"hospital_Rolling Hills Hospital, LLC" last_updated_ 2023-12-31 version_1 "hospital_Ada, Oklahoma" hospital_address 1000 Rolling Hills Lane license_ 2319 | OK "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_AETNA | HMO/PPO] standard_charge|[payer_AETNA | HMO/PPO] |percent standard_charge|[payer_AETNA | HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA | HMO/PPO] standard_charge|[payer_AETNA | MANAGED MEDICARE] standard_charge|[payer_AETNA | MANAGED MEDICARE] |percent standard_charge|[payer_AETNA | MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AETNA | MANAGED MEDICARE] standard_charge|[payer_AETNA BETTER HEALTH OF KS MANAGED MEDICAID] standard_charge|[payer_AETNA BETTER HEALTH OF KS MANAGED MEDICAID] |percent standard_charge|[payer_AETNA BETTER HEALTH OF KS MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AETNA BETTER HEALTH OF KS MANAGED MEDICAID] standard_charge|[payer_ALL SAVERS | COMMERCIAL] standard_charge|[payer_ALL SAVERS | COMMERCIAL] |percent standard_charge|[payer_ALL SAVERS | COMMERCIAL] |contracting_method additional_payer_notes |[payer_ALL SAVERS | COMMERCIAL] standard_charge|[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_ALL SAVERS|HMO/PPO] |percent standard_charge|[payer_ALL SAVERS|HMO/PPO] |contracting_method additional_payer_notes |[payer_ALL SAVERS|HMO/PPO] standard_charge|[payer_AMERIGROUP TEXAS|MEDICAID: OUT OF STATE] standard_charge|[payer_AMERIGROUP TEXAS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_AMERIGROUP TEXAS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_AMERIGROUP TEXAS|MEDICAID: OUT OF STATE] standard_charge|[payer_ANOKA COUNTY|LOCAL GOVT] standard_charge|[payer_ANOKA COUNTY|LOCAL GOVT] |percent standard_charge|[payer_ANOKA COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ANOKA COUNTY|LOCAL GOVT] standard_charge|[payer_ANTHEM BCBS HEALTHCARE|MANAGED MEDICAID] standard_charge|[payer_ANTHEM BCBS HEALTHCARE|MANAGED MEDICAID] |percent standard_charge|[payer_ANTHEM BCBS HEALTHCARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_ANTHEM BCBS HEALTHCARE|MANAGED MEDICAID] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MANAGED MEDICAID] standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MANAGED MEDICAID] |percent standard_charge|[payer_ARIZONA UHC COMMUNITYPLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_ARIZONA UHC COMMUNITYPLAN|MANAGED MEDICAID] standard_charge|[payer_AZ CARE FIRST HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_AZ CARE FIRST HEALTH|MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ CARE FIRST HEALTH|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ CARE FIRST HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_AZ MERCY CARE|MEDICAID: CBS OOS] standard_charge|[payer_AZ MERCY CARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_AZ MERCY CARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_AZ MERCY CARE|MEDICAID: CBS OOS] standard_charge|[payer_BCBS OF OK|BLUE CROSS] standard_charge|[payer_BCBS OF OK|BLUE CROSS] |percent standard_charge|[payer_BCBS OF OK|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OF OK|BLUE CROSS] standard_charge|[payer_BCBS OF OK PPO ACUTE|BLUE CROSS] standard_charge|[payer_BCBS OF OK PPO ACUTE|BLUE CROSS] |percent standard_charge|[payer_BCBS OF OK PPO ACUTE|BLUE CROSS] |contracting_method additional_payer_notes |[payer_BCBS OF OK PPO ACUTE|BLUE CROSS] standard_charge|[payer_BCBS HMO] standard_charge|[payer_BCBS HMO] |percent standard_charge|[payer_BCBS HMO] |contracting_method additional_payer_notes |[payer_BCBS HMO] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |percent standard_charge|[payer_BEACON HEALTH OPTIONS|HMO/PPO] |contracting_method additional_payer_notes |[payer_BEACON HEALTH OPTIONS|HMO/PPO] standard_charge|[payer_BEACON HEALTH OPTIONS|MANAGED MEDICARE] standard_charge|[payer_BEACON HEALTH OPTIONS|MANAGED MEDICARE] |percent standard_charge|[payer_BEACON HEALTH OPTIONS|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BEACON HEALTH OPTIONS|MANAGED MEDICARE] standard_charge|[payer_BLUECARE TN|MEDICAID: CBS OOS] standard_charge|[payer_BLUECARE TN|MEDICAID: CBS OOS] |percent standard_charge|[payer_BLUECARE TN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_BLUECARE TN|MEDICAID: CBS OOS] standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] |percent standard_charge|[payer_BRIGHT HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_BRIGHT HEALTH|HMO/PPO] standard_charge|[payer_BUREAU OF INDIAN AFFAIRS|LOCAL GOVT] standard_charge|[payer_BUREAU OF INDIAN AFFAIRS|LOCAL GOVT] |percent standard_charge|[payer_BUREAU OF INDIAN AFFAIRS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BUREAU OF INDIAN AFFAIRS|LOCAL GOVT] standard_charge|[payer_BUTLER COUNTY|LOCAL GOVT] standard_charge|[payer_BUTLER COUNTY|LOCAL GOVT] |percent standard_charge|[payer_BUTLER COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_BUTLER COUNTY|LOCAL GOVT] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHEROKEE NATION|LOCAL GOVT] standard_charge|[payer_CHEROKEE NATION|LOCAL GOVT] |percent standard_charge|[payer_CHEROKEE NATION|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CHEROKEE NATION|LOCAL GOVT] standard_charge|[payer_CHICKASAW INDIAN HEALTH|LOCAL GOVT] standard_charge|[payer_CHICKASAW INDIAN HEALTH|LOCAL GOVT] |percent standard_charge|[payer_CHICKASAW INDIAN HEALTH|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CHICKASAW INDIAN HEALTH|LOCAL GOVT] standard_charge|[payer_CHICKASAW NATION|LOCAL GOVT] standard_charge|[payer_CHICKASAW NATION|LOCAL GOVT] |percent standard_charge|[payer_CHICKASAW NATION|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CHICKASAW NATION|LOCAL GOVT] standard_charge|[payer_CIGNA|HMO/PPO] standard_charge|[payer_CIGNA|HMO/PPO] |percent standard_charge|[payer_CIGNA|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA|HMO/PPO] standard_charge|[payer_CIGNA BEHAVORIAL HEALTH|HMO/PPO] standard_charge|[payer_CIGNA BEHAVORIAL HEALTH|HMO/PPO] |percent standard_charge|[payer_CIGNA BEHAVORIAL HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_CIGNA BEHAVORIAL HEALTH|HMO/PPO] standard_charge|[payer_CO ACCESS|MEDICAID: CBS OOS] standard_charge|[payer_CO ACCESS|MEDICAID: CBS OOS] |percent standard_charge|[payer_CO ACCESS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO ACCESS|MEDICAID: CBS OOS] standard_charge|[payer_CO CCHA|MEDICAID: CBS OOS] standard_charge|[payer_CO CCHA|MEDICAID: CBS OOS] |percent standard_charge|[payer_CO CCHA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO CCHA|MEDICAID: CBS OOS] standard_charge|[payer_CO EL PASO COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_CO EL PASO COUNTY|MEDICAID: CBS OOS] |percent standard_charge|[payer_CO EL PASO COUNTY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO EL PASO COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] |percent standard_charge|[payer_CO EPDST|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CO EPDST|MEDICAID: CBS OOS] standard_charge|[payer_COMMUNITY CARE|HMO/PPO] standard_charge|[payer_COMMUNITY CARE|HMO/PPO] |percent standard_charge|[payer_COMMUNITY CARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_COMMUNITY CARE|HMO/PPO] standard_charge|[payer_COMMUNITY CARE|HMO/PPO PHYSICIAN] standard_charge|[payer_COMMUNITY CARE|HMO/PPO PHYSICIAN] |percent standard_charge|[payer_COMMUNITY CARE|HMO/PPO PHYSICIAN] |contracting_method additional_payer_notes |[payer_COMMUNITY CARE|HMO/PPO PHYSICIAN] standard_charge|[payer_COMPSYCH|COMMERCIAL] standard_charge|[payer_COMPSYCH|COMMERCIAL] |percent standard_charge|[payer_COMPSYCH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_COMPSYCH|COMMERCIAL] standard_charge|[payer_CONNECT CARE|HMO/PPO] standard_charge|[payer_CONNECT CARE|HMO/PPO] |percent standard_charge|[payer_CONNECT CARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_CONNECT CARE|HMO/PPO] standard_charge|[payer_CORNERSTONES OF CARE|MEDICAID: CBS OOS] standard_charge|[payer_CORNERSTONES OF CARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_CORNERSTONES OF CARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_CORNERSTONES OF CARE|MEDICAID: CBS OOS] standard_charge|[payer_CUYAHOGA COUNTY|LOCAL GOVT] standard_charge|[payer_CUYAHOGA COUNTY|LOCAL GOVT] |percent standard_charge|[payer_CUYAHOGA COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CUYAHOGA COUNTY|LOCAL GOVT] standard_charge|[payer_DANE COUNTY|LOCAL GOVT] standard_charge|[payer_DANE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_DANE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_DANE COUNTY|LOCAL GOVT] standard_charge|[payer_FIRST HEALTH NETWORK|HMO/PPO] standard_charge|[payer_FIRST HEALTH NETWORK|HMO/PPO] |percent standard_charge|[payer_FIRST HEALTH NETWORK|HMO/PPO] |contracting_method additional_payer_notes |[payer_FIRST HEALTH NETWORK|HMO/PPO] standard_charge|[payer_FISCAL SERVICES|MEDICAID: OUT OF STATE] standard_charge|[payer_FISCAL SERVICES|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_FISCAL SERVICES|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_FISCAL SERVICES|MEDICAID: OUT OF STATE] standard_charge|[payer_GILSBAR|COMMERCIAL] standard_charge|[payer_GILSBAR|COMMERCIAL] |percent standard_charge|[payer_GILSBAR|COMMERCIAL] |contracting_method additional_payer_notes |[payer_GILSBAR|COMMERCIAL] standard_charge|[payer_HEALTH CHOICE|HMO/PPO] standard_charge|[payer_HEALTH CHOICE|HMO/PPO] |percent standard_charge|[payer_HEALTH CHOICE|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTH CHOICE|HMO/PPO] standard_charge|[payer_HEALTH CHOICE OF AZ|MANAGED MEDICAID] standard_charge|[payer_HEALTH CHOICE OF AZ|MANAGED MEDICAID] |percent standard_charge|[payer_HEALTH CHOICE OF AZ|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_HEALTH CHOICE OF AZ|MANAGED MEDICAID] standard_charge|[payer_HEALTH PLAN OF NEVADA|MEDICAID: CBS OOS] standard_charge|[payer_HEALTH PLAN OF NEVADA|MEDICAID: CBS OOS] |percent standard_charge|[payer_HEALTH PLAN OF NEVADA|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_HEALTH PLAN OF NEVADA|MEDICAID: CBS OOS] standard_charge|[payer_HEALTHCHOICE|HMO/PPO] standard_charge|[payer_HEALTHCHOICE|HMO/PPO] |percent standard_charge|[payer_HEALTHCHOICE|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHCHOICE|HMO/PPO] standard_charge|[payer_HEALTHLINK|COMMERCIAL] standard_charge|[payer_HEALTHLINK|COMMERCIAL] |percent standard_charge|[payer_HEALTHLINK|COMMERCIAL] |contracting_method additional_payer_notes |[payer_HEALTHLINK|COMMERCIAL] standard_charge|[payer_HEALTHSMART|HMO/PPO] standard_charge|[payer_HEALTHSMART|HMO/PPO] |percent standard_charge|[payer_HEALTHSMART|HMO/PPO] |contracting_method additional_payer_notes |[payer_HEALTHSMART|HMO/PPO] standard_charge|[payer_HI CAMHD|MEDICAID: CBS OOS] standard_charge|[payer_HI CAMHD|MEDICAID: CBS OOS] |percent standard_charge|[payer_HI CAMHD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_HI CAMHD|MEDICAID: CBS OOS] standard_charge|[payer_HIGHMARK DELAWARE BCBS|MEDICAID: CBS OOS] standard_charge|[payer_HIGHMARK DELAWARE BCBS|MEDICAID: CBS OOS] |percent standard_charge|[payer_HIGHMARK DELAWARE BCBS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_HIGHMARK DELAWARE BCBS|MEDICAID: CBS OOS] standard_charge|[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA|HMO/PPO] |percent standard_charge|[payer_HUMANA|HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA COMMERCIAL|HMO/PPO] standard_charge|[payer_HUMANA COMMERCIAL|HMO/PPO] |percent standard_charge|[payer_HUMANA COMMERCIAL|HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA COMMERCIAL|HMO/PPO] standard_charge|[payer_HUMANA MANAGED MEDICARE|MANAGED MEDICARE] standard_charge|[payer_HUMANA MANAGED MEDICARE|MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA MANAGED MEDICARE|MANAGED MEDICARE] standard_charge|[payer_HUMANA TRICARE|TRICARE] standard_charge|[payer_HUMANA TRICARE|TRICARE] |percent standard_charge|[payer_HUMANA TRICARE|TRICARE] |contracting_method additional_payer_notes |[payer_HUMANA TRICARE|TRICARE] standard_charge|[payer_IA AMERIGROUP|MEDICAID: CBS OOS] standard_charge|[payer_IA AMERIGROUP|MEDICAID: CBS OOS] |percent standard_charge|[payer_IA AMERIGROUP|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IA AMERIGROUP|MEDICAID: CBS OOS] standard_charge|[payer_IA TOTAL CARE|MEDICAID: CBS OOS] standard_charge|[payer_IA TOTAL CARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_IA TOTAL CARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_IA TOTAL CARE|MEDICAID: CBS OOS] standard_charge|[payer_ID MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_ID MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_ID MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ID MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_INDIANA DCS|MEDICAID: OUT OF STATE] standard_charge|[payer_INDIANA DCS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_INDIANA DCS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_INDIANA DCS|MEDICAID: OUT OF STATE] standard_charge|[payer_KAISER PERMANENTE|COMMERCIAL] standard_charge|[payer_KAISER PERMANENTE|COMMERCIAL] |percent standard_charge|[payer_KAISER PERMANENTE|COMMERCIAL] |contracting_method additional_payer_notes |[payer_KAISER PERMANENTE|COMMERCIAL] standard_charge|[payer_KEMPTON GROUP|COMMERCIAL] standard_charge|[payer_KEMPTON GROUP|COMMERCIAL] |percent standard_charge|[payer_KEMPTON GROUP|COMMERCIAL] |contracting_method additional_payer_notes |[payer_KEMPTON GROUP|COMMERCIAL] standard_charge|[payer_LA HEALTHCARE CONNECTIONS|MEDICAID: CBS OOS] standard_charge|[payer_LA HEALTHCARE CONNECTIONS|MEDICAID: CBS OOS] |percent standard_charge|[payer_LA HEALTHCARE CONNECTIONS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_LA HEALTHCARE CONNECTIONS|MEDICAID: CBS OOS] standard_charge|[payer_LARIMER COUNTY|LOCAL GOVT] standard_charge|[payer_LARIMER COUNTY|LOCAL GOVT] |percent standard_charge|[payer_LARIMER COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_LARIMER COUNTY|LOCAL GOVT] standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|HMO/PPO] standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|HMO/PPO] |percent standard_charge|[payer_MAGELLAN BEHAVIORAL HEALT|HMO/PPO] |contracting_method additional_payer_notes |[payer_MAGELLAN BEHAVIORAL HEALT|HMO/PPO] standard_charge|[payer_MAINECARE|MEDICAID: OUT OF STATE] standard_charge|[payer_MAINECARE|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_MAINECARE|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_MAINECARE|MEDICAID: OUT OF STATE] standard_charge|[payer_MARYLAND PHYSICIANS CARE|MANAGED MEDICAID] standard_charge|[payer_MARYLAND PHYSICIANS CARE|MANAGED MEDICAID] |percent standard_charge|[payer_MARYLAND PHYSICIANS CARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MARYLAND PHYSICIANS CARE|MANAGED MEDICAID] standard_charge|[payer_MD DHS|MEDICAID: CBS OOS] standard_charge|[payer_MD DHS|MEDICAID: CBS OOS] |percent standard_charge|[payer_MD DHS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MD DHS|MEDICAID: CBS OOS] standard_charge|[payer_ME MAINECARE|MEDICAID: CBS OOS] standard_charge|[payer_ME MAINECARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_ME MAINECARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ME MAINECARE|MEDICAID: CBS OOS] standard_charge|[payer_MEDICARE|MEDICARE] standard_charge|[payer_MEDICARE|MEDICARE] |percent standard_charge|[payer_MEDICARE|MEDICARE] |contracting_method additional_payer_notes |[payer_MEDICARE|MEDICARE] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |percent standard_charge|[payer_MERITAIN HEALTH|HMO/PPO] |contracting_method additional_payer_notes |[payer_MERITAIN HEALTH|HMO/PPO] standard_charge|[payer_MESA COUNTY DHS/SOC SERV|LOCAL GOVT] standard_charge|[payer_MESA COUNTY DHS/SOC SERV|LOCAL GOVT] |percent standard_charge|[payer_MESA COUNTY DHS/SOC SERV|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MESA COUNTY DHS/SOC SERV|LOCAL GOVT] standard_charge|[payer_MHNET|HMO/PPO] standard_charge|[payer_MHNET|HMO/PPO] |percent standard_charge|[payer_MHNET|HMO/PPO] |contracting_method additional_payer_notes |[payer_MHNET|HMO/PPO] standard_charge|[payer_MISSOURI FAMILY FORWARD|MEDICAID: CBS OOS] standard_charge|[payer_MISSOURI FAMILY FORWARD|MEDICAID: CBS OOS] |percent standard_charge|[payer_MISSOURI FAMILY FORWARD|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MISSOURI FAMILY FORWARD|MEDICAID: CBS OOS] standard_charge|[payer_MO DSS|MEDICAID: CBS OOS] standard_charge|[payer_MO DSS|MEDICAID: CBS OOS] |percent standard_charge|[payer_MO DSS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MO DSS|MEDICAID: CBS OOS] standard_charge|[payer_MOLINA HEALTHCARE OF MS|MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE OF MS|MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA HEALTHCARE OF MS|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE OF MS|MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE OF WA|MANAGED MEDICAID] standard_charge|[payer_MOLINA HEALTHCARE OF WA|MANAGED MEDICAID] |percent standard_charge|[payer_MOLINA HEALTHCARE OF WA|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_MOLINA HEALTHCARE OF WA|MANAGED MEDICAID] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MONTANA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MONTGOMERY COUNTY|LOCAL GOVT] standard_charge|[payer_MONTGOMERY COUNTY|LOCAL GOVT] |percent standard_charge|[payer_MONTGOMERY COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MONTGOMERY COUNTY|LOCAL GOVT] standard_charge|[payer_MS MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_MS MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_MS MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MS MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NE DHHS|MEDICAID: CBS OOS] standard_charge|[payer_NE DHHS|MEDICAID: CBS OOS] |percent standard_charge|[payer_NE DHHS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NE DHHS|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NEVADA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NH MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NH MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_NH MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NH MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_NM BCBS|MEDICAID: CBS OOS] standard_charge|[payer_NM BCBS|MEDICAID: CBS OOS] |percent standard_charge|[payer_NM BCBS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NM BCBS|MEDICAID: CBS OOS] standard_charge|[payer_NM PRES MAGELLAN|MEDICAID: CBS OOS] standard_charge|[payer_NM PRES MAGELLAN|MEDICAID: CBS OOS] |percent standard_charge|[payer_NM PRES MAGELLAN|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_NM PRES MAGELLAN|MEDICAID: CBS OOS] standard_charge|[payer_OH AETNA BETTER HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_OH AETNA BETTER HEALTH|MEDICAID: CBS OOS] |percent standard_charge|[payer_OH AETNA BETTER HEALTH|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OH AETNA BETTER HEALTH|MEDICAID: CBS OOS] standard_charge|[payer_OH CUYAHOGA COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OH CUYAHOGA COUNTY|MEDICAID: CBS OOS] |percent standard_charge|[payer_OH CUYAHOGA COUNTY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OH CUYAHOGA COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OH FRANKLIN COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OH FRANKLIN COUNTY|MEDICAID: CBS OOS] |percent standard_charge|[payer_OH FRANKLIN COUNTY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OH FRANKLIN COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OH HAMILTON COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OH HAMILTON COUNTY|MEDICAID: CBS OOS] |percent standard_charge|[payer_OH HAMILTON COUNTY|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OH HAMILTON COUNTY|MEDICAID: CBS OOS] standard_charge|[payer_OHIO MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OHIO MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_OHIO MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_OHIO MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_OK DEPT OF HUMAN SERVICES|LOCAL GOVT] standard_charge|[payer_OK DEPT OF HUMAN SERVICES|LOCAL GOVT] |percent standard_charge|[payer_OK DEPT OF HUMAN SERVICES|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OK DEPT OF HUMAN SERVICES|LOCAL GOVT] standard_charge|[payer_OK MEDICAID RTC|MEDICAID] standard_charge|[payer_OK MEDICAID RTC|MEDICAID] |percent standard_charge|[payer_OK MEDICAID RTC|MEDICAID] |contracting_method additional_payer_notes |[payer_OK MEDICAID RTC|MEDICAID] standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID] standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID] |percent standard_charge|[payer_OKLAHOMA MEDICAID|MEDICAID] |contracting_method additional_payer_notes |[payer_OKLAHOMA MEDICAID|MEDICAID] standard_charge|[payer_ONEIDA COUNTY|LOCAL GOVT] standard_charge|[payer_ONEIDA COUNTY|LOCAL GOVT] |percent standard_charge|[payer_ONEIDA COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_ONEIDA COUNTY|LOCAL GOVT] standard_charge|[payer_OPTUM HEALTH|MANAGED MEDICARE] standard_charge|[payer_OPTUM HEALTH|MANAGED MEDICARE] |percent standard_charge|[payer_OPTUM HEALTH|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_OPTUM HEALTH|MANAGED MEDICARE] standard_charge|[payer_OREGON DHS|MEDICAID: OUT OF STATE] standard_charge|[payer_OREGON DHS|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_OREGON DHS|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_OREGON DHS|MEDICAID: OUT OF STATE] standard_charge|[payer_OSCAR HEALTH|COMMERCIAL] standard_charge|[payer_OSCAR HEALTH|COMMERCIAL] |percent standard_charge|[payer_OSCAR HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_OSCAR HEALTH|COMMERCIAL] standard_charge|[payer_OUTAGAMIE COUTNY DHS|LOCAL GOVT] standard_charge|[payer_OUTAGAMIE COUTNY DHS|LOCAL GOVT] |percent standard_charge|[payer_OUTAGAMIE COUTNY DHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OUTAGAMIE COUTNY DHS|LOCAL GOVT] standard_charge|[payer_PINE COUNTY|LOCAL GOVT] standard_charge|[payer_PINE COUNTY|LOCAL GOVT] |percent standard_charge|[payer_PINE COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_PINE COUNTY|LOCAL GOVT] standard_charge|[payer_POINT COMFORT UNDERWRITER|LOCAL GOVT] standard_charge|[payer_POINT COMFORT UNDERWRITER|LOCAL GOVT] |percent standard_charge|[payer_POINT COMFORT UNDERWRITER|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_POINT COMFORT UNDERWRITER|LOCAL GOVT] standard_charge|[payer_QUAPAW TRIBE|LOCAL GOVT] standard_charge|[payer_QUAPAW TRIBE|LOCAL GOVT] |percent standard_charge|[payer_QUAPAW TRIBE|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_QUAPAW TRIBE|LOCAL GOVT] standard_charge|[payer_RAMSEY COUNTY|LOCAL GOVT] standard_charge|[payer_RAMSEY COUNTY|LOCAL GOVT] |percent standard_charge|[payer_RAMSEY COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_RAMSEY COUNTY|LOCAL GOVT] standard_charge|[payer_SALT RIVER PIMA|LOCAL GOVT] standard_charge|[payer_SALT RIVER PIMA|LOCAL GOVT] |percent standard_charge|[payer_SALT RIVER PIMA|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SALT RIVER PIMA|LOCAL GOVT] standard_charge|[payer_SAN DIEGO UNIFIED SCHOOL|MEDICAID: CBS OOS] standard_charge|[payer_SAN DIEGO UNIFIED SCHOOL|MEDICAID: CBS OOS] |percent standard_charge|[payer_SAN DIEGO UNIFIED SCHOOL|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_SAN DIEGO UNIFIED SCHOOL|MEDICAID: CBS OOS] standard_charge|[payer_SELECT HEALTH OF SC|MEDICAID: CBS OOS] standard_charge|[payer_SELECT HEALTH OF SC|MEDICAID: CBS OOS] |percent standard_charge|[payer_SELECT HEALTH OF SC|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_SELECT HEALTH OF SC|MEDICAID: CBS OOS] standard_charge|[payer_SICANGU CFS|LOCAL GOVT] standard_charge|[payer_SICANGU CFS|LOCAL GOVT] |percent standard_charge|[payer_SICANGU CFS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SICANGU CFS|LOCAL GOVT] standard_charge|[payer_SOUTH CAROLINA DSS|LOCAL GOVT] standard_charge|[payer_SOUTH CAROLINA DSS|LOCAL GOVT] |percent standard_charge|[payer_SOUTH CAROLINA DSS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_SOUTH CAROLINA DSS|LOCAL GOVT] standard_charge|[payer_SOUTH DAKOTA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_SOUTH DAKOTA MEDICAID|MEDICAID: CBS OOS] |percent standard_charge|[payer_SOUTH DAKOTA MEDICAID|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_SOUTH DAKOTA MEDICAID|MEDICAID: CBS OOS] standard_charge|[payer_STEARNS COUNTY|LOCAL GOVT] standard_charge|[payer_STEARNS COUNTY|LOCAL GOVT] |percent standard_charge|[payer_STEARNS COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_STEARNS COUNTY|LOCAL GOVT] standard_charge|[payer_SUNFLOWER HEALTH PLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_SUNFLOWER HEALTH PLAN|MEDICAID: OUT OF STATE] |percent standard_charge|[payer_SUNFLOWER HEALTH PLAN|MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_SUNFLOWER HEALTH PLAN|MEDICAID: OUT OF STATE] standard_charge|[payer_SUNSHINE HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_SUNSHINE HEALTH PLAN|MANAGED MEDICAID] |percent standard_charge|[payer_SUNSHINE HEALTH PLAN|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_SUNSHINE HEALTH PLAN|MANAGED MEDICAID] standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] |percent standard_charge|[payer_TENNESSEE DCS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_TENNESSEE DCS|LOCAL GOVT] standard_charge|[payer_TN BLUECARE|MEDICAID: CBS OOS] standard_charge|[payer_TN BLUECARE|MEDICAID: CBS OOS] |percent standard_charge|[payer_TN BLUECARE|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TN BLUECARE|MEDICAID: CBS OOS] standard_charge|[payer_TN DCS|MEDICAID: CBS OOS] standard_charge|[payer_TN DCS|MEDICAID: CBS OOS] |percent standard_charge|[payer_TN DCS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TN DCS|MEDICAID: CBS OOS] standard_charge|[payer_TRICARE|TRICARE] standard_charge|[payer_TRICARE|TRICARE] |percent standard_charge|[payer_TRICARE|TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE|TRICARE] standard_charge|[payer_TX DFPS|MEDICAID: CBS OOS] standard_charge|[payer_TX DFPS|MEDICAID: CBS OOS] |percent standard_charge|[payer_TX DFPS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TX DFPS|MEDICAID: CBS OOS] standard_charge|[payer_TX ST FRANCIS|MEDICAID: CBS OOS] standard_charge|[payer_TX ST FRANCIS|MEDICAID: CBS OOS] |percent standard_charge|[payer_TX ST FRANCIS|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_TX ST FRANCIS|MEDICAID: CBS OOS] standard_charge|[payer_UBH MEDICA|HMO/PPO] standard_charge|[payer_UBH MEDICA|HMO/PPO] |percent standard_charge|[payer_UBH MEDICA|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH MEDICA|HMO/PPO] standard_charge|[payer_UBH OPTUM|HMO/PPO] standard_charge|[payer_UBH OPTUM|HMO/PPO] |percent standard_charge|[payer_UBH OPTUM|HMO/PPO] |contracting_method additional_payer_notes |[payer_UBH OPTUM|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO] |percent standard_charge|[payer_UMR|HMO/PPO] |contracting_method additional_payer_notes |[payer_UMR|HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH|MANAGED MEDICAID] standard_charge|[payer_UNITED BEHAVIORAL HEALTH|MANAGED MEDICAID] |percent standard_charge|[payer_UNITED BEHAVIORAL HEALTH|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UNITED BEHAVIORAL HEALTH|MANAGED MEDICAID] standard_charge|[payer_UNITED HEALTHCARE|HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE|HMO/PPO] |percent standard_charge|[payer_UNITED HEALTHCARE|HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE|HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE|MANAGED MEDICARE] standard_charge|[payer_UNITED HEALTHCARE|MANAGED MEDICARE] |percent standard_charge|[payer_UNITED HEALTHCARE|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE|MANAGED MEDICARE] standard_charge|[payer_UNITED HEALTHCARE INC|COMMERCIAL] standard_charge|[payer_UNITED HEALTHCARE INC|COMMERCIAL] |percent standard_charge|[payer_UNITED HEALTHCARE INC|COMMERCIAL] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE INC|COMMERCIAL] standard_charge|[payer_UNITED HEALTHCARE INC|HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE INC|HMO/PPO] |percent standard_charge|[payer_UNITED HEALTHCARE INC|HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE INC|HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE INC|MANAGED MEDICARE] standard_charge|[payer_UNITED HEALTHCARE INC|MANAGED MEDICARE] |percent standard_charge|[payer_UNITED HEALTHCARE INC|MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE INC|MANAGED MEDICARE] standard_charge|[payer_UNIVERSITY FAMILY CARE|MANAGED MEDICAID] standard_charge|[payer_UNIVERSITY FAMILY CARE|MANAGED MEDICAID] |percent standard_charge|[payer_UNIVERSITY FAMILY CARE|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_UNIVERSITY FAMILY CARE|MANAGED MEDICAID] standard_charge|[payer_WEB TPA|COMMERCIAL] standard_charge|[payer_WEB TPA|COMMERCIAL] |percent standard_charge|[payer_WEB TPA|COMMERCIAL] |contracting_method additional_payer_notes |[payer_WEB TPA|COMMERCIAL] standard_charge|[payer_WELL FIRST HEALTH|COMMERCIAL] standard_charge|[payer_WELL FIRST HEALTH|COMMERCIAL] |percent standard_charge|[payer_WELL FIRST HEALTH|COMMERCIAL] |contracting_method additional_payer_notes |[payer_WELL FIRST HEALTH|COMMERCIAL] standard_charge|[payer_WESTERN SKY|MANAGED MEDICAID] standard_charge|[payer_WESTERN SKY|MANAGED MEDICAID] |percent standard_charge|[payer_WESTERN SKY|MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_WESTERN SKY|MANAGED MEDICAID] standard_charge|[payer_WISCONSIN DHHS|LOCAL GOVT] standard_charge|[payer_WISCONSIN DHHS|LOCAL GOVT] |percent standard_charge|[payer_WISCONSIN DHHS|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WISCONSIN DHHS|LOCAL GOVT] standard_charge|[payer_WV DHHR|MEDICAID: CBS OOS] standard_charge|[payer_WV DHHR|MEDICAID: CBS OOS] |percent standard_charge|[payer_WV DHHR|MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_WV DHHR|MEDICAID: CBS OOS] standard_charge|[payer_WV DHHR MERCER COUNTY|LOCAL GOVT] standard_charge|[payer_WV DHHR MERCER COUNTY|LOCAL GOVT] |percent standard_charge|[payer_WV DHHR MERCER COUNTY|LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WV DHHR MERCER COUNTY|LOCAL GOVT] ROOM AND BOARD ADULT PSYCH 124 facility Inpatient 2430 690 475.00 "1,275.00" 810.00 per diem 810.00 per diem 664.91 per diem 800.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 550 per diem 875 per diem 800 per diem 800 per diem 700 per diem 900 per diem 664.91 per diem 800 per diem 800 per diem 850 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD GERIATRIC PSYCH 124 facility Inpatient 2430 690 475.00 "1,275.00" 810.00 per diem 810.00 per diem 664.91 per diem 800.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 550 per diem 875 per diem 800 per diem 800 per diem 700 per diem 900 per diem 664.91 per diem 800 per diem 800 per diem 850 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD MRDD PSYCH 124 facility Inpatient 2430 690 475.00 "1,275.00" 810.00 per diem 810.00 per diem 664.91 per diem 800.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 550 per diem 875 per diem 800 per diem 800 per diem 700 per diem 900 per diem 664.91 per diem 800 per diem 800 per diem 850 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD GERIATRIC PSYCH 124 facility Inpatient 2430 690 475.00 "1,275.00" 810.00 per diem 810.00 per diem 664.91 per diem 800.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 550 per diem 875 per diem 800 per diem 800 per diem 700 per diem 900 per diem 664.91 per diem 800 per diem 800 per diem 850 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD MRDD PSYCH 124 facility Inpatient 2430 690 475.00 "1,275.00" 810.00 per diem 810.00 per diem 664.91 per diem 800.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 550 per diem 875 per diem 800 per diem 800 per diem 700 per diem 900 per diem 664.91 per diem 800 per diem 800 per diem 850 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD ADULT DETOX 126 facility Inpatient 2430 690 500.00 "1,275.00" 559.00 per diem 559.00 per diem 800.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 875 per diem 800 per diem 800 per diem 700 per diem 664.91 per diem 800 per diem 800 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD GERIATRIC DETOX 126 facility Inpatient 2430 690 500.00 "1,275.00" 559.00 per diem 559.00 per diem 800.00 per diem 550.00 per diem 817.00 per diem 720.00 per diem 665.00 per diem 850 per diem 850 per diem 1275 per diem 817 per diem 863 per diem 900 per diem 670 per diem 840 per diem 850 per diem 800 per diem 944 per diem 500 per diem 700 per diem 875 per diem 800 per diem 800 per diem 700 per diem 664.91 per diem 800 per diem 800 per diem 925 per diem 800 800 800 per diem 800 per diem 800 per diem 800 per diem 800 per diem ROOM AND BOARD ADULT REHAB 128 facility Inpatient 2430 690 440.00 800.00 440.00 per diem 800 per diem INTENSIVE OUTPATIENT PROGRAM AUDLT 905 facility Outpatient 618 160 160.00 472.00 233.00 per diem 168 per diem 212 per diem 213 per diem 472 per diem 206 per diem 200 per diem 160 per diem 192 per diem 192 192 per diem 384 per diem 192 per diem 181 per diem PARTIAL HOSPITAL PROGRAM PROGRAM 912 facility Outpatient 824 210 160.00 880.00 437.00 per diem 220 per diem 371 per diem 400 per diem 640 per diem 206 per diem 206 per diem 160 per diem 440 per diem 440 440 per diem 880 per diem 440 per diem INTENSIVE OUTPATIENT PROGRAM PROCESS GROUP 1 915 facility Outpatient 206 55 160.00 880.00 204 per diem 206 per diem 206 per diem 160 per diem 192 per diem 880 per diem PARTIAL HOSPITAL PROGRAM PROCESS GROUP 1 915 facility Outpatient 165 42 160.00 880.00 204 per diem 206 per diem 206 per diem 160 per diem 192 per diem 880 per diem BLOCKED BED 1001 facility Outpatient 310 250 350.00 "1,128.00" 478.00 per diem 550.00 per diem 436.00 per diem 550.00 per diem 480.00 per diem 425.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 534.00 per diem 481 per diem 399 per diem 550 per diem 817 per diem 436 per diem 500 per diem 759 per diem 525 per diem 669 per diem 765 per diem 787 per diem 925 per diem 485 per diem 380 per diem 630 per diem 500 per diem 620 per diem 550 per diem 436 per diem 570 per diem 458 per diem 944 per diem 500 per diem 481 per diem 944 per diem 500 per diem 418 per diem 550 per diem 350 per diem 350 per diem 495 per diem 550 per diem 550 per diem 545 per diem 450 per diem 1000 per diem 424 per diem 480 per diem 480 per diem 436 per diem 1128 per diem 436 per diem 450 per diem 500 per diem 436 per diem 450 per diem 500 per diem 525 per diem 550 per diem 900 per diem 459 per diem 400 per diem 690 per diem 469 per diem 425 per diem 391 per diem 450 per diem 480 per diem 550 per diem 475 per diem 509 per diem 489 per diem 500 per diem 870 per diem 790 per diem 570 per diem 545 per diem 525 per diem 480 per diem 450 per diem 525 per diem 480 per diem 600 per diem 628 per diem 550 per diem 475 per diem 550 per diem 475 per diem 500 per diem 500 per diem 670 per diem 500 per diem 670 per diem 475 per diem 565 per diem 565 per diem 436 436 per diem 505 per diem 436 per diem 436 per diem 475 per diem 500 per diem 450 per diem 450 per diem 615 per diem 615 per diem RESIDENTIAL TREATMENT CENTER 1001 facility Outpatient 1763 505 350.00 "1,128.00" 478.00 per diem 550.00 per diem 436.00 per diem 550.00 per diem 480.00 per diem 425.00 per diem 500.00 per diem 475.00 per diem 550.00 per diem 534.00 per diem 481 per diem 399 per diem 550 per diem 817 per diem 436 per diem 500 per diem 759 per diem 525 per diem 669 per diem 765 per diem 787 per diem 925 per diem 485 per diem 380 per diem 630 per diem 500 per diem 620 per diem 550 per diem 436 per diem 570 per diem 458 per diem 944 per diem 500 per diem 481 per diem 944 per diem 500 per diem 418 per diem 550 per diem 350 per diem 350 per diem 495 per diem 550 per diem 550 per diem 545 per diem 450 per diem 1000 per diem 424 per diem 480 per diem 480 per diem 436 per diem 1128 per diem 436 per diem 450 per diem 500 per diem 436 per diem 450 per diem 500 per diem 525 per diem 550 per diem 900 per diem 459 per diem 400 per diem 690 per diem 469 per diem 425 per diem 391 per diem 450 per diem 480 per diem 550 per diem 475 per diem 509 per diem 489 per diem 500 per diem 870 per diem 790 per diem 570 per diem 545 per diem 525 per diem 480 per diem 450 per diem 525 per diem 480 per diem 600 per diem 628 per diem 550 per diem 475 per diem 550 per diem 475 per diem 500 per diem 500 per diem 670 per diem 500 per diem 670 per diem 475 per diem 565 per diem 565 per diem 436 436 per diem 505 per diem 436 per diem 436 per diem 475 per diem 500 per diem 450 per diem 450 per diem 615 per diem 615 per diem