hospital_name last_updated_on version hospital_location hospital_address license_number|MA "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." "Northeast Behavioarl Health, LLC" 5/31/2024 2.0.0 "Dartmouth, Massachusetts" 581 Faunce Corner Road license_ 1191 | MA 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| payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE |negotiated_dollar standard_charge| payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE | negotiated_percentage standard_charge|payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE |negotiated_algorithm estimated_amount|payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE standard_charge| payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE |methodology additional_payer_notes | payer_AARP MEDICARE COMPLETE |plan_ MANAGED MEDICARE standard_charge| payer_AETNA 13+|plan_HMO/PPO |negotiated_dollar standard_charge| payer_AETNA 13+|plan_HMO/PPO | negotiated_percentage standard_charge|payer_AETNA 13+|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_AETNA 13+|plan_HMO/PPO | standard_charge| payer_AETNA 13+|plan_HMO/PPO |methodology additional_payer_notes | payer_AETNA 13+|plan_HMO/PPO standard_charge| payer_AETNA 2-12|plan_HMO/PPO |negotiated_dollar standard_charge| payer_AETNA 2-12|plan_HMO/PPO|negotiated_percentage standard_charge|payer_AETNA 2-12|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_AETNA 2-12|plan_HMO/PPO standard_charge| payer_AETNA 2-12|plan_HMO/PPO|methodology additional_payer_notes | payer_AETNA 2-12|plan_HMO/PPO standard_charge| payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE|negotiated_percentage standard_charge|payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE standard_charge| payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_AETNA MNGD MEDICARE|plan_MANAGED MEDICARE standard_charge| payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE |negotiated_percentage standard_charge|payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE |negotiated_algorithm estimated_amount|payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE standard_charge| payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE |methodology additional_payer_notes | payer_BCBS MA MCR ADVANTAGE|plan_MANAGED MEDICARE standard_charge| payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS |negotiated_dollar standard_charge| payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS| negotiated_percentage standard_charge|payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS|negotiated_algorithm estimated_amount|payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS standard_charge| payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS|methodology additional_payer_notes | payer_BCBS MASS ADOL 13-17|plan_BLUE CROSS standard_charge| payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS |negotiated_dollar standard_charge| payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS| negotiated_percentage standard_charge|payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS|negotiated_algorithm estimated_amount|payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS standard_charge| payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS|methodology additional_payer_notes | payer_BCBS OF MASS ADUL 18 PLUS|plan_BLUE CROSS standard_charge| payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS |negotiated_dollar standard_charge| payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS| negotiated_percentage standard_charge|payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS|negotiated_algorithm estimated_amount|payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS standard_charge| payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS |methodology additional_payer_notes | payer_BCBS OF MASS CHILD 2-12|plan_BLUE CROSS standard_charge| payer_BEACON HEALTH OPTIONS|plan_HMO/PPO |negotiated_dollar standard_charge| payer_BEACON HEALTH OPTIONS|plan_HMO/PPO | negotiated_percentage standard_charge|payer_BEACON HEALTH OPTIONS|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_BEACON HEALTH OPTIONS|plan_HMO/PPO standard_charge| payer_BEACON HEALTH OPTIONS|plan_HMO/PPO |methodology additional_payer_notes | payer_BEACON HEALTH OPTIONS|plan_HMO/PPO standard_charge| payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS |negotiated_dollar standard_charge| payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS| negotiated_percentage standard_charge|payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS|negotiated_algorithm estimated_amount|payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS standard_charge| payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS|methodology additional_payer_notes | payer_BLUE BENEFIT ADMIN ADOL|plan_BLUE CROSS standard_charge| payer_BMCHP COMMERCIAL|plan_HMO/PPO |negotiated_dollar standard_charge| payer_BMCHP COMMERCIAL|plan_HMO/PPO | negotiated_percentage standard_charge|payer_BMCHP COMMERCIAL|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_BMCHP COMMERCIAL|plan_HMO/PPO standard_charge| payer_BMCHP COMMERCIAL|plan_HMO/PPO|methodology additional_payer_notes | payer_BMCHP COMMERCIAL|plan_HMO/PPO standard_charge| payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID standard_charge| payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID|methodology additional_payer_notes | payer_BMCHP COMMUNITY ALLIANCE|plan_MANAGED MEDICAID standard_charge| payer_BMCHP MEDICAID|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_BMCHP MEDICAID|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_BMCHP MEDICAID|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_BMCHP MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_BMCHP MEDICAID|plan_MANAGED MEDICAID|methodology additional_payer_notes | payer_BMCHP MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_BMCHP QHP HBE|plan_HMO/PPO |negotiated_dollar standard_charge| payer_BMCHP QHP HBE|plan_HMO/PPO| negotiated_percentage standard_charge|payer_BMCHP QHP HBE|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_BMCHP QHP HBE|plan_HMO/PPO standard_charge| payer_BMCHP QHP HBE|plan_HMO/PPO|methodology additional_payer_notes | payer_BMCHP QHP HBE|plan_HMO/PPO standard_charge| payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID | negotiated_percentage standard_charge|payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID standard_charge| payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_BMCHP SOUTHCOAST ALLIANCE|plan_MANAGED MEDICAID standard_charge| payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE | negotiated_percentage standard_charge|payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE standard_charge| payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_BMCHP SR CARE OPTIONS MC|plan_MANAGED MEDICARE 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 CHILD 2-12|plan_HMO/PPO |negotiated_dollar standard_charge| payer_CIGNA CHILD 2-12|plan_HMO/PPO| negotiated_percentage standard_charge|payer_CIGNA CHILD 2-12|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_CIGNA CHILD 2-12|plan_HMO/PPO standard_charge| payer_CIGNA CHILD 2-12|plan_HMO/PPO |methodology additional_payer_notes | payer_CIGNA CHILD 2-12|plan_HMO/PPO standard_charge| payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE| negotiated_percentage standard_charge|payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE standard_charge| payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_COMMONWEALTH CARE ALLIANC|plan_MANAGED MEDICARE standard_charge| payer_COMPSYCH CORP CHILD|plan_HMO/PPO |negotiated_dollar standard_charge| payer_COMPSYCH CORP CHILD|plan_HMO/PPO | negotiated_percentage standard_charge|payer_COMPSYCH CORP CHILD|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_COMPSYCH CORP CHILD|plan_HMO/PPO standard_charge| payer_COMPSYCH CORP CHILD|plan_HMO/PPO |methodology additional_payer_notes | payer_COMPSYCH CORP CHILD|plan_HMO/PPO standard_charge| payer_COMPSYCH CORPORATION|plan_HMO/PPO |negotiated_dollar standard_charge| payer_COMPSYCH CORPORATION|plan_HMO/PPO | negotiated_percentage standard_charge|payer_COMPSYCH CORPORATION|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_COMPSYCH CORPORATION|plan_HMO/PPO standard_charge| payer_COMPSYCH CORPORATION|plan_HMO/PPO |methodology additional_payer_notes | payer_COMPSYCH CORPORATION|plan_HMO/PPO standard_charge| payer_FALLON 365 CARE|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_FALLON 365 CARE|plan_MANAGED MEDICAID | negotiated_percentage standard_charge|payer_FALLON 365 CARE|plan_MANAGED MEDICAID |negotiated_algorithm estimated_amount|payer_FALLON 365 CARE|plan_MANAGED MEDICAID standard_charge| payer_FALLON 365 CARE|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_FALLON 365 CARE|plan_MANAGED MEDICAID standard_charge| payer_FALLON HEALTH|plan_HMO/PPO |negotiated_dollar standard_charge| payer_FALLON HEALTH|plan_HMO/PPO| negotiated_percentage standard_charge|payer_FALLON HEALTH|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_FALLON HEALTH|plan_HMO/PPO standard_charge| payer_FALLON HEALTH|plan_HMO/PPO |methodology additional_payer_notes | payer_FALLON HEALTH|plan_HMO/PPO standard_charge| payer_FALLON MEDICAID|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_FALLON MEDICAID|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_FALLON MEDICAID|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_FALLON MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_FALLON MEDICAID|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_FALLON MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_FALLON MEDICARE|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_FALLON MEDICARE|plan_MANAGED MEDICARE | negotiated_percentage standard_charge|payer_FALLON MEDICARE|plan_MANAGED MEDICARE |negotiated_algorithm estimated_amount|payer_FALLON MEDICARE|plan_MANAGED MEDICARE |plan_HMO/PPO standard_charge| payer_FALLON MEDICARE|plan_MANAGED MEDICARE |methodology additional_payer_notes | payer_FALLON MEDICARE|plan_MANAGED MEDICARE standard_charge| payer_FALLON PPO|plan_HMO/PPO |negotiated_dollar standard_charge| payer_FALLON PPO|plan_HMO/PPO | negotiated_percentage standard_charge|payer_FALLON PPO|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_FALLON PPO|plan_HMO/PPO standard_charge| payer_FALLON PPO|plan_HMO/PPO |methodology additional_payer_notes | payer_FALLON PPO|plan_HMO/PPO standard_charge| payer_FALLON QHP|plan_HMO/PPO |negotiated_dollar standard_charge| payer_FALLON QHP|plan_HMO/PPO| negotiated_percentage standard_charge|payer_FALLON QHP|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_FALLON QHP|plan_HMO/PPO standard_charge| payer_FALLON QHP|plan_HMO/PPO|methodology additional_payer_notes | payer_FALLON QHP|plan_HMO/PPO standard_charge| payer_GROUP INS COMMISSION|plan_HMO/PPO|negotiated_dollar standard_charge| payer_GROUP INS COMMISSION|plan_HMO/PPO| negotiated_percentage standard_charge|payer_GROUP INS COMMISSION|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_GROUP INS COMMISSION|plan_HMO/PPO standard_charge| payer_GROUP INS COMMISSION|plan_HMO/PPO|methodology additional_payer_notes | payer_GROUP INS COMMISSION|plan_HMO/PPO standard_charge| payer_HARVARD PILGIRM|plan_HMO/PPO |negotiated_dollar standard_charge| payer_HARVARD PILGIRM|plan_HMO/PPO| negotiated_percentage standard_charge|payer_HARVARD PILGIRM|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_HARVARD PILGIRM|plan_HMO/PPO standard_charge| payer_HARVARD PILGIRM|plan_HMO/PPO|methodology additional_payer_notes | payer_HARVARD PILGIRM|plan_HMO/PPO standard_charge| payer_HARVARD PILGIRM MCARE|plan_HMO/PPO |negotiated_dollar standard_charge| payer_HARVARD PILGIRM MCARE|plan_HMO/PPO| negotiated_percentage standard_charge|payer_HARVARD PILGIRM MCARE|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_HARVARD PILGIRM MCARE|plan_HMO/PPO standard_charge| payer_HARVARD PILGIRM MCARE|plan_HMO/PPO|methodology additional_payer_notes | payer_HARVARD PILGIRM MCARE|plan_HMO/PPO standard_charge| payer_HEALTH PLANS INC|plan_HMO/PPO |negotiated_dollar standard_charge| payer_HEALTH PLANS INC|plan_HMO/PPO | negotiated_percentage standard_charge|payer_HEALTH PLANS INC|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_HEALTH PLANS INC|plan_HMO/PPO standard_charge| payer_HEALTH PLANS INC|plan_HMO/PPO |methodology additional_payer_notes | payer_HEALTH PLANS INC|plan_HMO/PPO standard_charge| payer_MAGELLAN HEALTHCARE|plan_HMO/PPO |negotiated_dollar standard_charge| payer_MAGELLAN HEALTHCARE|plan_HMO/PPO | negotiated_percentage standard_charge|payer_MAGELLAN HEALTHCARE|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_MAGELLAN HEALTHCARE|plan_HMO/PPO standard_charge| payer_MAGELLAN HEALTHCARE|plan_HMO/PPO |methodology additional_payer_notes | payer_MAGELLAN HEALTHCARE|plan_HMO/PPO standard_charge| payer_MASS HEALTH|plan_MEDICAID |negotiated_dollar standard_charge| payer_MASS HEALTH|plan_MEDICAID | negotiated_percentage standard_charge|payer_MASS HEALTH|plan_MEDICAID|negotiated_algorithm estimated_amount|payer_MASS HEALTH|plan_MEDICAID standard_charge| payer_MASS HEALTH|plan_MEDICAID |methodology additional_payer_notes | payer_MASS HEALTH|plan_MEDICAID standard_charge| payer_MBHP 13+|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_MBHP 13+|plan_MANAGED MEDICAID | negotiated_percentage standard_charge|payer_MBHP 13+|plan_MANAGED MEDICAID |negotiated_algorithm estimated_amount|payer_MBHP 13+|plan_MANAGED MEDICAID standard_charge| payer_MBHP 13+|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_MBHP 13+|plan_MANAGED MEDICAID standard_charge| payer_MBHP 2-12|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_MBHP 2-12|plan_MANAGED MEDICAID | negotiated_percentage standard_charge|payer_MBHP 2-12|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_MBHP 2-12|plan_MANAGED MEDICAID standard_charge| payer_MBHP 2-12|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_MBHP 2-12|plan_MANAGED MEDICAID standard_charge| payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE |negotiated_dollar standard_charge| payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE | negotiated_percentage standard_charge|payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE|negotiated_algorithm estimated_amount|payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE |methodology additional_payer_notes | payer_MEDICAID OF VERMONT|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE |negotiated_dollar standard_charge| payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE | negotiated_percentage standard_charge|payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE |negotiated_algorithm estimated_amount|payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE |methodology additional_payer_notes | payer_MEDICAID OF VERMONT ADOL|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE |negotiated_dollar standard_charge| payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE | negotiated_percentage standard_charge|payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE |negotiated_algorithm estimated_amount|payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE |methodology additional_payer_notes | payer_MEDICAID OF VERMONT CHILD|plan_MEDICAID: OUT OF STATE standard_charge| payer_MEDICARE NGS|plan_MEDICARE |negotiated_dollar standard_charge| payer_MEDICARE NGS|plan_MEDICARE | negotiated_percentage standard_charge|payer_MEDICARE NGS|plan_MEDICARE|negotiated_algorithm estimated_amount|payer_MEDICARE NGS|plan_MEDICARE standard_charge| payer_MEDICARE NGS|plan_MEDICARE |methodology additional_payer_notes | payer_MEDICARE NGS|plan_MEDICARE standard_charge| payer_MOD ASST ADOL 13-17|plan_HMO/PPO |negotiated_dollar standard_charge| payer_MOD ASST ADOL 13-17|plan_HMO/PPO | negotiated_percentage standard_charge|payer_MOD ASST ADOL 13-17|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_MOD ASST ADOL 13-17|plan_HMO/PPO standard_charge| payer_MOD ASST ADOL 13-17|plan_HMO/PPO |methodology additional_payer_notes | payer_MOD ASST ADOL 13-17|plan_HMO/PPO standard_charge| payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO |negotiated_dollar standard_charge| payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO | negotiated_percentage standard_charge|payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO standard_charge| payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO|methodology additional_payer_notes | payer_MOD ASST PROG- GERI 65+|plan_HMO/PPO standard_charge| payer_MOD ASST PROG-18-64|plan_HMO/PPO |negotiated_dollar standard_charge| payer_MOD ASST PROG-18-64|plan_HMO/PPO| negotiated_percentage standard_charge|payer_MOD ASST PROG-18-64|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_MOD ASST PROG-18-64|plan_HMO/PPO standard_charge| payer_MOD ASST PROG-18-64|plan_HMO/PPO|methodology additional_payer_notes | payer_MOD ASST PROG-18-64|plan_HMO/PPO standard_charge| payer_MOD ASST PROG-5-12|plan_HMO/PPO |negotiated_dollar standard_charge| payer_MOD ASST PROG-5-12|plan_HMO/PPO | negotiated_percentage standard_charge|payer_MOD ASST PROG-5-12|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_MOD ASST PROG-5-12|plan_HMO/PPO standard_charge| payer_MOD ASST PROG-5-12|plan_HMO/PPO |methodology additional_payer_notes | payer_MOD ASST PROG-5-12|plan_HMO/PPO standard_charge| payer_NHP COMMERCIAL|plan_HMO/PPO |negotiated_dollar standard_charge| payer_NHP COMMERCIAL|plan_HMO/PPO | negotiated_percentage standard_charge|payer_NHP COMMERCIAL|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_NHP COMMERCIAL|plan_HMO/PPO standard_charge| payer_NHP COMMERCIAL|plan_HMO/PPO |methodology additional_payer_notes | payer_NHP COMMERCIAL|plan_HMO/PPO standard_charge| payer_NHP PPO|plan_HMO/PPO |negotiated_dollar standard_charge| payer_NHP PPO|plan_HMO/PPO | negotiated_percentage standard_charge|payer_NHP PPO|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_NHP PPO|plan_HMO/PPO standard_charge| payer_NHP PPO|plan_HMO/PPO|methodology additional_payer_notes | payer_NHP PPO|plan_HMO/PPO standard_charge| payer_NHP QHP|plan_HMO/PPO |negotiated_dollar standard_charge| payer_NHP QHP|plan_HMO/PPO| negotiated_percentage standard_charge|payer_NHP QHP|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_NHP QHP|plan_HMO/PPO standard_charge| payer_NHP QHP|plan_HMO/PPO |methodology additional_payer_notes | payer_NHP QHP|plan_HMO/PPO standard_charge| payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID|negotiated_algorithm estimated_amount|payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID standard_charge| payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID|methodology additional_payer_notes | payer_NTWK HEALTH TUFTS 21+|plan_MANAGED MEDICAID standard_charge| payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID |negotiated_algorithm estimated_amount|payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID standard_charge| payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID|methodology additional_payer_notes | payer_NTWK HEALTH TUFTS 2-20|plan_MANAGED MEDICAID standard_charge| payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE | negotiated_percentage standard_charge|payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE standard_charge| payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE |methodology additional_payer_notes | payer_SR WHOLE HEALTH MC|plan_MANAGED MEDICARE standard_charge| payer_TUFTS COMM HEALTH|plan_HMO/PPO |negotiated_dollar standard_charge| payer_TUFTS COMM HEALTH|plan_HMO/PPO| negotiated_percentage standard_charge|payer_TUFTS COMM HEALTH|plan_HMO/PPO |negotiated_algorithm estimated_amount|payer_TUFTS COMM HEALTH|plan_HMO/PPO standard_charge| payer_TUFTS COMM HEALTH|plan_HMO/PPO|methodology additional_payer_notes | payer_TUFTS COMM HEALTH|plan_HMO/PPO standard_charge| payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO |negotiated_dollar standard_charge| payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO| negotiated_percentage standard_charge|payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO standard_charge| payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO|methodology additional_payer_notes | payer_TUFTS HLTH QHP DIRECT 21+|plan_HMO/PPO standard_charge| payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO |negotiated_dollar standard_charge| payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO| negotiated_percentage standard_charge|payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO standard_charge| payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO|methodology additional_payer_notes | payer_TUFTS HLTH QHP DRCT 2-20|plan_HMO/PPO standard_charge| payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE | negotiated_percentage standard_charge|payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE |negotiated_algorithm estimated_amount|payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE standard_charge| payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_TUFTS MEDICARE PREFERRED|plan_MANAGED MEDICARE standard_charge| payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE| negotiated_percentage standard_charge|payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE standard_charge| payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE |methodology additional_payer_notes | payer_TUFTS ONECARE UNIFY|plan_MANAGED MEDICARE standard_charge| payer_UBH 13+|plan_HMO/PPO |negotiated_dollar standard_charge| payer_UBH 13+|plan_HMO/PPO| negotiated_percentage standard_charge|payer_UBH 13+|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_UBH 13+|plan_HMO/PPO standard_charge| payer_UBH 13+|plan_HMO/PPO |methodology additional_payer_notes | payer_UBH 13+|plan_HMO/PPO standard_charge| payer_UBH 2-12|plan_HMO/PPO |negotiated_dollar standard_charge| payer_UBH 2-12|plan_HMO/PPO| negotiated_percentage standard_charge|payer_UBH 2-12|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_UBH 2-12|plan_HMO/PPO standard_charge| payer_UBH 2-12|plan_HMO/PPO|methodology additional_payer_notes | payer_UBH 2-12|plan_HMO/PPO standard_charge| payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE| negotiated_percentage standard_charge|payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE standard_charge| payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_UBH MCARE HMO DDU|plan_MANAGED MEDICARE standard_charge| payer_UBH MEDICAID|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_UBH MEDICAID|plan_MANAGED MEDICAID | negotiated_percentage standard_charge|payer_UBH MEDICAID|plan_MANAGED MEDICAID |negotiated_algorithm estimated_amount|payer_UBH MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_UBH MEDICAID|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_UBH MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE |negotiated_dollar standard_charge| payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE| negotiated_percentage standard_charge|payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE standard_charge| payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE|methodology additional_payer_notes | payer_UBH MEDICARE HMO|plan_MANAGED MEDICARE standard_charge| payer_UBH RI MEDICAID|plan_MANAGED MEDICAID |negotiated_dollar standard_charge| payer_UBH RI MEDICAID|plan_MANAGED MEDICAID| negotiated_percentage standard_charge|payer_UBH RI MEDICAID|plan_MANAGED MEDICAID |negotiated_algorithm estimated_amount|payer_UBH RI MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_UBH RI MEDICAID|plan_MANAGED MEDICAID |methodology additional_payer_notes | payer_UBH RI MEDICAID|plan_MANAGED MEDICAID standard_charge| payer_ULTRA BENEFITS FALLON|plan_HMO/PPO |negotiated_dollar standard_charge| payer_ULTRA BENEFITS FALLON|plan_HMO/PPO| negotiated_percentage standard_charge|payer_ULTRA BENEFITS FALLON|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_ULTRA BENEFITS FALLON|plan_HMO/PPO standard_charge| payer_ULTRA BENEFITS FALLON|plan_HMO/PPO|methodology additional_payer_notes | payer_ULTRA BENEFITS FALLON|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_UPRISE HEALTH ADUL|plan_HMO/PPO |negotiated_dollar standard_charge| payer_UPRISE HEALTH ADUL|plan_HMO/PPO| negotiated_percentage standard_charge|payer_UPRISE HEALTH ADUL|plan_HMO/PPO|negotiated_algorithm estimated_amount|payer_UPRISE HEALTH ADUL|plan_HMO/PPO standard_charge| payer_UPRISE HEALTH ADUL|plan_HMO/PPO|methodology additional_payer_notes | payer_UPRISE HEALTH ADUL|plan_HMO/PPO standard_charge| payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE |negotiated_dollar standard_charge| payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE| negotiated_percentage standard_charge|payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE|negotiated_algorithm estimated_amount|payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE standard_charge| payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE|methodology additional_payer_notes | payer_WELLCARE OF MA/ME/RI |plan_ MANAGED MEDICARE standard_charge|min standard_charge | max additional_generic_notes PRIVATE ROOM 114 RC inpatient 3200 1800 1909.18 per diem 1909.18 per diem 2004.64 per diem 2100 per diem 1909.18 2100 ROOM AND BOARD ADOL PSYCH >13 124 RC inpatient 1600 900 1096 per diem 1174 per diem 1096 per diem 1270.34 per diem 1362.22 per diem 1270.34 per diem 1362.22 per diem 1273.75 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1137 per diem 1300 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1362.22 per diem 1362.22 per diem 968.3 per diem 1194 per diem 1121 per diem 1233 per diem 954.59 per diem 1002.32 per diem 1054.59 per diem 1216.95 per diem 1362.22 per diem 1362.22 per diem 1362.22 per diem 1239 per diem 1194 per diem 1239 per diem 1121 per diem 955 per diem 955 per diem 1362.22 per diem 1121 per diem 954.59 1442 ROOM AND BOARD ADULT 4 124 RC inpatient 1600 900 case rate 1096 per diem 1174 per diem 1096 per diem 1129.2 per diem 1270.34 per diem 1129.2 per diem 1362.22 per diem 1362.22 per diem 1273.75 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1137 per diem case rate 1200 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1362.22 per diem 1362.22 per diem 968.3 per diem 1194 per diem 1072 per diem 1121 per diem 1233 per diem 954.59 per diem 1002.32 per diem 954.59 per diem case rate 1200.15 per diem 1095.15 per diem 1362.22 per diem 1362.22 per diem 1362.22 per diem 1169 per diem 1239 per diem 1202 per diem 1194 per diem 1169 per diem 1239 per diem 1072 per diem case rate 1121 per diem 955 per diem case rate 955 per diem 1362.22 per diem 1121 per diem 1100 per diem case rate 954.59 1442 ROOM AND BOARD CHILD 124 RC inpatient 1600 900 1096 per diem 1174 per diem 1096 per diem 1270.34 per diem 1411.5 per diem 1362.22 per diem 1270.34 per diem 1362.22 per diem 1273.75 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1137 per diem 1189 per diem 1300 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1362.22 per diem 1362.22 per diem 968.3 per diem 1194 per diem 1121 per diem 1233 per diem 954.59 per diem 1002.32 per diem 1050 per diem 1054.59 per diem 1254.59 per diem 1216.95 per diem 1321.95 per diem 1362.22 per diem 1362.22 per diem 1362.22 per diem 1239 per diem 1194 per diem 1239 per diem 1121 per diem 1442 per diem 955 per diem 955 per diem 1362.22 per diem 1121 per diem 954.59 1442 ROOM AND BOARD DUAL DX 124 RC inpatient 1600 900 case rate 1096 per diem 1174 per diem 1096 per diem 1129.2 per diem 1270.34 per diem 1129.2 per diem 1362.22 per diem 1362.22 per diem 1273.75 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1137 per diem case rate 1200 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1362.22 per diem 1362.22 per diem 968.3 per diem 1194 per diem 1072 per diem 1121 per diem 1233 per diem 954.59 per diem 1002.32 per diem 954.59 per diem case rate 1200.15 per diem 1095.15 per diem 1362.22 per diem 1362.22 per diem 1362.22 per diem 1169 per diem 1239 per diem 1202 per diem 1194 per diem 1169 per diem 1239 per diem 1072 per diem case rate 1121 per diem 955 per diem case rate 955 per diem 1362.22 per diem 1121 per diem 1100 per diem case rate 954.59 1442 ROOM AND BOARD GERI PSYCH 124 RC inpatient 1600 900 case rate 1096 per diem 1174 per diem 1096 per diem 1129.2 per diem 1270.34 per diem 1129.2 per diem 1362.22 per diem 1362.22 per diem 1273.75 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1137 per diem case rate 1200 per diem 1273.75 per diem 1362.22 per diem 1273.75 per diem 1225.62 per diem 1362.22 per diem 1362.22 per diem 968.3 per diem 1194 per diem 1072 per diem 1121 per diem 1233 per diem 954.59 per diem 1002.32 per diem 954.59 per diem case rate 1200.15 per diem 1095.15 per diem 1362.22 per diem 1362.22 per diem 1362.22 per diem 1169 per diem 1239 per diem 1202 per diem 1194 per diem 1169 per diem 1239 per diem 1072 per diem case rate 1121 per diem 955 per diem case rate 955 per diem 1362.22 per diem 1121 per diem 1100 per diem case rate 954.59 1442 ROOM AND BOARD DUAL SUD DX 126 RC inpatient 1600 900 case rate case rate case rate 1075 per diem 975 per diem 975 per diem 1075 per diem case rate 975 1075 ROOM AND BOARD DUAL SUD DX 138 RC inpatient 1600 900 case rate 952.22 per diem 952.22 per diem 1137 per diem 1233 per diem 954.59 per diem case rate 1202 per diem case rate 1362.22 per diem case rate 952.22 1362.22 Psych Diagnostic Evaluation NP 90791 RC both 310 154.1 fee schedule Rates based on patient diagnose 130.99 fee schedule Rates based on patient diagnose 124.44 fee schedule Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 154.1 fee schedule Rates based on patient diagnose 167.15 fee schedule Rates based on patient diagnose 154.1 fee schedule Rates based on patient diagnose Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 124.44 208.76 Psych Diagnostic Evaluation MD 90791 RC both 310 154.1 fee schedule Rates based on patient diagnose 154.1 fee schedule Rates based on patient diagnose 146.4 fee schedule Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 154.1 fee schedule Rates based on patient diagnose 167.15 fee schedule Rates based on patient diagnose 154.1 fee schedule Rates based on patient diagnose Rates based on patient diagnose 208.76 fee schedule Rates based on patient diagnose 146.4 208.76 Psych Diagnostic Evaluation W/ Meds NP 90792 RC both 310 166.89 fee schedule Rates based on patient diagnose 149.32 fee schedule Rates based on patient diagnose 141.86 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 166.89 fee schedule Rates based on patient diagnose 131.8 fee schedule Rates based on patient diagnose 166.89 fee schedule Rates based on patient diagnose 175.67 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 131.8 232.94 Psych Diagnostic Evaluation W/ Meds MD 90792 RC both 310 166.89 fee schedule Rates based on patient diagnose 175.67 fee schedule Rates based on patient diagnose 166.89 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 166.89 fee schedule Rates based on patient diagnose 131.8 fee schedule Rates based on patient diagnose 166.89 fee schedule Rates based on patient diagnose 175.67 fee schedule Rates based on patient diagnose 232.94 fee schedule Rates based on patient diagnose 131.8 232.94 Subsequent Hospital Follow Up Low 25 Minutes NP 99231 RC both 120 50.71 fee schedule Rates based on patient diagnose 43.1 fee schedule Rates based on patient diagnose 40.94 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 50.71 fee schedule Rates based on patient diagnose 47.47 fee schedule Rates based on patient diagnose 50.71 fee schedule Rates based on patient diagnose 17 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 17 57.53 Subsequent Hospital Follow Up Low 25 Minutes MD 99231 RC both 120 50.71 fee schedule Rates based on patient diagnose 50.71 fee schedule Rates based on patient diagnose 48.17 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 50.71 fee schedule Rates based on patient diagnose 47.47 fee schedule Rates based on patient diagnose 50.71 fee schedule Rates based on patient diagnose 17 fee schedule Rates based on patient diagnose 57.53 fee schedule Rates based on patient diagnose 17 57.53 Subsequent Hospital Follow Up Moderate 35 Minutes 99232 RC both 140 77 fee schedule Rates based on patient diagnose 68.89 fee schedule Rates based on patient diagnose 65.45 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 77 fee schedule Rates based on patient diagnose 88.19 fee schedule Rates based on patient diagnose 77 fee schedule Rates based on patient diagnose 29.72 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 29.72 91.59 Subsequent Hospital Follow Up Moderate 35 Minutes 99232 RC both 140 77 fee schedule Rates based on patient diagnose 81.05 fee schedule Rates based on patient diagnose 77 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 77 fee schedule Rates based on patient diagnose 88.19 fee schedule Rates based on patient diagnose 77 fee schedule Rates based on patient diagnose 29.72 fee schedule Rates based on patient diagnose 91.59 fee schedule Rates based on patient diagnose 29.72 91.59 Subsequent Hospital Follow Up High 50 Minutes NP 99233 RC both 200 121.91 fee schedule Rates based on patient diagnose 103.62 fee schedule Rates based on patient diagnose 98.44 fee schedule Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 121.91 fee schedule Rates based on patient diagnose fee schedule Rates based on patient diagnose 121.91 fee schedule Rates based on patient diagnose Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 98.44 122.55 Subsequent Hospital Follow Up High 50 Minutes MD 99233 RC both 200 121.91 fee schedule Rates based on patient diagnose 121.91 fee schedule Rates based on patient diagnose 115.81 fee schedule Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 121.91 fee schedule Rates based on patient diagnose fee schedule Rates based on patient diagnose 121.91 fee schedule Rates based on patient diagnose Rates based on patient diagnose 122.55 fee schedule Rates based on patient diagnose 115.81 122.55 Hospital Discharge < 30 Minutes NP 99238 RC both 160 61.63 fee schedule Rates based on patient diagnose 70.59 fee schedule Rates based on patient diagnose 67.07 fee schedule Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 61.63 fee schedule Rates based on patient diagnose 56.16 fee schedule Rates based on patient diagnose 61.63 fee schedule Rates based on patient diagnose Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 56.16 85.86 Hospital Discharge < 30 Minutes MD 99238 RC both 160 61.63 fee schedule Rates based on patient diagnose 83.05 fee schedule Rates based on patient diagnose 78.9 fee schedule Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 61.63 fee schedule Rates based on patient diagnose 56.16 fee schedule Rates based on patient diagnose 61.63 fee schedule Rates based on patient diagnose Rates based on patient diagnose 85.86 fee schedule Rates based on patient diagnose 56.16 85.86 Hospital Discharge > 30 Minutes NP 99239 RC both 213 81.05 fee schedule Rates based on patient diagnose 100 fee schedule Rates based on patient diagnose 95.5 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 81.05 fee schedule Rates based on patient diagnose 91.2 fee schedule Rates based on patient diagnose 81.05 fee schedule Rates based on patient diagnose 47.47 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 47.47 132.69 Hospital Discharge > 30 Minutes MD 99239 RC both 213 81.05 fee schedule Rates based on patient diagnose 117.65 fee schedule Rates based on patient diagnose 111.77 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 81.05 fee schedule Rates based on patient diagnose 91.2 fee schedule Rates based on patient diagnose 81.05 fee schedule Rates based on patient diagnose 47.47 fee schedule Rates based on patient diagnose 132.69 fee schedule Rates based on patient diagnose 47.47 132.69