240 227 247 242 per diem 247 per diem 247 per diem 247 per diem 227 per diem 227 per diem 227 per diem ADOL PARTIAL PSYCH 912 RC outpatient 1200 350 221 500 325 per diem 394 per diem 394 per diem 250 per diem 400 per diem 400 per diem 287 per diem 313 per diem 355 per diem 355 per diem 355 per diem 470 per diem 470 per diem 447 per diem 500 per diem 306 per diem 303 per diem 254 per diem 276 per diem 334 per diem 238 per diem 375 per diem 375 per diem 375 per diem 287 per diem 375 per diem 300 per diem 221 per diem 234 per diem 221 per diem 250 per diem 334 per diem 305 per diem 410 per diem 383 per diem 334 per diem 334 per diem 334 per diem 421 per diem ADULT PARTIAL PSYCH 912 RC outpatient 1200 350 221 500 325 per diem 394 per diem 394 per diem 250 per diem 400 per diem 400 per diem 287 per diem 313 per diem 355 per diem 355 per diem 355 per diem 447 per diem 470 per diem 447 per diem 500 per diem 306 per diem 303 per diem 254 per diem 276 per diem 334 per diem 238 per diem 375 per diem 375 per diem 375 per diem 287 per diem 375 per diem 300 per diem 221 per diem 234 per diem 250 per diem 334 per diem 305 per diem 410 per diem 383 per diem 334 per diem 334 per diem 334 per diem 421 per diem TELE PARTIAL PSYCH 912 RC outpatient 1200 350 221 500 325 per diem 394 per diem 394 per diem 250 per diem 400 per diem 400 per diem 287 per diem 313 per diem 355 per diem 355 per diem 355 per diem 447 per diem 470 per diem 447 per diem 500 per diem 306 per diem 303 per diem 254 per diem 276 per diem 334 per diem 238 per diem 375 per diem 375 per diem 375 per diem 287 per diem 375 per diem 300 per diem 221 per diem 234 per diem 250 per diem 334 per diem 305 per diem 410 per diem 383 per diem 334 per diem 334 per diem 334 per diem ADULT PARTIAL PSYCH 913 RC outpatient 1200 425 221 500 394 per diem 394 per diem 355 per diem 355 per diem 355 per diem 500 per diem 306 per diem 303 per diem 254 per diem 276 per diem 238 per diem 375 per diem 287 per diem 375 per diem 221 per diem 234 per diem 334 per diem 305 per diem 410 per diem 383 per diem GROUP THERAPY 915 RC outpatient 465 165 221 500 394 per diem 394 per diem 355 per diem 355 per diem 355 per diem 500 per diem 306 per diem 303 per diem 254 per diem 276 per diem 238 per diem 375 per diem 287 per diem 375 per diem 221 per diem 234 per diem 334 per diem 305 per diem 410 per diem 383 per diem IOP PROCESS GROUP 1 915 RC outpatient 175 62 221 394 394 per diem 221 per diem 238 per diem 375 per diem 221 per diem IOP PROCESS GROUP 2 915 RC outpatient 175 62 221 394 394 per diem 221 per diem 238 per diem 375 per diem 221 per diem IOP PROCESS GROUP 3 915 RC outpatient 150 54 221 394 394 per diem 221 per diem 238 per diem 375 per diem 221 per diem INITIAL HOSP/PHP LOW 99221 RC outpatient 200 84 84 84 fee schedule Rates based on patient diagnose INITIAL HOSP/PHP MOD 99222 RC outpatient 200 111 111 111 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP LOW 99233 RC outpatient 200 131 131 131 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP MOD 99232 RC outpatient 200 80 80 80 fee schedule Rates based on patient diagnose SUBSEQ HOSP/PHP HIGH 99231 RC outpatient 200 50 50 50 fee schedule Rates based on patient diagnose DISCH HOSP/PHP LOW 99238 RC outpatient 200 81 81 81 fee schedule Rates based on patient diagnose