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.",general_contract_provisions,,,,,,,,,,,
Northeast Rehabilitation Hospital Network,1/1/2025,2.0.0,"Northeast Rehabilitation Hospital at Salem|NortheastRehabiliation Hospital Nashua at Southern New Hampshire Medical Center|Northeast Rehabilitation Hospital at Portsmouth|Northeast Rehabilitation Hospital at Elliot Hospital|Northeast Rehabilitation Hospital Billerica, MA|Northeast Rehabilitation Hospital Chelmsford, MA|Northeast Rehabilitation Hospital Haverhill, MA - Brown Street|Northeast Rehabilitation Hospital Haverhill, MA - Cedardale|Northeast Rehabilitation Hospital Haverhill, MA - Pentucket Medical Building|Northeast Rehabilitation Hospital Lawrence, MA - Amesbury Street|Northeast Rehabilitation Hospital Lawrence, MA - Riverwalk|Northeast Rehabilitation Hospital Lowell, MA - Bridge Street|Northeast Rehabilitation Hospital Lowell, MA - Gateway Center|Northeast Rehabilitation Hospital Lowell, MA - Jackson Street|Northeast Rehabilitation Hospital Methuen, MA - Pelham Street|Northeast Rehabilitation Hospital Methuen, MA, Merrimack Street - Adult Clinic|Northeast Rehabilitation Hospital Methuen, MA, Merrimack Street - Pediatric Clinic|Northeast Rehabilitation Hospital Newburyport, MA|Northeast Rehabilitation Hospital North Andover, MA - Chestnut Green|Northeast Rehabilitation Hospital North Andover, MA - Sutton Street|Northeast Rehabilitation Hospital Plaistow, NH|Northeast Rehabilitation Hospital Portsmouth, NH|Northeast Rehabilitation Hospital Salem, NH - Outpatient|Northeast Rehabilitation Hospital Salem, NH - Stiles Road|Northeast Rehabilitation Hospital Tewksbury, MA|Northeast Rehabilitation Hospital Windham, NH","70 Butler Street, Salem, NH 03079|29 Northwest Boulevard, Nashua, NH 03063|105 Corporate Drive, Pease International Tradeport, Portsmouth, NH 03801|1 Elliot Way, Manchester, NH 03103|333 Boston Road, Billerica, MA 01862|1 Olde North Road, Suite 202, Chelmsford, MA 01824|62 Brown Street, Suite 506, Haverhill, MA 01830|931 Boston Road, Haverhill, MA 01835|1 Parkway Street, Suite 401, Haverhill, MA 01830|101 Amesbury Street, Suites 301-304, Lawrence, MA 01840|354 Merrimack Street, Lawrence, MA 01843|1230 Bridge Street, Lowell, MA 01850|10 George Street, Lowell, MA 01852|101 Jackson Street, Lowell, MA 01852|147 Pelham Street, Methuen, MA 01844|380R Merrimack Street, Methuen, MA 01844|386 Merrimack Street, Methuen, MA 01844|260 Merrimac Street, Newburyport, MA 01950|575 Turnpike Street, North Andover, MA 01845|220 Sutton Street, North Andover, MA 01845|4 Plaistow Road, Plaistow, NH 03865|105 Corporate Drive, Portsmouth, NH 03801|70 Butler Street, Salem, NH 03079|29 Stiles Road, Salem, NH 03079|1555 Main Street, Suite 102, Tewksbury, MA 01876|125 Indian Rock Road, Windham, NH 03087",2362,TRUE,Anthem NH contract reiburses a percent of charge rate for outpatient services rendered in the inpatient hospital building and fee schedule for outpatient services outside the inpatient hospital locations.,,,,,,,,,,,
description,code|1,code|1|type,setting,drug_unit_of_measurement,drug_type_of_measurement,standard_charge|gross,standard_charge|discounted_cash,payer_name,plan_name,modifiers,standard_charge|negotiated_dollar,standard_charge|negotiated_percentage,standard_charge|negotiated_algorithm,estimated_amount,standard_charge|min,standard_charge|max,standard_charge|methodology,additional_generic_notes
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, AARP Medicare Advantage , AARP Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, AARP Medicare Advantage , AARP Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, AARP Medicare Advantage , AARP Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, AARP Medicare Advantage , AARP Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, AARP Medicare Advantage , AARP Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, AARP Medicare Advantage , AARP Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, AARP Medicare Advantage , AARP Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Aetna Commercial Products , Aetna Commercial Products ,,1575,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 2,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Aetna Commercial Products , Aetna Commercial Products ,,1650,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",30.17,,,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",12.62,,,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",31.73,,,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",13.65,,,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",38.67,,,,38.67,165.69,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Aetna Commercial Products , Aetna Commercial Products ,GN,118.65,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",20.22,,,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",4.15,,,,4.15,17.83,fee schedule,for discounted cash price see follow up visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",96.93,,,,96.93,374.47,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",26.99,,,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",23.74,,,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",34.59,,,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",38.62,,,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GO,118.65,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GO,118.65,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GO,118.65,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Aetna Commercial Products , Aetna Commercial Products ,GO,40.68,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",7.39,,,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GP,118.65,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GP,118.65,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Aetna Commercial Products , Aetna Commercial Products ,GP,118.65,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Aetna Commercial Products , Aetna Commercial Products ,GP,43.24,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",25.02,,,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Aetna Commercial Products , Aetna Commercial Products ,GN,92.27,,,,77.21,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",51.27,,,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",11.3,,,,11.3,66.3,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",40.35,,,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",11.76,,,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",9.1,,,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",22.05,,,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Aetna Commercial Products , Aetna Commercial Products ,"GP,GO",15.9,,,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, AETNA Medicare Advantage , AETNA Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, AETNA Medicare Advantage , AETNA Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Ambetter - NH , Ambetter - NH ,,1448,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Ambetter - NH , Ambetter - NH ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Ambetter - NH , Ambetter - NH ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Ambetter - NH , Ambetter - NH ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Ambetter - NH , Ambetter - NH ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Ambetter - NH , Ambetter - NH ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Ambetter - NH , Ambetter - NH ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Ambetter - NH , Ambetter - NH ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Ambetter - NH , Ambetter - NH ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Ambetter - NH , Ambetter - NH ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Ambetter - NH , Ambetter - NH ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Ambetter - NH , Ambetter - NH ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Ambetter - NH , Ambetter - NH ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Ambetter - NH , Ambetter - NH ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Ambetter - NH , Ambetter - NH ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Ambetter - NH , Ambetter - NH ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Ambetter - NH , Ambetter - NH ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Ambetter - NH , Ambetter - NH ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Ambetter - NH , Ambetter - NH ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,13.77,51,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,2832.54,51,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,2832.54,51,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,371.28,51,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,203.49,51,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,156.57,51,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,346.8,51,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,361.59,51,,,311.96,526.79,percent of total billed charges,
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,42.84,51,,,36.96,62.41,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4.59,51,,,3.96,6.69,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,124.44,51,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,364.14,51,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,364.14,51,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,183.09,51,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,183.09,51,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,151.47,51,,,130.68,220.67,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,627.81,51,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,364.14,51,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,364.14,51,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,235.62,51,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,17.34,51,,,14.96,25.26,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,15.81,51,,,13.64,23.03,percent of total billed charges,
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,262.65,51,,,226.6,382.65,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,822.12,51,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,519.69,51,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,570.18,51,,,491.92,830.67,percent of total billed charges,
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",60.18,,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",113.73,,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,194.82,51,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,20.91,51,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,23.97,51,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,257.04,,,,86.46,374.47,percent of total billed charges,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,215.22,,,,90,313.55,percent of total billed charges,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,215.22,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,215.22,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,215.22,,,,90,313.55,percent of total billed charges,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,215.22,,,,90,313.55,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,150.96,51,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,729.81,51,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,171.87,51,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,63.24,51,,,54.56,92.13,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,316.71,51,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",12.24,,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3.06,51,,,2.64,4.46,percent of total billed charges,
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",257.04,,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",64.77,,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",64.77,,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,252.96,51,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,342.21,51,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3.06,51,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,342.21,51,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,342.21,51,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,49.47,51,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,611.49,51,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,6044.52,51,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,6.63,51,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,95.88,51,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,153,51,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,58.14,51,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,224.91,51,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3.06,51,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4.59,51,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,220.32,51,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,6.12,51,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,52.53,51,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,269.79,51,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3993.81,51,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4309.5,51,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,379.95,51,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,5194.35,51,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,9159.6,51,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,9159.6,51,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,290.19,51,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,579.87,51,,,500.28,844.79,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,7.65,51,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,7.65,51,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4285.02,51,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,729.81,51,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,729.81,51,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,451.35,51,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,574.77,51,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,401.37,51,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,31.62,51,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,574.77,51,,,495.88,837.36,percent of total billed charges,
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,384.03,61.84,,,273.24,461.4,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,23.97,51,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,43.35,51,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,208.08,51,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,623.22,51,,,537.68,907.95,percent of total billed charges,
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,176.97,51,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,89.76,51,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,71.91,51,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,141.78,51,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,107.1,51,,,92.4,156.03,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4.59,51,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,568.65,51,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GO,193.8,,,,90,282.34,percent of total billed charges,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GO,193.8,,,,90,282.34,percent of total billed charges,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GO,193.8,,,,90,282.34,percent of total billed charges,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GO,113.73,,,,40.68,165.69,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,132.6,51,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,62.73,51,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,80.58,51,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,97.41,51,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,115.26,51,,,99.44,167.92,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,5038.8,51,,,4347.2,7340.84,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GP,193.8,,,,90,282.34,percent of total billed charges,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GP,193.8,,,,90,282.34,percent of total billed charges,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GP,193.8,,,,90,282.34,percent of total billed charges,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GP,113.73,,,,43.24,165.69,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,315.18,51,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,775.2,51,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,312.12,51,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,153.51,51,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,203.49,51,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,35.7,51,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,137.7,51,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,35.7,51,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,35.7,51,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,35.7,51,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,28.05,51,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,9.18,51,,,7.92,13.37,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,584.97,51,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,584.97,51,,,504.68,852.22,percent of total billed charges,
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,GN,207.06,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,401.37,51,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4.08,51,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",64.77,,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",66.3,,,,11.3,66.3,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,5.1,51,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3.06,51,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,7.65,51,,,6.6,11.15,percent of total billed charges,
THEREX - OP,97110,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,3151.8,51,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,8404.8,51,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4285.02,51,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,16.32,51,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,367.2,51,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,359.55,51,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,519.69,51,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,363.63,51,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,252.96,51,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,623.22,51,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,370.26,51,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,731.85,51,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,370.26,51,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,451.35,51,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,451.35,51,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,519.69,51,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,574.77,51,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,466.14,51,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,519.69,51,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,621.18,51,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,258.06,51,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,48.96,51,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,627.81,51,,,541.64,914.63,percent of total billed charges,
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",73.44,,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",43.86,,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,9.18,51,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,21.93,51,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,165.75,51,,,143,241.48,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,78.54,51,,,67.76,114.42,percent of total billed charges,
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",52.53,,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,"GP,GO",78.54,,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,389.13,51,,,335.72,566.91,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, ANTHEM MAINE BCBS HMO/POS/PPO, ANTHEM MAINE BCBS HMO/POS/PPO,,1732.5,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,1732.5,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,16.7,61.84,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3434.59,61.84,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3434.59,61.84,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,450.2,61.84,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,246.74,61.84,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,189.85,61.84,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,420.51,61.84,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,438.45,61.84,,,311.96,526.79,percent of total billed charges,
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,51.95,61.84,,,36.96,62.41,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,2.55,51,,,2.2,3.72,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5.57,61.84,,,3.96,6.69,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3.09,61.84,,,2.2,3.72,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75, Tufts Health Direct , Tufts Health Direct ,,2.25,45,,,2.2,3.72,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,150.89,61.84,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,441.54,61.84,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,441.54,61.84,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,222.01,61.84,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,222.01,61.84,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,183.66,61.84,,,130.68,220.67,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2.2,44,,,2.2,3.72,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,Aetna Commercial Products,Aetna Commercial Products,,3.47,69.3,,,2.2,3.72,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2.32,46.39,,,2.2,3.72,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,761.25,61.84,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,441.54,61.84,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,441.54,61.84,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,285.7,61.84,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,2.63,52.56,,,2.2,3.72,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,21.03,61.84,,,14.96,25.26,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,CIGNA Commercial,CIGNA Commercial,,2.31,46.2,,,2.2,3.72,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.17,61.84,,,13.64,23.03,percent of total billed charges,
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,318.48,61.84,,,226.6,382.65,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,2.5,50,,,2.2,3.72,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,996.86,61.84,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,630.15,61.84,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,United Healthcare Commercial,United Healthcare Commercial,,3.72,74.3,,,2.2,3.72,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,691.37,61.84,,,491.92,830.67,percent of total billed charges,
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",72.97,61.84,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",137.9,61.84,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,2.5,50,,,2.2,3.72,percent of total billed charges,
BENADRYL 25 MG - PAIN CL,00904555124 ,NDC,outpatient,1,EA,5,2.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,2.5,50,,,2.2,3.72,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,236.23,61.84,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,25.35,61.84,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,29.06,61.84,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,233.81,61.84,,,86.46,374.47,percent of total billed charges,for services rendered inside IP hospital location
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,195.77,61.84,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,195.77,61.84,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,195.77,61.84,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,195.77,61.84,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,195.77,61.84,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,183.05,61.84,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,884.93,61.84,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,13.77,51,,,11.88,20.06,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,16.7,61.84,,,11.88,20.06,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,208.4,61.84,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,76.68,61.84,,,54.56,92.13,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Direct , Tufts Health Direct ,,279.45,45,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85, Tufts Health Direct , Tufts Health Direct ,,12.15,45,,,11.88,20.06,percent of total billed charges,
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",14.84,61.84,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3.71,61.84,,,2.64,4.46,percent of total billed charges,
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",311.67,61.84,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",78.54,61.84,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",78.54,61.84,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,306.73,61.84,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,414.95,61.84,,,295.24,498.55,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,11.88,44,,,11.88,20.06,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3.71,61.84,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,414.95,61.84,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,414.95,61.84,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,59.98,61.84,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,741.46,61.84,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,7329.28,61.84,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,8.04,61.84,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,116.26,61.84,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,185.52,61.84,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,70.5,61.84,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,272.71,61.84,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3.71,61.84,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5.57,61.84,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,267.15,61.84,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,7.42,61.84,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,63.7,61.84,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,327.13,61.84,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,4842.69,61.84,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5225.48,61.84,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,460.71,61.84,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,6298.4,61.84,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,11106.46,61.84,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,11106.46,61.84,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,351.87,61.84,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,703.12,61.84,,,500.28,844.79,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,Aetna Commercial Products,Aetna Commercial Products,,18.71,69.3,,,11.88,20.06,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,12.53,46.39,,,11.88,20.06,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,14.19,52.56,,,11.88,20.06,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,CIGNA Commercial,CIGNA Commercial,,12.47,46.2,,,11.88,20.06,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,273.24,44,,,273.24,461.4,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,9.28,61.84,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,9.28,61.84,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5195.8,61.84,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,884.93,61.84,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,884.93,61.84,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,547.28,61.84,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,696.94,61.84,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,486.68,61.84,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,38.34,61.84,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,696.94,61.84,,,495.88,837.36,percent of total billed charges,
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,United Healthcare Commercial,United Healthcare Commercial,,20.06,74.3,,,11.88,20.06,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,29.06,61.84,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,52.56,61.84,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,252.31,61.84,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,755.68,61.84,,,537.68,907.95,percent of total billed charges,
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,214.58,61.84,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,108.84,61.84,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,87.19,61.84,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,171.92,61.84,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,129.86,61.84,,,92.4,156.03,percent of total billed charges,
BENADRYL 50 MG/AMP - PAIN CL,63323066416,NDC,outpatient,1,ML,27,14.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5.57,61.84,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,689.52,61.84,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GO,176.28,61.84,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GO,176.28,61.84,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GO,176.28,61.84,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GO,103.45,61.84,,,40.68,165.69,percent of total billed charges,for services rendered inside IP hospital location
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,160.78,61.84,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,76.06,61.84,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,97.71,61.84,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,118.11,61.84,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,139.76,61.84,,,99.44,167.92,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,6109.79,61.84,,,4347.2,7340.84,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,26.52,51,,,22.88,38.64,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,32.16,61.84,,,22.88,38.64,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GP,176.28,61.84,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GP,176.28,,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GP,176.28,61.84,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GP,103.45,61.84,,,43.24,165.69,percent of total billed charges,for services rendered inside IP hospital location
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,382.17,61.84,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,939.97,61.84,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,378.46,61.84,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,186.14,61.84,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,246.74,61.84,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,43.29,61.84,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,166.97,61.84,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,43.29,61.84,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,43.29,61.84,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,43.29,61.84,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,34.01,61.84,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,11.13,61.84,,,7.92,13.37,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6, Tufts Health Direct , Tufts Health Direct ,,23.4,45,,,22.88,38.64,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,709.3,61.84,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,709.3,61.84,,,504.68,852.22,percent of total billed charges,
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,GN,251.07,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,486.68,61.84,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,4.95,61.84,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",78.54,61.84,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,6.18,61.84,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3.71,61.84,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,9.28,61.84,,,6.6,11.15,percent of total billed charges,
THEREX - OP,97110,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,3821.71,61.84,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,10191.23,61.84,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5195.8,61.84,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.79,61.84,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,445.25,61.84,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,435.97,61.84,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,630.15,61.84,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,440.92,61.84,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,306.73,61.84,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,755.68,61.84,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,448.96,61.84,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,887.4,61.84,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,448.96,61.84,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,547.28,61.84,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,547.28,61.84,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,630.15,61.84,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,696.94,61.84,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,565.22,61.84,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,630.15,61.84,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,753.21,61.84,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,312.91,61.84,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,59.37,61.84,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,761.25,61.84,,,541.64,914.63,percent of total billed charges,
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",89.05,61.84,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,22.88,44,,,22.88,38.64,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,Aetna Commercial Products,Aetna Commercial Products,,36.04,69.3,,,22.88,38.64,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,24.12,46.39,,,22.88,38.64,percent of total billed charges,
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",53.18,61.84,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,11.13,61.84,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,26.59,61.84,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,200.98,61.84,,,143,241.48,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,27.33,52.56,,,22.88,38.64,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,95.23,61.84,,,67.76,114.42,percent of total billed charges,
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",63.7,61.84,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,"GP,GO",95.23,61.84,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,471.84,61.84,,,335.72,566.91,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,CIGNA Commercial,CIGNA Commercial,,24.02,46.2,,,22.88,38.64,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",39.99,,,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",15.26,,,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",41.33,,,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",15.63,,,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",65.08,,,,38.67,165.69,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,120.29,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,224.98,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,385.68,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,188.33,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,185.5,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",31.99,,,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",6.91,,,,4.15,17.83,fee schedule,for discounted cash price see follow up visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",163.43,,,,96.93,374.47,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",51.98,,,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",45.44,,,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",29.44,,,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",36.71,,,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GO,110.5,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GO,110.5,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GO,110.5,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GO,76.34,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",6.18,,,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GP,109.41,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GP,109.41,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GP,109.41,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GP,75.98,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",35.63,,,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,GN,111.01,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",57.08,,,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",6.25,,,,11.3,66.3,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",31.99,,,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",15.26,,,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",15.26,,,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",34.54,,,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) , ANTHEM NH BCBS HMO/POS/PPO/IND/FEP /POS/PPO/IND/FEP (Service outside of IP Hospital) ,"GP,GO",18.54,,,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, BCBS Medicare Advantage , BCBS Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, CIGNA Carelink , CIGNA Carelink ,,1675,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,313.55,fee schedule,
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, CIGNA Carelink , CIGNA Carelink ,GO,120,,,,90,120,fee schedule,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GO,120,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GO,120,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GO,120,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, CIGNA Carelink , CIGNA Carelink ,GO,120,,,,40.68,165.69,fee schedule,
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, CIGNA Carelink , CIGNA Carelink ,GP,120,,,,90,120,fee schedule,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GP,120,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GP,120,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, CIGNA Carelink , CIGNA Carelink ,GP,120,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, CIGNA Carelink , CIGNA Carelink ,GP,120,,,,43.24,165.69,fee schedule,
SPEECH follow up visit ,440,RC,outpatient,,,,110, CIGNA Carelink , CIGNA Carelink ,GN,120,,,,90,120,fee schedule,payment per visit
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, CIGNA Commercial , CIGNA Commercial ,,1675,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,313.55,fee schedule,
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, CIGNA Commercial , CIGNA Commercial ,GO,120,,,,90,120,fee schedule,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GO,120,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GO,120,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GO,120,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, CIGNA Commercial , CIGNA Commercial ,GO,120,,,,40.68,165.69,fee schedule,
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, CIGNA Commercial , CIGNA Commercial ,GP,120,,,,90,120,fee schedule,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GP,120,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GP,120,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, CIGNA Commercial , CIGNA Commercial ,GP,120,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, CIGNA Commercial , CIGNA Commercial ,GP,120,,,,43.24,165.69,fee schedule,
SPEECH follow up visit ,440,RC,outpatient,,,,110, CIGNA Commercial , CIGNA Commercial ,GN,120,,,,90,120,fee schedule,payment per visit
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Commonwealth Care Alliance - Massachusetts , Commonwealth Care Alliance - Massachusetts ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Fallon Commercial , Fallon Commercial ,,1336.2,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 2,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Fallon Commercial , Fallon Commercial ,,1489.2,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,86.46,374.47,fee schedule,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,313.55,fee schedule,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,313.55,fee schedule,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,313.55,fee schedule,payment per visit
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, Fallon Commercial , Fallon Commercial ,GO,111,,,,90,120,fee schedule,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GO,111,,,,90,282.34,fee schedule,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GO,111,,,,90,282.34,fee schedule,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GO,111,,,,90,282.34,fee schedule,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Fallon Commercial , Fallon Commercial ,GO,111,,,,40.68,165.69,fee schedule,payment per visit
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, Fallon Commercial , Fallon Commercial ,GP,111,,,,90,120,fee schedule,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GP,111,,,,90,282.34,fee schedule,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GP,111,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Fallon Commercial , Fallon Commercial ,GP,111,,,,90,282.34,fee schedule,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Fallon Commercial , Fallon Commercial ,GP,111,,,,43.24,165.69,fee schedule,payment per visit
SPEECH follow up visit ,440,RC,outpatient,,,,110, Fallon Commercial , Fallon Commercial ,GN,111,,,,90,120,fee schedule,payment per visit
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,,1566.52,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 2,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,,1597.32,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,86.46,374.47,fee schedule,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,313.55,fee schedule,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,313.55,fee schedule,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,313.55,fee schedule,payment per visit
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GO,106,,,,90,120,fee schedule,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GO,106,,,,90,282.34,fee schedule,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GO,106,,,,90,282.34,fee schedule,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GO,106,,,,90,282.34,fee schedule,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GO,106,,,,40.68,165.69,fee schedule,payment per visit
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GP,106,,,,90,120,fee schedule,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GP,106,,,,90,282.34,fee schedule,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GP,106,,,,90,282.34,fee schedule,payment per visit
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GP,106,,,,90,282.34,fee schedule,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GP,106,,,,43.24,165.69,fee schedule,payment per visit
SPEECH follow up visit ,440,RC,outpatient,,,,110, Fallon Medicare Advantage (Navicare) , Fallon Medicare Advantage (Navicare) ,GN,106,,,,90,120,fee schedule,payment per visit
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,,1402,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 2,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,,1402,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,86.46,374.47,other,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,90,313.55,other,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,90,313.55,other,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,90,313.55,other,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,90,313.55,other,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,128,,,128,90,313.55,other,payment per visit
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GO,110,,,110,90,120,other,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GO,128,,,128,90,282.34,other,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GO,128,,,128,90,282.34,other,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GO,128,,,128,90,282.34,other,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GO,128,,,128,40.68,165.69,other,payment per visit
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GP,110,,,110,90,120,other,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GP,128,,,128,90,282.34,other,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GP,128,,,128,90,282.34,other,payment per visit
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GP,128,,,128,90,282.34,other,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GP,128,,,128,43.24,165.69,other,payment per visit
SPEECH follow up visit ,440,RC,outpatient,,,,110, Harvard Pilgrim HMO , Harvard Pilgrim HMO ,GN,110,,,110,90,120,other,payment per visit
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Humana Medicare Advantage , Humana Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Humana Medicare Advantage , Humana Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Humana Medicare Advantage , Humana Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Humana Medicare Advantage , Humana Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Humana Medicare Advantage , Humana Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Humana Medicare Advantage , Humana Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Humana Medicare Advantage , Humana Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Martins Point Commercial , Martins Point Commercial ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Martins Point Commercial , Martins Point Commercial ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Martins Point Commercial , Martins Point Commercial ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Martins Point Commercial , Martins Point Commercial ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Martins Point Commercial , Martins Point Commercial ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Martins Point Commercial , Martins Point Commercial ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Martins Point Commercial , Martins Point Commercial ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Martins Point Commercial , Martins Point Commercial ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Martins Point Commercial , Martins Point Commercial ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Martins Point Commercial , Martins Point Commercial ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Martins Point Commercial , Martins Point Commercial ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Martins Point Commercial , Martins Point Commercial ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Martins Point Commercial , Martins Point Commercial ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Martins Point Commercial , Martins Point Commercial ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Martins Point Commercial , Martins Point Commercial ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Martins Point Commercial , Martins Point Commercial ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Martins Point Commercial , Martins Point Commercial ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Martins Point Commercial , Martins Point Commercial ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Martins Point Commercial , Martins Point Commercial ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Martins Point Generations Advantage Medicare , Martins Point Generations Advantage Medicare ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,1050,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Cc,MS-560,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Mcc,MS-559,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue Without Cc/Mcc,MS-561,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare With Cc/Mcc,MS-949,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare Without Cc/Mcc,MS-950,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies With Mcc,MS-553,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies Without Mcc,MS-554,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cellulitis With Mcc,MS-602,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cellulitis Without Mcc,MS-603,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Cc,MS-191,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Mcc,MS-190,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease Without Cc/Mcc,MS-192,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Cc,MS-546,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Mcc,MS-545,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders Without Cc/Mcc,MS-547,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders With Mcc,MS-056,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders Without Mcc,MS-057,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Cc,MS-442,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Mcc,MS-441,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc,MS-443,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,MS-065,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Mcc,MS-064,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,MS-066,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Medical Back Problems With Mcc,MS-551,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Medical Back Problems Without Mcc,MS-552,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders With Cc,MS-071,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders Without Cc/Mcc,MS-072,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis With Cc,MS-540,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis With Mcc,MS-539,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis Without Cc/Mcc,MS-541,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Cc,MS-092,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Mcc,MS-091,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System Without Cc/Mcc,MS-093,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rehabilitation With Cc/Mcc,MS-945,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rehabilitation Without Cc/Mcc,MS-946,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,MS-555,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,MS-556,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries With Cc/Mcc,MS-052,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries Without Cc/Mcc,MS-053,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis With Mcc,MS-557,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis Without Mcc,MS-558,MS-DRG,inpatient,,,,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,,15428.86,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",59,,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",111.5,,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,252,,,,86.46,374.47,percent of total billed charges,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,211,,,,90,313.55,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",12,,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",252,,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",63.5,,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",63.5,,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GO,190,,,,90,282.34,percent of total billed charges,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GO,111.5,,,,40.68,165.69,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GP,190,,,,90,282.34,percent of total billed charges,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GP,11.5,,,,43.24,165.69,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,GN,207.06,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",63.5,,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",65,,,,11.3,66.3,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",72,,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",43,,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",51.5,,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, NH Healthy Families Medicaid MCO , NH Healthy Families Medicaid MCO ,"GP,GO",77,,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Senior Whole Health Massachusetts Medicare , Senior Whole Health Massachusetts Medicare ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Tufts Carelink , Tufts Carelink ,,1402,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",45.34,,Daily payment max per discipline of $110,110,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",45.75,,Daily payment max per discipline of $110,110,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Tufts Carelink , Tufts Carelink ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Tufts Carelink , Tufts Carelink ,GN,112.41,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",36.27,,Daily payment max per discipline of $110,110,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Tufts Carelink , Tufts Carelink ,"GP,GO",7.83,,Daily payment max per discipline of $110,110,4.15,17.83,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Tufts Carelink , Tufts Carelink ,"GP,GO",59.76,,Daily payment max per discipline of $110,110,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Tufts Carelink , Tufts Carelink ,"GP,GO",101.6,,Daily payment max per discipline of $110,110,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",33.39,,Daily payment max per discipline of $110,110,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",41.62,,Daily payment max per discipline of $110,110,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GO,112.41,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Tufts Carelink , Tufts Carelink ,GO,112.41,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",82.4,,Daily payment max per discipline of $110,110,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Tufts Carelink , Tufts Carelink ,GP,112.41,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Tufts Carelink , Tufts Carelink ,GP,112.41,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",40.39,,Daily payment max per discipline of $110,110,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Tufts Carelink , Tufts Carelink ,GN,93.97,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Tufts Carelink , Tufts Carelink ,"GP,GO",65.54,,Daily payment max per discipline of $110,110,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Tufts Carelink , Tufts Carelink ,"GP,GO",15.25,,Daily payment max per discipline of $110,110,11.3,66.3,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",36.27,,Daily payment max per discipline of $110,110,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Tufts Carelink , Tufts Carelink ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Tufts Carelink , Tufts Carelink ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Tufts Carelink , Tufts Carelink ,"GP,GO",39.16,,Daily payment max per discipline of $110,110,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Tufts Health Direct , Tufts Health Direct ,,1200,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85, Tufts Health Direct , Tufts Health Direct ,,12.15,45,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Tufts Health Direct , Tufts Health Direct ,,2499.3,45,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Tufts Health Direct , Tufts Health Direct ,,2499.3,45,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4, Tufts Health Direct , Tufts Health Direct ,,327.6,45,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45, Tufts Health Direct , Tufts Health Direct ,,179.55,45,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85, Tufts Health Direct , Tufts Health Direct ,,138.15,45,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374, Tufts Health Direct , Tufts Health Direct ,,306,45,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95, Tufts Health Direct , Tufts Health Direct ,,319.05,45,,,311.96,526.79,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,26,50,,,22.88,38.64,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2, Tufts Health Direct , Tufts Health Direct ,,37.8,45,,,36.96,62.41,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,United Healthcare Commercial,United Healthcare Commercial,,38.64,74.3,,,22.88,38.64,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,26,50,,,22.88,38.64,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95, Tufts Health Direct , Tufts Health Direct ,,4.05,45,,,3.96,6.69,percent of total billed charges,
BUPIVACINE 0.25% 10 ML - PAIN CL,250,RC,outpatient,1,EA,52,28.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,26,50,,,22.88,38.64,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,21.93,51,,,18.92,31.95,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2, Tufts Health Direct , Tufts Health Direct ,,109.8,45,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7, Tufts Health Direct , Tufts Health Direct ,,321.3,45,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7, Tufts Health Direct , Tufts Health Direct ,,321.3,45,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45, Tufts Health Direct , Tufts Health Direct ,,161.55,45,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45, Tufts Health Direct , Tufts Health Direct ,,161.55,45,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35, Tufts Health Direct , Tufts Health Direct ,,133.65,45,,,130.68,220.67,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,26.59,61.84,,,18.92,31.95,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65, Tufts Health Direct , Tufts Health Direct ,,19.35,45,,,18.92,31.95,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,18.92,44,,,18.92,31.95,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05, Tufts Health Direct , Tufts Health Direct ,,553.95,45,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,, Tufts Health Direct , Tufts Health Direct ,,321.3,45,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,, Tufts Health Direct , Tufts Health Direct ,,321.3,45,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1, Tufts Health Direct , Tufts Health Direct ,,207.9,45,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,Aetna Commercial Products,Aetna Commercial Products,,29.8,69.3,,,18.92,31.95,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7, Tufts Health Direct , Tufts Health Direct ,,15.3,45,,,14.96,25.26,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,19.95,46.39,,,18.92,31.95,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05, Tufts Health Direct , Tufts Health Direct ,,13.95,45,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25, Tufts Health Direct , Tufts Health Direct ,,231.75,45,,,226.6,382.65,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,22.6,52.56,,,18.92,31.95,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,, Tufts Health Direct , Tufts Health Direct ,,725.4,45,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,, Tufts Health Direct , Tufts Health Direct ,,458.55,45,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Aetna Commercial Products,Aetna Commercial Products,,430.35,69.3,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,CIGNA Commercial,CIGNA Commercial,,19.87,46.2,,,18.92,31.95,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9, Tufts Health Direct , Tufts Health Direct ,,503.1,45,,,491.92,830.67,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,United Healthcare Commercial,United Healthcare Commercial,,31.95,74.3,,,18.92,31.95,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1, Tufts Health Direct , Tufts Health Direct ,,171.9,45,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55, Tufts Health Direct , Tufts Health Direct ,,18.45,45,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85, Tufts Health Direct , Tufts Health Direct ,,21.15,45,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,86.46,374.47,fee schedule,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,313.55,fee schedule,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,313.55,fee schedule,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,313.55,fee schedule,payment per visit
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8, Tufts Health Direct , Tufts Health Direct ,,133.2,45,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,, Tufts Health Direct , Tufts Health Direct ,,643.95,45,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
CEFAZOLIN 1 GM IV - PAIN CL,00264310311 ,NDC,outpatient,50,ML,43,23.65,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35, Tufts Health Direct , Tufts Health Direct ,,151.65,45,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2, Tufts Health Direct , Tufts Health Direct ,,55.8,45,,,54.56,92.13,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,288.08,46.39,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3, Tufts Health Direct , Tufts Health Direct ,,2.7,45,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8, Tufts Health Direct , Tufts Health Direct ,,223.2,45,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05, Tufts Health Direct , Tufts Health Direct ,,301.95,45,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Direct , Tufts Health Direct ,,2.7,45,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05, Tufts Health Direct , Tufts Health Direct ,,301.95,45,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05, Tufts Health Direct , Tufts Health Direct ,,301.95,45,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35, Tufts Health Direct , Tufts Health Direct ,,43.65,45,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,, Tufts Health Direct , Tufts Health Direct ,,539.55,45,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,, Tufts Health Direct , Tufts Health Direct ,,5333.4,45,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15, Tufts Health Direct , Tufts Health Direct ,,5.85,45,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4, Tufts Health Direct , Tufts Health Direct ,,84.6,45,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165, Tufts Health Direct , Tufts Health Direct ,,135,45,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7, Tufts Health Direct , Tufts Health Direct ,,51.3,45,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55, Tufts Health Direct , Tufts Health Direct ,,198.45,45,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Direct , Tufts Health Direct ,,2.7,45,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95, Tufts Health Direct , Tufts Health Direct ,,4.05,45,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6, Tufts Health Direct , Tufts Health Direct ,,194.4,45,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6, Tufts Health Direct , Tufts Health Direct ,,5.4,45,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65, Tufts Health Direct , Tufts Health Direct ,,46.35,45,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95, Tufts Health Direct , Tufts Health Direct ,,238.05,45,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05, Tufts Health Direct , Tufts Health Direct ,,3523.95,45,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5, Tufts Health Direct , Tufts Health Direct ,,3802.5,45,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,, Tufts Health Direct , Tufts Health Direct ,,335.25,45,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75, Tufts Health Direct , Tufts Health Direct ,,4583.25,45,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878, Tufts Health Direct , Tufts Health Direct ,,8082,45,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878, Tufts Health Direct , Tufts Health Direct ,,8082,45,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95, Tufts Health Direct , Tufts Health Direct ,,256.05,45,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35, Tufts Health Direct , Tufts Health Direct ,,511.65,45,,,500.28,844.79,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25, Tufts Health Direct , Tufts Health Direct ,,6.75,45,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25, Tufts Health Direct , Tufts Health Direct ,,6.75,45,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1, Tufts Health Direct , Tufts Health Direct ,,3780.9,45,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05, Tufts Health Direct , Tufts Health Direct ,,643.95,45,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05, Tufts Health Direct , Tufts Health Direct ,,643.95,45,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75, Tufts Health Direct , Tufts Health Direct ,,398.25,45,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85, Tufts Health Direct , Tufts Health Direct ,,507.15,45,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85, Tufts Health Direct , Tufts Health Direct ,,354.15,45,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1, Tufts Health Direct , Tufts Health Direct ,,27.9,45,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Tufts Health Direct , Tufts Health Direct ,,507.15,45,,,495.88,837.36,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85, Tufts Health Direct , Tufts Health Direct ,,21.15,45,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75, Tufts Health Direct , Tufts Health Direct ,,38.25,45,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4, Tufts Health Direct , Tufts Health Direct ,,183.6,45,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1, Tufts Health Direct , Tufts Health Direct ,,549.9,45,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85, Tufts Health Direct , Tufts Health Direct ,,156.15,45,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8, Tufts Health Direct , Tufts Health Direct ,,79.2,45,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55, Tufts Health Direct , Tufts Health Direct ,,63.45,45,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9, Tufts Health Direct , Tufts Health Direct ,,125.1,45,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5, Tufts Health Direct , Tufts Health Direct ,,94.5,45,,,92.4,156.03,percent of total billed charges,
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, Tufts Health Direct , Tufts Health Direct ,GO,110,,,,90,120,fee schedule,payment per visit
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95, Tufts Health Direct , Tufts Health Direct ,,4.05,45,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25, Tufts Health Direct , Tufts Health Direct ,,501.75,45,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GO,110,,,,90,282.34,fee schedule,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GO,110,,,,90,282.34,fee schedule,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GO,110,,,,90,282.34,fee schedule,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Tufts Health Direct , Tufts Health Direct ,GO,110,,,,40.68,165.69,fee schedule,payment per visit
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143, Tufts Health Direct , Tufts Health Direct ,,117,45,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65, Tufts Health Direct , Tufts Health Direct ,,55.35,45,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9, Tufts Health Direct , Tufts Health Direct ,,71.1,45,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05, Tufts Health Direct , Tufts Health Direct ,,85.95,45,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3, Tufts Health Direct , Tufts Health Direct ,,101.7,45,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434, Tufts Health Direct , Tufts Health Direct ,,4446,45,,,4347.2,7340.84,percent of total billed charges,
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, Tufts Health Direct , Tufts Health Direct ,GP,110,,,,90,120,fee schedule,payment per visit
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GP,110,,,,90,282.34,fee schedule,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GP,110,,,,90,282.34,fee schedule,payment per visit
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Tufts Health Direct , Tufts Health Direct ,GP,110,,,,90,282.34,fee schedule,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Tufts Health Direct , Tufts Health Direct ,GP,110,,,,43.24,165.69,fee schedule,payment per visit
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9, Tufts Health Direct , Tufts Health Direct ,,278.1,45,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836, Tufts Health Direct , Tufts Health Direct ,,684,45,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6, Tufts Health Direct , Tufts Health Direct ,,275.4,45,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55, Tufts Health Direct , Tufts Health Direct ,,135.45,45,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45, Tufts Health Direct , Tufts Health Direct ,,179.55,45,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Direct , Tufts Health Direct ,,31.5,45,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5, Tufts Health Direct , Tufts Health Direct ,,121.5,45,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Direct , Tufts Health Direct ,,31.5,45,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Direct , Tufts Health Direct ,,31.5,45,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Direct , Tufts Health Direct ,,31.5,45,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25, Tufts Health Direct , Tufts Health Direct ,,24.75,45,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9, Tufts Health Direct , Tufts Health Direct ,,8.1,45,,,7.92,13.37,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,35.7,51,,,30.8,52.01,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85, Tufts Health Direct , Tufts Health Direct ,,516.15,45,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85, Tufts Health Direct , Tufts Health Direct ,,516.15,45,,,504.68,852.22,percent of total billed charges,
SPEECH follow up visit ,440,RC,outpatient,,,,110, Tufts Health Direct , Tufts Health Direct ,GN,110,,,,90,120,fee schedule,payment per visit
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85, Tufts Health Direct , Tufts Health Direct ,,354.15,45,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4, Tufts Health Direct , Tufts Health Direct ,,3.6,45,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5, Tufts Health Direct , Tufts Health Direct ,,4.5,45,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Direct , Tufts Health Direct ,,2.7,45,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25, Tufts Health Direct , Tufts Health Direct ,,6.75,45,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,, Tufts Health Direct , Tufts Health Direct ,,2781,45,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,, Tufts Health Direct , Tufts Health Direct ,,7416,45,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1, Tufts Health Direct , Tufts Health Direct ,,3780.9,45,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Direct , Tufts Health Direct ,,14.4,45,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396, Tufts Health Direct , Tufts Health Direct ,,324,45,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75, Tufts Health Direct , Tufts Health Direct ,,317.25,45,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45, Tufts Health Direct , Tufts Health Direct ,,458.55,45,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15, Tufts Health Direct , Tufts Health Direct ,,320.85,45,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8, Tufts Health Direct , Tufts Health Direct ,,223.2,45,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1, Tufts Health Direct , Tufts Health Direct ,,549.9,45,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3, Tufts Health Direct , Tufts Health Direct ,,326.7,45,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25, Tufts Health Direct , Tufts Health Direct ,,645.75,45,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3, Tufts Health Direct , Tufts Health Direct ,,326.7,45,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75, Tufts Health Direct , Tufts Health Direct ,,398.25,45,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75, Tufts Health Direct , Tufts Health Direct ,,398.25,45,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45, Tufts Health Direct , Tufts Health Direct ,,458.55,45,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Tufts Health Direct , Tufts Health Direct ,,507.15,45,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7, Tufts Health Direct , Tufts Health Direct ,,411.3,45,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45, Tufts Health Direct , Tufts Health Direct ,,458.55,45,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9, Tufts Health Direct , Tufts Health Direct ,,548.1,45,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3, Tufts Health Direct , Tufts Health Direct ,,227.7,45,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8, Tufts Health Direct , Tufts Health Direct ,,43.2,45,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05, Tufts Health Direct , Tufts Health Direct ,,553.95,45,,,541.64,914.63,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,43.29,61.84,,,30.8,52.01,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5, Tufts Health Direct , Tufts Health Direct ,,31.5,45,,,30.8,52.01,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,30.8,44,,,30.8,52.01,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9, Tufts Health Direct , Tufts Health Direct ,,8.1,45,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65, Tufts Health Direct , Tufts Health Direct ,,19.35,45,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75, Tufts Health Direct , Tufts Health Direct ,,146.25,45,,,143,241.48,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,Aetna Commercial Products,Aetna Commercial Products,,48.51,69.3,,,30.8,52.01,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7, Tufts Health Direct , Tufts Health Direct ,,69.3,45,,,67.76,114.42,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65, Tufts Health Direct , Tufts Health Direct ,,343.35,45,,,335.72,566.91,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,32.47,46.39,,,30.8,52.01,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,326.4,52.56,,,273.24,461.4,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,1000,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,11.88,44,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2443.76,44,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2443.76,44,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,320.32,44,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,175.56,44,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,135.08,44,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,299.2,44,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,311.96,44,,,311.96,526.79,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,36.79,52.56,,,30.8,52.01,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,36.96,44,,,36.96,62.41,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,CIGNA Commercial,CIGNA Commercial,,32.34,46.2,,,30.8,52.01,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3.96,44,,,3.96,6.69,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,United Healthcare Commercial,United Healthcare Commercial,,52.01,74.3,,,30.8,52.01,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,107.36,44,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,314.16,44,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,314.16,44,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,157.96,44,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,157.96,44,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,130.68,44,,,130.68,220.67,percent of total billed charges,
CLINDAMYCIN - PAIN CL,00904595961 ,RC,outpatient,1,EA,70,38.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,541.64,44,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,314.16,44,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,314.16,44,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,203.28,44,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.96,44,,,14.96,25.26,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,13.64,44,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,226.6,44,,,226.6,382.65,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,709.28,44,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,448.36,44,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,491.92,44,,,491.92,830.67,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,168.08,44,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,18.04,44,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,20.68,44,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,86.46,374.47,fee schedule,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,313.55,fee schedule,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,313.55,fee schedule,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,313.55,fee schedule,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,313.55,fee schedule,payment per visit
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,130.24,44,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,629.64,44,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,148.28,44,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,54.56,44,,,54.56,92.13,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,CIGNA Commercial,CIGNA Commercial,,286.9,46.2,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2.64,44,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,218.24,44,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,295.24,44,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2.64,44,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,295.24,44,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,295.24,44,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,42.68,44,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,527.56,44,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,5214.88,44,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,5.72,44,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,82.72,44,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,132,44,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,50.16,44,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,194.04,44,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2.64,44,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3.96,44,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,190.08,44,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,5.28,44,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,45.32,44,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,232.76,44,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3445.64,44,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3718,44,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,327.8,44,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,4481.4,44,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7902.4,44,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7902.4,44,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,250.36,44,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,500.28,44,,,500.28,844.79,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,29.07,51,,,25.08,42.35,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,35.25,61.84,,,25.08,42.35,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35, Tufts Health Direct , Tufts Health Direct ,,25.65,45,,,25.08,42.35,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,25.08,44,,,25.08,42.35,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,6.6,44,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,6.6,44,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3696.88,44,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,629.64,44,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,629.64,44,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,389.4,44,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,495.88,44,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,346.28,44,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,27.28,44,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,495.88,44,,,495.88,837.36,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,Aetna Commercial Products,Aetna Commercial Products,,39.5,69.3,,,25.08,42.35,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,26.44,46.39,,,25.08,42.35,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,29.96,52.56,,,25.08,42.35,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,20.68,44,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,37.4,44,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,179.52,44,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,537.68,44,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,152.68,44,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,77.44,44,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,62.04,44,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,122.32,44,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,92.4,44,,,92.4,156.03,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,CIGNA Commercial,CIGNA Commercial,,26.33,46.2,,,25.08,42.35,percent of total billed charges,
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GO,90,,,,90,120,fee schedule,payment per visit
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3.96,44,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,490.6,44,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GO,90,,,,90,282.34,fee schedule,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GO,90,,,,90,282.34,fee schedule,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GO,90,,,,90,282.34,fee schedule,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GO,90,,,,40.68,165.69,fee schedule,payment per visit
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,114.4,44,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,54.12,44,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,69.52,44,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,84.04,44,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,99.44,44,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,4347.2,44,,,4347.2,7340.84,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,28.5,50,,,25.08,42.35,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,United Healthcare Commercial,United Healthcare Commercial,,42.35,74.3,,,25.08,42.35,percent of total billed charges,
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GP,90,,,,90,120,fee schedule,payment per visit
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GP,90,,,,90,282.34,fee schedule,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GP,90,,,,90,282.34,fee schedule,payment per visit
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GP,90,,,,90,282.34,fee schedule,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GP,90,,,,43.24,165.69,fee schedule,payment per visit
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,271.92,44,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,668.8,44,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,269.28,44,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,132.44,44,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,175.56,44,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,30.8,44,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,118.8,44,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,30.8,44,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,30.8,44,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,30.8,44,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,24.2,44,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7.92,44,,,7.92,13.37,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,28.5,50,,,25.08,42.35,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,504.68,44,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,504.68,44,,,504.68,852.22,percent of total billed charges,
SPEECH follow up visit ,440,RC,outpatient,,,,110, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,GN,90,,,,90,120,fee schedule,payment per visit
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,346.28,44,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3.52,44,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,4.4,44,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2.64,44,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,6.6,44,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,2719.2,44,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7251.2,44,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3696.88,44,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,14.08,44,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,316.8,44,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,310.2,44,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,448.36,44,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,313.72,44,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,218.24,44,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,537.68,44,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,319.44,44,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,631.4,44,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,319.44,44,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,389.4,44,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,389.4,44,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,448.36,44,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,495.88,44,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,402.16,44,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,448.36,44,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,535.92,44,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,222.64,44,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,42.24,44,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,541.64,44,,,541.64,914.63,percent of total billed charges,
DEPONEDROL 40 MG - PAIN CL,250,RC,outpatient,1,EA,57,31.35,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,28.5,50,,,25.08,42.35,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,6.12,51,,,5.28,8.92,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,7.42,61.84,,,5.28,8.92,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7.92,44,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,18.92,44,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,143,44,,,143,241.48,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6, Tufts Health Direct , Tufts Health Direct ,,5.4,45,,,5.28,8.92,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,67.76,44,,,67.76,114.42,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,335.72,44,,,335.72,566.91,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,5.28,44,,,5.28,8.92,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Tufts HMO , Tufts HMO ,,1402,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",45.34,,Daily payment max per discipline of $110,110,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",45.75,,Daily payment max per discipline of $110,110,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Tufts HMO , Tufts HMO ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Tufts HMO , Tufts HMO ,GN,112.41,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",36.27,,Daily payment max per discipline of $110,110,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Tufts HMO , Tufts HMO ,"GP,GO",7.83,,Daily payment max per discipline of $110,110,4.15,17.83,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Tufts HMO , Tufts HMO ,"GP,GO",59.76,,Daily payment max per discipline of $110,110,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Tufts HMO , Tufts HMO ,"GP,GO",101.6,,Daily payment max per discipline of $110,110,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",33.39,,Daily payment max per discipline of $110,110,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",41.62,,Daily payment max per discipline of $110,110,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GO,112.41,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Tufts HMO , Tufts HMO ,GO,112.41,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",82.4,,Daily payment max per discipline of $110,110,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Tufts HMO , Tufts HMO ,GP,112.41,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Tufts HMO , Tufts HMO ,GP,112.41,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",40.39,,Daily payment max per discipline of $110,110,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Tufts HMO , Tufts HMO ,GN,93.97,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Tufts HMO , Tufts HMO ,"GP,GO",65.54,,Daily payment max per discipline of $110,110,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Tufts HMO , Tufts HMO ,"GP,GO",15.25,,Daily payment max per discipline of $110,110,11.3,66.3,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",36.27,,Daily payment max per discipline of $110,110,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Tufts HMO , Tufts HMO ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Tufts HMO , Tufts HMO ,"GP,GO",17.72,,Daily payment max per discipline of $110,110,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Tufts HMO , Tufts HMO ,"GP,GO",39.16,,Daily payment max per discipline of $110,110,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, Tufts Medicare Advantage , Tufts Medicare Advantage ,,1578,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",45.34,,Daily payment max per discipline of $97,97,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",45.75,,Daily payment max per discipline of $97,97,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",17.72,,Daily payment max per discipline of $97,97,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,112.41,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",36.27,,Daily payment max per discipline of $97,97,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",59.76,,Daily payment max per discipline of $97,97,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",101.6,,Daily payment max per discipline of $97,97,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",33.39,,Daily payment max per discipline of $97,97,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",41.62,,Daily payment max per discipline of $97,97,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GO,112.41,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GO,112.41,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GO,112.41,,,,40.68,165.69,fee schedule,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GP,112.41,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GP,112.41,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Tufts Medicare Advantage , Tufts Medicare Advantage ,GP,112.41,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",40.39,,Daily payment max per discipline of $97,97,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Tufts Medicare Advantage , Tufts Medicare Advantage ,GN,93.97,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",65.54,,Daily payment max per discipline of $97,97,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",36.27,,Daily payment max per discipline of $97,97,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",17.72,,Daily payment max per discipline of $97,97,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",17.72,,Daily payment max per discipline of $97,97,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Tufts Medicare Advantage , Tufts Medicare Advantage ,"GP,GO",39.16,,Daily payment max per discipline of $97,97,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,,1402,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,86.46,374.47,other,payment per visit
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,90,313.55,other,payment per visit
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,90,313.55,other,payment per visit
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,90,313.55,other,payment per visit
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,90,313.55,other,payment per visit
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,128,,,128,90,313.55,other,payment per visit
OCCUPATIONAL THERAPY follow up visit,430,RC,outpatient,,,,110, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GO,110,,,110,90,120,other,payment per visit
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GO,128,,,128,90,282.34,other,payment per visit
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GO,128,,,128,90,282.34,other,payment per visit
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GO,128,,,128,90,282.34,other,payment per visit
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GO,128,,,128,40.68,165.69,other,payment per visit
PHYSICAL THERAPY follow up visit,420,RC,outpatient,,,,110, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GP,110,,,110,90,120,other,payment per visit
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GP,128,,,128,90,282.34,other,payment per visit
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GP,128,,,128,90,282.34,other,payment per visit
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GP,128,,,128,90,282.34,other,payment per visit
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GP,128,,,128,43.24,165.69,other,payment per visit
SPEECH follow up visit ,440,RC,outpatient,,,,110, United Healthcare / Harvard Pilgrim Commercial , United Healthcare / Harvard Pilgrim Commercial ,GN,110,,,110,90,120,other,payment per visit
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375, United Healthcare Commercial , United Healthcare Commercial ,,1232,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,87.67,,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,165.69,,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, United Healthcare Commercial , United Healthcare Commercial ,GN,374.47,,,,86.46,374.47,percent of total billed charges,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, United Healthcare Commercial , United Healthcare Commercial ,GN,313.55,,,,90,313.55,percent of total billed charges,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, United Healthcare Commercial , United Healthcare Commercial ,GN,313.55,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, United Healthcare Commercial , United Healthcare Commercial ,GN,313.55,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, United Healthcare Commercial , United Healthcare Commercial ,GN,313.55,,,,90,313.55,percent of total billed charges,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, United Healthcare Commercial , United Healthcare Commercial ,GN,313.55,,,,90,313.55,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,17.83,,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,374.47,,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,94.36,,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,94.36,,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GO,282.34,,,,90,282.34,percent of total billed charges,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GO,282.34,,,,90,282.34,percent of total billed charges,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GO,282.34,,,,90,282.34,percent of total billed charges,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, United Healthcare Commercial , United Healthcare Commercial ,GO,165.69,,,,40.68,165.69,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GP,282.34,,,,90,282.34,percent of total billed charges,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GP,282.34,,,,90,282.34,percent of total billed charges,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, United Healthcare Commercial , United Healthcare Commercial ,GP,282.34,,,,90,282.34,percent of total billed charges,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, United Healthcare Commercial , United Healthcare Commercial ,GP,165.69,,,,43.24,165.69,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, United Healthcare Commercial , United Healthcare Commercial ,GN,301.66,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,94.36,,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,106.99,,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,63.9,,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,76.53,,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, United Healthcare Commercial , United Healthcare Commercial ,GP|GO,114.42,,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, United Healthcare Massachusetts Senior Care Options Dual Eligible, United Healthcare Massachusetts Senior Care Options Dual Eligible,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, United Healthcare Medicare Advantage , United Healthcare Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, United Healthcare Senior Care Options Medicare Advantage , United Healthcare Senior Care Options Medicare Advantage ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, VA CCN OPTUM , VA CCN OPTUM ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,37.27,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,37.32,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,14.47,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, VA CCN OPTUM , VA CCN OPTUM ,GN,86.46,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, VA CCN OPTUM , VA CCN OPTUM ,GN,134.53,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, VA CCN OPTUM , VA CCN OPTUM ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, VA CCN OPTUM , VA CCN OPTUM ,GN,230.63,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, VA CCN OPTUM , VA CCN OPTUM ,GN,112.47,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, VA CCN OPTUM , VA CCN OPTUM ,GN,110.75,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,48.61,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,42.41,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,27.35,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,34.15,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GO,102.71,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GO,102.71,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, VA CCN OPTUM , VA CCN OPTUM ,GO,71.06,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,5.74,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GP,101.68,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, VA CCN OPTUM , VA CCN OPTUM ,GP,101.68,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, VA CCN OPTUM , VA CCN OPTUM ,GP,70.71,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,33.18,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, VA CCN OPTUM , VA CCN OPTUM ,GN,77.21,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,53.45,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,29.73,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,14.13,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,14.17,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,32.11,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, VA CCN OPTUM , VA CCN OPTUM ,GP|GO,17.32,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",59,,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",111.5,,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,252,,,,86.46,374.47,percent of total billed charges,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",12,,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",252,,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",63.5,,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",63.5,,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GO,111.5,,,,40.68,165.69,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GP,11.5,,,,43.24,165.69,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,GN,207.06,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",63.5,,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",65,,,,11.3,66.3,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",72,,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",43,,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",51.5,,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Wellsense Massachusetts Medicaid , Wellsense Massachusetts Medicaid ,"GP,GO",77,,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15726.3,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19922.66,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23343.84,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29884.95,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23236.39,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29435.96,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34488.1,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,44152.98,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19216.55,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24343.53,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28522.62,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36516.25,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17554.89,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22238.63,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26055.07,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33356.02,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19118.7,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24305.15,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30309,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24272.53,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30859.69,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,38482.99,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19512.04,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24805.95,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30934.53,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19512.04,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24805.95,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30934.53,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15931.61,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20598.07,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24784.84,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28737.53,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31692.44,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23000.38,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29737.21,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35781.36,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41485.88,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,45753.24,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18401.07,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23792.84,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28626.24,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33191.01,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36604.51,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16904.43,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21854.87,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26296.84,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30489.37,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33624.65,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,13780.66,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18023.07,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22443.94,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27837.62,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35656.64,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19567.69,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25588.81,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31867.05,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39522.97,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,50626.93,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16115.81,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21075.85,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26246.95,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32553.97,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41696.95,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14638.35,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19141.72,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23838.89,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29566.44,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37872.82,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18738.78,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28858.41,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28875.68,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,44469.58,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21941.22,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33791.58,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21941.22,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33791.58,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14594.22,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18508.52,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22647.33,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27749.35,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21653.4,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27461.54,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33601.63,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41173.12,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17057.93,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21634.21,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26471.45,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32435.01,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15860.61,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20114.54,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24612.15,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30157.42,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14070.39,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22514.93,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33970.03,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,49485.26,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19959.12,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31938.05,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,48188.17,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,70194.62,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15344.46,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24554.59,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37045.83,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,53965.61,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14317.91,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22912.12,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34568.69,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,50356.39,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16294.26,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20124.13,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24748.39,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30232.25,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24065.3,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29725.7,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36554.62,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,44655.7,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18615.98,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22994.63,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28277.02,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34543.74,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17635.48,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21781.96,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26786.13,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32722.83,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14285.3,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19166.66,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24625.59,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26928.12,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32647.99,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,46365.33,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20344.79,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27294.6,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35067.57,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,38348.68,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,46493.89,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,66028.96,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16229.02,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21774.28,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27975.77,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30592.98,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37089.96,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,52674.27,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15407.78,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20672.9,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26559.71,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29042.61,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35211.48,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,50007.17,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16756.68,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20818.73,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24738.79,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27998.8,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32857.14,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25655.97,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31874.73,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37876.66,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,42871.24,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,50310.34,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19941.85,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24777.17,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29441.72,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33323.4,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39106.6,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18470.15,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22946.66,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27267.74,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30861.61,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36216.92,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16071.68,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20383.17,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24017.33,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30120.96,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25494.79,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32337.15,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,38103.08,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,47785.23,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19087.99,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24211.13,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28526.46,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35775.6,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17819.68,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22601.28,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26630.71,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33398.23,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15749.32,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19615.66,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23424.43,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28067.87,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23057.94,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28718.34,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34294.3,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41092.53,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18468.23,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23002.3,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27467.29,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32912.78,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17213.35,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21438.5,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25602.24,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30677.41,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16601.26,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20099.19,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26037.81,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27306.12,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25475.6,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30842.42,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39956.62,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41900.34,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19368.14,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23447.46,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30376.16,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31855.54,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18159.31,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21985.35,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28482.33,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29867.68,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15382.84,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19180.1,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22967.76,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27461.54,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28946.67,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22649.25,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28240.56,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33818.45,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,40434.39,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,42619.88,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18092.15,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22557.14,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27012.54,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32296.86,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34042.94,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16900.59,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21072.01,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25233.84,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30170.85,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31801.81,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15613.09,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17890.68,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22593.6,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27993.04,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25120.63,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28787.41,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36355.07,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,45043.29,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18660.11,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21382.85,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27002.95,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33455.8,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16866.05,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19325.92,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24406.85,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30239.93,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17453.2,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22140.77,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25162.84,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31160.94,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24443.3,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31007.44,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35240.26,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,43640.67,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19838.24,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25166.68,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28601.29,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35420.63,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18658.19,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23668.12,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26899.34,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33311.89,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15916.26,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18044.18,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20085.76,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22501.5,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26987.6,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23326.57,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26446.51,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29435.96,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32978.02,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39551.75,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18717.67,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21221.68,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23620.15,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26461.86,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31736.57,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17065.6,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19347.03,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,21534.44,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24126.7,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28935.16,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,15361.73,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20999.1,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23890.69,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30170.85,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28892.95,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20924.26,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28601.29,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32538.62,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41092.53,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39352.2,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17299.69,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23648.93,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26905.09,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33975.79,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32536.7,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16513,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22574.41,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25680.91,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32431.17,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31057.33,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16501.48,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20701.69,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23731.44,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,28209.86,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39198.7,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24366.55,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30568.04,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,35038.79,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41650.9,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,57876.07,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18955.6,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23779.41,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,27258.15,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32402.39,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,45026.02,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,17907.95,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,22466.96,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25751.91,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30612.17,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,42537.37,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18151.63,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23411,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29378.4,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,45870.29,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,36477.87,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,46545.7,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,63632.41,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23140.45,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29844.66,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37452.61,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,58476.65,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,46503.48,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,59338.18,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,81122.06,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20578.88,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26540.53,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,33306.13,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,52002.7,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,41355.4,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,52768.29,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,72140.26,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,19976.39,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,25763.42,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,32331.39,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,50481.11,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,40144.66,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,51223.67,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,70029.61,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14187.44,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18003.89,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23203.77,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,29614.41,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,37032.4,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,42119.08,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18784.83,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,23836.97,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,30723.46,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,39210.21,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,49030.51,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,55767.34,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,16292.34,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,20672.9,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,26646.06,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,34004.57,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,42522.02,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,48364.7,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,14887.79,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,18890.36,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,24349.28,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,31074.6,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,38857.16,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,,44197.11,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,37.64,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,14.31,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,37.69,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,14.61,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,87.32,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,135.88,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,232.94,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,232.94,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,113.59,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,111.86,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,30.03,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,49.1,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,42.83,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,27.62,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,34.49,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GO,103.74,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GO,103.74,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GO,103.74,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GO,71.77,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,5.8,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP,102.7,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP,102.7,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP,102.7,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP,71.42,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,33.51,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GN,77.98,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,53.98,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,30.03,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,14.27,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,14.31,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,32.43,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Wellsense Massachusetts Medicare Advantage , Wellsense Massachusetts Medicare Advantage ,GP|GO,17.49,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",59,,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",111.5,,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,252,,,,86.46,374.47,percent of total billed charges,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,211,,,,90,313.55,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",12,,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",252,,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",63.5,,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",63.5,,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GO,190,,,,90,282.34,percent of total billed charges,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GO,111.5,,,,40.68,165.69,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GP,190,,,,90,282.34,percent of total billed charges,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Wellsense NH Medicaid , Wellsense NH Medicaid ,GP,11.5,,,,43.24,165.69,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Wellsense NH Medicaid , Wellsense NH Medicaid ,GN,207.06,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",63.5,,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUPERVISED E-STIM - OP,97014,CPT,outpatient,,,130,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",65,,,,11.3,66.3,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",72,,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",43,,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",51.5,,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Wellsense NH Medicaid , Wellsense NH Medicaid ,"GP,GO",77,,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16193.42,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20514.43,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24037.22,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30772.63,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23926.58,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30310.3,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35512.5,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,45464.46,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19787.34,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25066.6,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29369.83,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37600.89,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18076.32,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22899.18,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26828.99,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34346.79,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19686.58,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25027.09,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31209.27,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24993.5,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31776.32,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,39626.05,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20091.61,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25542.76,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31853.37,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20091.61,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25542.76,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31853.37,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16404.82,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21209.9,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25521.03,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29591.12,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32633.8,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23683.56,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30620.49,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36844.17,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42718.13,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47112.25,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18947.64,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24499.55,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29476.52,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34176.88,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37691.77,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17406.54,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22504.03,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27077.93,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31394.99,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34623.4,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,14189.98,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18558.41,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23110.59,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28664.48,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36715.74,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20148.91,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26348.88,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32813.6,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40696.92,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,52130.71,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16594.5,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21701.86,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27026.56,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33520.92,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42935.47,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15073.15,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19710.29,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24546.97,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30444.65,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,38997.76,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19295.37,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29715.59,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29733.37,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,45790.46,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22592.94,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34795.29,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22592.94,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34795.29,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15027.71,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19058.28,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23320.02,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28573.59,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22296.57,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28277.23,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34599.69,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42396.08,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17564.6,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22276.81,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27257.73,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33398.42,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16331.72,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20712,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25343.21,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31053.19,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,14488.33,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23183.69,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34979.04,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,50955.12,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20551.96,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32886.7,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,49619.5,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,72279.61,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15800.24,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25283.94,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,38146.2,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,55568.55,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,14743.2,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23592.68,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35595.48,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,51852.12,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16778.24,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20721.88,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25483.49,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31130.24,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24780.11,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30608.64,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37640.4,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,45982.11,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19168.93,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23677.63,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29116.93,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35569.8,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18159.31,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22428.95,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27581.76,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33694.79,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,14709.61,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19735.97,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25357.04,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27727.96,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33617.74,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47742.52,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20949.09,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28105.34,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36109.18,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,39487.75,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47874.9,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,67990.22,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16711.07,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22421.04,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28806.73,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31501.69,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,38191.64,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,54238.85,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15865.44,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21286.95,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27348.62,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29905.26,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36257.36,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,51492.53,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17254.4,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21437.11,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25473.61,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28830.44,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33833.09,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26418.03,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32821.5,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,39001.71,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,44144.64,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,51804.7,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20534.18,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25513.12,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30316.22,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34313.21,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40268.18,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19018.77,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23628.24,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28077.67,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31778.29,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37292.67,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16549.05,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20988.61,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24730.72,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31015.65,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26252.06,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33297.66,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,39234.85,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,49204.59,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19654.97,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24930.27,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29373.78,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36838.24,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18348.98,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23272.6,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27421.72,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34390.26,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16217.12,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20198.3,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24120.21,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28901.57,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23742.83,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29571.36,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35312.95,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42313.1,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19016.79,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23685.54,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28283.15,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33890.39,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17724.64,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22075.28,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26362.71,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31588.62,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17094.37,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20696.2,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26811.21,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28117.19,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26232.31,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31758.54,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,41143.45,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,43144.9,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19943.43,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24143.92,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31278.42,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32801.74,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18698.69,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22638.38,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29328.34,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30754.84,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15839.75,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19749.8,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23649.97,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28277.23,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29806.47,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23322,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29079.39,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34822.96,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,41635.41,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,43885.81,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18629.54,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23227.16,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27814.9,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33256.17,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35054.12,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17402.59,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21697.91,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25983.36,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31067.02,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32746.42,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16076.84,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18422.08,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23264.7,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28824.52,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25866.79,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29642.49,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37434.92,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,46381.21,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19214.37,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22017.99,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27805.02,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34449.53,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17367.02,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19899.96,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25131.8,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31138.14,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17971.61,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22798.42,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25910.25,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32086.51,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25169.34,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31928.45,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36287,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,44936.92,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20427.49,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25914.21,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29450.84,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36472.72,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19212.39,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24371.13,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27698.33,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34301.35,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16389.02,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18580.15,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20682.37,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23169.86,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27789.21,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24019.44,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27232.05,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30310.3,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33957.57,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40726.56,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19273.64,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21852.02,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24321.74,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27247.85,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,32679.24,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17572.5,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19921.69,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,22174.07,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24843.34,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29794.62,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15818.02,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21622.83,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24600.32,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31067.02,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29751.15,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21545.78,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29450.84,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33505.12,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42313.1,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40521.08,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17813.55,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24351.37,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27704.25,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34984.97,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33503.14,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,17003.48,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23244.94,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26443.71,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33394.47,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31979.82,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16991.63,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21316.59,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24436.33,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,29047.78,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40363.02,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25090.31,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31476,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,36079.55,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42888.05,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,59595.17,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19518.64,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24485.72,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,28067.8,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33364.84,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,46363.43,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18439.87,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23134.3,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26516.82,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31521.44,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,43800.86,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18690.79,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24106.38,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30251.02,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47232.77,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,37561.37,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47928.24,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,65522.48,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23827.79,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30731.13,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,38565.06,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,60213.58,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,47884.77,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,61100.7,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,83531.63,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21190.14,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27328.86,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,34295.42,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,53547.33,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,42583.78,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,54335.67,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,74283.04,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,20569.75,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,26528.67,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,33291.73,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,51980.55,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,41337.07,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,52745.17,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,72109.7,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,14608.85,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,18538.65,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,23892.99,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,30494.04,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,38132.37,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,43370.14,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19342.79,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,24545,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31636.04,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40374.87,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,50486.86,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,57423.79,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,16776.27,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,21286.95,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,27437.53,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,35014.61,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,43785.05,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,49801.27,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,15330,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,19451.46,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,25072.53,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,31997.6,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,40011.33,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,,45509.9,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,38.76,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,39.13,,follows medicare multiple procedure payment reduction rules,,30.17,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,14.74,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,14.88,,follows medicare multiple procedure payment reduction rules,,12.62,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,38.81,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,39.19,,follows medicare multiple procedure payment reduction rules,,31.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,15.05,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,15.19,,follows medicare multiple procedure payment reduction rules,,13.65,87.67,fee schedule,for discounted cash price see follow up visit (any payer)
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,89.92,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,139.91,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,239.86,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,239.86,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,116.97,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,115.18,,,,90,313.55,fee schedule,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,30.92,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,31.22,,follows medicare multiple procedure payment reduction rules,,20.22,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,50.55,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,51.04,,follows medicare multiple procedure payment reduction rules,,26.99,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,44.11,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,44.53,,follows medicare multiple procedure payment reduction rules,,23.74,101.6,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,28.44,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,28.72,,follows medicare multiple procedure payment reduction rules,,27.35,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,35.52,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,35.86,,follows medicare multiple procedure payment reduction rules,,34.15,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GO,106.82,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GO,106.82,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GO,106.82,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GO,73.9,,,,40.68,165.69,fee schedule,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,5.97,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,6.03,,follows medicare multiple procedure payment reduction rules,,5.74,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP,105.75,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP,105.75,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP,105.75,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP,73.54,,,,43.24,165.69,fee schedule,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,34.51,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,34.84,,follows medicare multiple procedure payment reduction rules,,25.02,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,80.3,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GN,80.3,,,,77.21,301.66,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,55.59,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,56.12,,follows medicare multiple procedure payment reduction rules,,51.27,94.36,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,30.92,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
THEREX - OP,97110,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,31.22,,follows medicare multiple procedure payment reduction rules,,29.73,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,14.7,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,14.74,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
ULTRASOUND - OP,97035,CPT,outpatient,,,86,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,14.88,,follows medicare multiple procedure payment reduction rules,,9.1,63.9,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,33.39,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,33.72,,follows medicare multiple procedure payment reduction rules,,22.05,76.53,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,18.01,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,, Wellsense NH Medicare Advantage , Wellsense NH Medicare Advantage ,GP|GO,18.19,,follows medicare multiple procedure payment reduction rules,,15.9,114.42,fee schedule,for discounted cash price see follow up visit (any payer)
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,Aetna Commercial Products,Aetna Commercial Products,,18.71,69.3,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Aetna Commercial Products,Aetna Commercial Products,,3848.92,69.3,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Aetna Commercial Products,Aetna Commercial Products,,3848.92,69.3,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,Aetna Commercial Products,Aetna Commercial Products,,504.5,69.3,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,Aetna Commercial Products,Aetna Commercial Products,,276.51,69.3,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,Aetna Commercial Products,Aetna Commercial Products,,212.75,69.3,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,Aetna Commercial Products,Aetna Commercial Products,,471.24,69.3,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,Aetna Commercial Products,Aetna Commercial Products,,491.34,69.3,,,311.96,526.79,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,Aetna Commercial Products,Aetna Commercial Products,,8.32,69.3,,,5.28,8.92,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,Aetna Commercial Products,Aetna Commercial Products,,58.21,69.3,,,36.96,62.41,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,5.57,46.39,,,5.28,8.92,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,6.31,52.56,,,5.28,8.92,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,Aetna Commercial Products,Aetna Commercial Products,,6.24,69.3,,,3.96,6.69,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,CIGNA Commercial,CIGNA Commercial,,5.54,46.2,,,5.28,8.92,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,Aetna Commercial Products,Aetna Commercial Products,,169.09,69.3,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,Aetna Commercial Products,Aetna Commercial Products,,494.8,69.3,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,Aetna Commercial Products,Aetna Commercial Products,,494.8,69.3,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,Aetna Commercial Products,Aetna Commercial Products,,248.79,69.3,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,Aetna Commercial Products,Aetna Commercial Products,,248.79,69.3,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,Aetna Commercial Products,Aetna Commercial Products,,205.82,69.3,,,130.68,220.67,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,United Healthcare Commercial,United Healthcare Commercial,,8.92,74.3,,,5.28,8.92,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
DIAZEPAN TABLET 5 MG - PAIN CL,51079028520,NDC,outpatient,1,EA,12,6.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,Aetna Commercial Products,Aetna Commercial Products,,853.08,69.3,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,Aetna Commercial Products,Aetna Commercial Products,,494.8,69.3,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,Aetna Commercial Products,Aetna Commercial Products,,494.8,69.3,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,Aetna Commercial Products,Aetna Commercial Products,,320.17,69.3,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,Aetna Commercial Products,Aetna Commercial Products,,23.56,69.3,,,14.96,25.26,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,Aetna Commercial Products,Aetna Commercial Products,,21.48,69.3,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,Aetna Commercial Products,Aetna Commercial Products,,356.9,69.3,,,226.6,382.65,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,Aetna Commercial Products,Aetna Commercial Products,,1117.12,69.3,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,Aetna Commercial Products,Aetna Commercial Products,,706.17,69.3,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,Aetna Commercial Products,Aetna Commercial Products,,774.77,69.3,,,491.92,830.67,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,Aetna Commercial Products,Aetna Commercial Products,,264.73,69.3,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,Aetna Commercial Products,Aetna Commercial Products,,28.41,69.3,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,Aetna Commercial Products,Aetna Commercial Products,,32.57,69.3,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,Aetna Commercial Products,Aetna Commercial Products,,205.13,69.3,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,Aetna Commercial Products,Aetna Commercial Products,,991.68,69.3,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,Aetna Commercial Products,Aetna Commercial Products,,233.54,69.3,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,Aetna Commercial Products,Aetna Commercial Products,,85.93,69.3,,,54.56,92.13,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,United Healthcare Commercial,United Healthcare Commercial,,461.4,74.3,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,Aetna Commercial Products,Aetna Commercial Products,,4.16,69.3,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,Aetna Commercial Products,Aetna Commercial Products,,343.73,69.3,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,Aetna Commercial Products,Aetna Commercial Products,,465,69.3,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,Aetna Commercial Products,Aetna Commercial Products,,4.16,69.3,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,Aetna Commercial Products,Aetna Commercial Products,,465,69.3,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,Aetna Commercial Products,Aetna Commercial Products,,465,69.3,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,Aetna Commercial Products,Aetna Commercial Products,,67.22,69.3,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,Aetna Commercial Products,Aetna Commercial Products,,830.91,69.3,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,Aetna Commercial Products,Aetna Commercial Products,,8213.44,69.3,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,Aetna Commercial Products,Aetna Commercial Products,,9.01,69.3,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,Aetna Commercial Products,Aetna Commercial Products,,130.28,69.3,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,Aetna Commercial Products,Aetna Commercial Products,,207.9,69.3,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,Aetna Commercial Products,Aetna Commercial Products,,79,69.3,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,Aetna Commercial Products,Aetna Commercial Products,,305.61,69.3,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,Aetna Commercial Products,Aetna Commercial Products,,4.16,69.3,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,Aetna Commercial Products,Aetna Commercial Products,,6.24,69.3,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,Aetna Commercial Products,Aetna Commercial Products,,299.38,69.3,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,Aetna Commercial Products,Aetna Commercial Products,,8.32,69.3,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,Aetna Commercial Products,Aetna Commercial Products,,71.38,69.3,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,Aetna Commercial Products,Aetna Commercial Products,,366.6,69.3,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,Aetna Commercial Products,Aetna Commercial Products,,5426.88,69.3,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,Aetna Commercial Products,Aetna Commercial Products,,5855.85,69.3,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,Aetna Commercial Products,Aetna Commercial Products,,516.29,69.3,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,Aetna Commercial Products,Aetna Commercial Products,,7058.21,69.3,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,Aetna Commercial Products,Aetna Commercial Products,,12446.28,69.3,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,Aetna Commercial Products,Aetna Commercial Products,,12446.28,69.3,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,Aetna Commercial Products,Aetna Commercial Products,,394.32,69.3,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,Aetna Commercial Products,Aetna Commercial Products,,787.94,69.3,,,500.28,844.79,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,Aetna Commercial Products,Aetna Commercial Products,,10.4,69.3,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,Aetna Commercial Products,Aetna Commercial Products,,10.4,69.3,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,Aetna Commercial Products,Aetna Commercial Products,,5822.59,69.3,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,Aetna Commercial Products,Aetna Commercial Products,,991.68,69.3,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,Aetna Commercial Products,Aetna Commercial Products,,991.68,69.3,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,Aetna Commercial Products,Aetna Commercial Products,,613.31,69.3,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,Aetna Commercial Products,Aetna Commercial Products,,781.01,69.3,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,Aetna Commercial Products,Aetna Commercial Products,,545.39,69.3,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,Aetna Commercial Products,Aetna Commercial Products,,42.97,69.3,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Aetna Commercial Products,Aetna Commercial Products,,781.01,69.3,,,495.88,837.36,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,Aetna Commercial Products,Aetna Commercial Products,,32.57,69.3,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,Aetna Commercial Products,Aetna Commercial Products,,58.91,69.3,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,Aetna Commercial Products,Aetna Commercial Products,,282.74,69.3,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,Aetna Commercial Products,Aetna Commercial Products,,846.85,69.3,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,Aetna Commercial Products,Aetna Commercial Products,,240.47,69.3,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,Aetna Commercial Products,Aetna Commercial Products,,121.97,69.3,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,Aetna Commercial Products,Aetna Commercial Products,,97.71,69.3,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,Aetna Commercial Products,Aetna Commercial Products,,192.65,69.3,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,Aetna Commercial Products,Aetna Commercial Products,,145.53,69.3,,,92.4,156.03,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,Aetna Commercial Products,Aetna Commercial Products,,6.24,69.3,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,Aetna Commercial Products,Aetna Commercial Products,,772.7,69.3,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,Aetna Commercial Products,Aetna Commercial Products,,180.18,69.3,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,Aetna Commercial Products,Aetna Commercial Products,,85.24,69.3,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,Aetna Commercial Products,Aetna Commercial Products,,109.49,69.3,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,Aetna Commercial Products,Aetna Commercial Products,,132.36,69.3,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,Aetna Commercial Products,Aetna Commercial Products,,156.62,69.3,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,Aetna Commercial Products,Aetna Commercial Products,,6846.84,69.3,,,4347.2,7340.84,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,Aetna Commercial Products,Aetna Commercial Products,,428.27,69.3,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,Aetna Commercial Products,Aetna Commercial Products,,1053.36,69.3,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,Aetna Commercial Products,Aetna Commercial Products,,424.12,69.3,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,Aetna Commercial Products,Aetna Commercial Products,,208.59,69.3,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,Aetna Commercial Products,Aetna Commercial Products,,276.51,69.3,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,Aetna Commercial Products,Aetna Commercial Products,,48.51,69.3,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,Aetna Commercial Products,Aetna Commercial Products,,187.11,69.3,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,Aetna Commercial Products,Aetna Commercial Products,,48.51,69.3,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,Aetna Commercial Products,Aetna Commercial Products,,48.51,69.3,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,Aetna Commercial Products,Aetna Commercial Products,,48.51,69.3,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,Aetna Commercial Products,Aetna Commercial Products,,38.12,69.3,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,Aetna Commercial Products,Aetna Commercial Products,,12.47,69.3,,,7.92,13.37,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,Aetna Commercial Products,Aetna Commercial Products,,794.87,69.3,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,Aetna Commercial Products,Aetna Commercial Products,,794.87,69.3,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,Aetna Commercial Products,Aetna Commercial Products,,545.39,69.3,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,Aetna Commercial Products,Aetna Commercial Products,,5.54,69.3,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,Aetna Commercial Products,Aetna Commercial Products,,6.93,69.3,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,Aetna Commercial Products,Aetna Commercial Products,,4.16,69.3,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,Aetna Commercial Products,Aetna Commercial Products,,10.4,69.3,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,Aetna Commercial Products,Aetna Commercial Products,,4282.74,69.3,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,Aetna Commercial Products,Aetna Commercial Products,,11420.64,69.3,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,Aetna Commercial Products,Aetna Commercial Products,,5822.59,69.3,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Aetna Commercial Products,Aetna Commercial Products,,22.18,69.3,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,Aetna Commercial Products,Aetna Commercial Products,,498.96,69.3,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,Aetna Commercial Products,Aetna Commercial Products,,488.57,69.3,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,Aetna Commercial Products,Aetna Commercial Products,,706.17,69.3,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,Aetna Commercial Products,Aetna Commercial Products,,494.11,69.3,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,Aetna Commercial Products,Aetna Commercial Products,,343.73,69.3,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,Aetna Commercial Products,Aetna Commercial Products,,846.85,69.3,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,Aetna Commercial Products,Aetna Commercial Products,,503.12,69.3,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,Aetna Commercial Products,Aetna Commercial Products,,994.46,69.3,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,Aetna Commercial Products,Aetna Commercial Products,,503.12,69.3,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,Aetna Commercial Products,Aetna Commercial Products,,613.31,69.3,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,Aetna Commercial Products,Aetna Commercial Products,,613.31,69.3,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,Aetna Commercial Products,Aetna Commercial Products,,706.17,69.3,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Aetna Commercial Products,Aetna Commercial Products,,781.01,69.3,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,Aetna Commercial Products,Aetna Commercial Products,,633.4,69.3,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,Aetna Commercial Products,Aetna Commercial Products,,706.17,69.3,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,Aetna Commercial Products,Aetna Commercial Products,,844.07,69.3,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,Aetna Commercial Products,Aetna Commercial Products,,350.66,69.3,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,Aetna Commercial Products,Aetna Commercial Products,,66.53,69.3,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,Aetna Commercial Products,Aetna Commercial Products,,853.08,69.3,,,541.64,914.63,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,Aetna Commercial Products,Aetna Commercial Products,,12.47,69.3,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,Aetna Commercial Products,Aetna Commercial Products,,29.8,69.3,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,Aetna Commercial Products,Aetna Commercial Products,,225.23,69.3,,,143,241.48,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,24.99,51,,,21.56,36.41,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,Aetna Commercial Products,Aetna Commercial Products,,106.72,69.3,,,67.76,114.42,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,Aetna Commercial Products,Aetna Commercial Products,,528.76,69.3,,,335.72,566.91,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,30.3,61.84,,,21.56,36.41,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,1050,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Cc,MS-560,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Mcc,MS-559,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue Without Cc/Mcc,MS-561,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare With Cc/Mcc,MS-949,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Aftercare Without Cc/Mcc,MS-950,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies With Mcc,MS-553,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies Without Mcc,MS-554,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cellulitis With Mcc,MS-602,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cellulitis Without Mcc,MS-603,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Cc,MS-191,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Mcc,MS-190,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease Without Cc/Mcc,MS-192,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Cc,MS-546,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Mcc,MS-545,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Connective Tissue Disorders Without Cc/Mcc,MS-547,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders With Mcc,MS-056,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders Without Mcc,MS-057,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Cc,MS-442,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Mcc,MS-441,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc,MS-443,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,MS-065,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Mcc,MS-064,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,MS-066,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Medical Back Problems With Mcc,MS-551,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Medical Back Problems Without Mcc,MS-552,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders With Cc,MS-071,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders Without Cc/Mcc,MS-072,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis With Cc,MS-540,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis With Mcc,MS-539,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteomyelitis Without Cc/Mcc,MS-541,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Cc,MS-092,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Mcc,MS-091,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System Without Cc/Mcc,MS-093,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rehabilitation With Cc/Mcc,MS-945,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rehabilitation Without Cc/Mcc,MS-946,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,MS-555,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,MS-556,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries With Cc/Mcc,MS-052,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries Without Cc/Mcc,MS-053,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis With Mcc,MS-557,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis Without Mcc,MS-558,MS-DRG,inpatient,,,,,Amerihealth NH Medicaid MCO,Amerihealth NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,1237.5,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,12.53,46.39,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2576.5,46.39,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2576.5,46.39,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,337.72,46.39,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,185.1,46.39,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,142.42,46.39,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,315.45,46.39,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,328.91,46.39,,,311.96,526.79,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Tufts Health Direct , Tufts Health Direct ,,22.05,45,,,21.56,36.41,percent of total billed charges,
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,38.97,46.39,,,36.96,62.41,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,21.56,44,,,21.56,36.41,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Aetna Commercial Products,Aetna Commercial Products,,33.96,69.3,,,21.56,36.41,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.18,46.39,,,3.96,6.69,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,22.73,46.39,,,21.56,36.41,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,25.75,52.56,,,21.56,36.41,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,113.19,46.39,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,331.22,46.39,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,331.22,46.39,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,166.54,46.39,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,166.54,46.39,,,157.96,266.74,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,137.78,46.39,,,130.68,220.67,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,CIGNA Commercial,CIGNA Commercial,,22.64,46.2,,,21.56,36.41,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,United Healthcare Commercial,United Healthcare Commercial,,36.41,74.3,,,21.56,36.41,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,571.06,46.39,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,331.22,46.39,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,331.22,46.39,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,214.32,46.39,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,15.77,46.39,,,14.96,25.26,percent of total billed charges,
FENTANYL U. 0.5 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.38,46.39,,,13.64,23.03,percent of total billed charges,
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,238.91,46.39,,,226.6,382.65,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,747.81,46.39,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,472.71,46.39,,,448.36,757.12,percent of total billed charges,
GABLOFEN500 - 10MG - PAIN CL,J0475,HCPCS,outpatient,20,ML,621,341.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,310.5,50,,,273.24,461.4,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,136.17,51,,,117.48,198.38,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,518.64,46.39,,,491.92,830.67,percent of total billed charges,
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",54.74,46.39,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",103.45,46.39,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,177.21,46.39,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,19.02,46.39,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,21.8,46.39,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,233.81,46.39,,,86.46,374.47,percent of total billed charges,for services rendered inside IP hospital location
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,195.77,46.39,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,195.77,46.39,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,195.77,46.39,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,195.77,46.39,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,195.77,46.39,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,137.31,46.39,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,663.84,46.39,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,156.33,46.39,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,57.52,46.39,,,54.56,92.13,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,165.11,61.84,,,117.48,198.38,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85, Tufts Health Direct , Tufts Health Direct ,,120.15,45,,,117.48,198.38,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,117.48,44,,,117.48,198.38,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,Aetna Commercial Products,Aetna Commercial Products,,185.03,69.3,,,117.48,198.38,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,123.86,46.39,,,117.48,198.38,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,140.34,52.56,,,117.48,198.38,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",11.13,46.39,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2.78,46.39,,,2.64,4.46,percent of total billed charges,
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",233.81,46.39,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",58.92,46.39,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",58.92,46.39,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,230.09,46.39,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,311.28,46.39,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2.78,46.39,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,311.28,46.39,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,311.28,46.39,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,45,46.39,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,556.22,46.39,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,5498.14,46.39,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,6.03,46.39,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,87.21,46.39,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,139.17,46.39,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,52.88,46.39,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,204.58,46.39,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2.78,46.39,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.18,46.39,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,200.4,46.39,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,5.57,46.39,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,47.78,46.39,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,245.4,46.39,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,3632.8,46.39,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,3919.96,46.39,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,345.61,46.39,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4724.82,46.39,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,8331.64,46.39,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,8331.64,46.39,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,263.96,46.39,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,527.45,46.39,,,500.28,844.79,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,CIGNA Commercial,CIGNA Commercial,,123.35,46.2,,,117.48,198.38,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,6.96,46.39,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,6.96,46.39,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,3897.69,46.39,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,663.84,46.39,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,663.84,46.39,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,410.55,46.39,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,522.82,46.39,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,365.09,46.39,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,28.76,46.39,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,522.82,46.39,,,495.88,837.36,percent of total billed charges,
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,133.5,50,,,117.48,198.38,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,10.71,51,,,9.24,15.6,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,12.99,61.84,,,9.24,15.6,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,United Healthcare Commercial,United Healthcare Commercial,,198.38,74.3,,,117.48,198.38,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55, Tufts Health Direct , Tufts Health Direct ,,9.45,45,,,9.24,15.6,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,21.8,46.39,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,39.43,46.39,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,189.27,46.39,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,566.89,46.39,,,537.68,907.95,percent of total billed charges,
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,160.97,46.39,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,81.65,46.39,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,65.41,46.39,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,128.96,46.39,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,97.42,46.39,,,92.4,156.03,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,9.24,44,,,9.24,15.6,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.18,46.39,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,517.25,46.39,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GO,176.28,46.39,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GO,176.28,46.39,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GO,176.28,46.39,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GO,103.45,46.39,,,40.68,165.69,percent of total billed charges,for services rendered inside IP hospital location
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,120.61,46.39,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,57.06,46.39,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,73.3,46.39,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,88.6,46.39,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,104.84,46.39,,,99.44,167.92,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4583.33,46.39,,,4347.2,7340.84,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,Aetna Commercial Products,Aetna Commercial Products,,14.55,69.3,,,9.24,15.6,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,9.74,46.39,,,9.24,15.6,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GP,176.28,46.39,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GP,176.28,,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GP,176.28,46.39,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GP,103.45,46.39,,,43.24,165.69,percent of total billed charges,for services rendered inside IP hospital location
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,286.69,46.39,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,705.13,46.39,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,283.91,46.39,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,139.63,46.39,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,185.1,46.39,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,32.47,46.39,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,125.25,46.39,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,32.47,46.39,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,32.47,46.39,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,32.47,46.39,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,25.51,46.39,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,8.35,46.39,,,7.92,13.37,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,11.04,52.56,,,9.24,15.6,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,532.09,46.39,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,532.09,46.39,,,504.68,852.22,percent of total billed charges,
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),GN,188.34,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,365.09,46.39,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,3.71,46.39,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",58.92,46.39,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.64,46.39,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2.78,46.39,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,6.96,46.39,,,6.6,11.15,percent of total billed charges,
THEREX - OP,97110,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,2866.9,46.39,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,7645.07,46.39,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,3897.69,46.39,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.84,46.39,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,334.01,46.39,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,327.05,46.39,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,472.71,46.39,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,330.76,46.39,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,230.09,46.39,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,566.89,46.39,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,336.79,46.39,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,665.7,46.39,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,336.79,46.39,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,410.55,46.39,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,410.55,46.39,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,472.71,46.39,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,522.82,46.39,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,424,46.39,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,472.71,46.39,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,565.03,46.39,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,234.73,46.39,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,44.53,46.39,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,571.06,46.39,,,541.64,914.63,percent of total billed charges,
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",66.8,46.39,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,CIGNA Commercial,CIGNA Commercial,,9.7,46.2,,,9.24,15.6,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,10.5,50,,,9.24,15.6,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,United Healthcare Commercial,United Healthcare Commercial,,15.6,74.3,,,9.24,15.6,percent of total billed charges,
ULTRASOUND - OP,97035,CPT,outpatient,,,86,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",39.9,46.39,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,8.35,46.39,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,19.95,46.39,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,150.77,46.39,,,143,241.48,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,10.5,50,,,9.24,15.6,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,71.44,46.39,,,67.76,114.42,percent of total billed charges,
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",47.78,46.39,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),"GP,GO",71.44,46.39,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,133.5,50,,,117.48,198.38,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,353.96,46.39,,,335.72,566.91,percent of total billed charges,
GLYCOPYROLATE - PAIN CL,250,RC,outpatient,1,EA,21,11.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,10.5,50,,,9.24,15.6,percent of total billed charges,
LIORESAL SCREEN KIT#8563s - PAIN CL,J0476,HCPCS,outpatient,1,EA,267,146.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,133.5,50,,,117.48,198.38,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,1402.5,,,,1000,1732.5,per diem,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,14.19,52.56,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,2919.18,52.56,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,2919.18,52.56,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,382.64,52.56,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,209.71,52.56,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,161.36,52.56,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,357.41,52.56,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,372.65,52.56,,,311.96,526.79,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,4.59,51,,,3.96,6.69,percent of total billed charges,
AQUATIC THERAPY - OP,97113,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,30.17,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,44.15,52.56,,,36.96,62.41,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,5.57,61.84,,,3.96,6.69,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95, Tufts Health Direct , Tufts Health Direct ,,4.05,45,,,3.96,6.69,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4.73,52.56,,,3.96,6.69,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,3.96,44,,,3.96,6.69,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,Aetna Commercial Products,Aetna Commercial Products,,6.24,69.3,,,3.96,6.69,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,128.25,52.56,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,375.28,52.56,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,375.28,52.56,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,188.69,52.56,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,188.69,52.56,,,157.96,266.74,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,11.22,51,,,9.68,16.35,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,156.1,52.56,,,130.68,220.67,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.18,46.39,,,3.96,6.69,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4.73,52.56,,,3.96,6.69,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,CIGNA Commercial,CIGNA Commercial,,4.16,46.2,,,3.96,6.69,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,647.01,52.56,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,375.28,52.56,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,375.28,52.56,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,242.83,52.56,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,17.87,52.56,,,14.96,25.26,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,United Healthcare Commercial,United Healthcare Commercial,,6.69,74.3,,,3.96,6.69,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.29,52.56,,,13.64,23.03,percent of total billed charges,
CONTRAST BATHS - OP,97034,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,12.62,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,270.68,52.56,,,226.6,382.65,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,847.27,52.56,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,535.59,52.56,,,448.36,757.12,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,13.6,61.84,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1, Tufts Health Direct , Tufts Health Direct ,,9.9,45,,,9.68,16.35,percent of total billed charges,
INJECT STERILE SALINE 10 ML - PAIN CL,250,RC,outpatient,1,EA,9,4.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,587.62,52.56,,,491.92,830.67,percent of total billed charges,
DYNAMIC/THERAPEUTIC ACTIVITIES - OP,97530,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,31.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
E STIM DIRECT - OP,97032,CPT,outpatient,,,118,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",62.02,52.56,,,13.65,87.67,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
EA ADD.HR WORK HARDENING - OP,97546,CPT,outpatient,,,223,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",117.21,52.56,,,38.67,165.69,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,13.77,51,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,16.7,61.84,,,11.88,20.06,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,200.78,52.56,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,21.55,52.56,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,24.7,52.56,,,20.68,34.92,percent of total billed charges,
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,264.9,52.56,,,86.46,374.47,percent of total billed charges,for services rendered inside IP hospital location
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,221.8,52.56,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,221.8,52.56,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,221.8,52.56,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,221.8,52.56,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,221.8,52.56,,,90,313.55,percent of total billed charges,for services rendered inside IP hospital location
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,155.58,52.56,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,752.13,52.56,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85, Tufts Health Direct , Tufts Health Direct ,,12.15,45,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,11.88,44,,,11.88,20.06,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,177.13,52.56,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,65.17,52.56,,,54.56,92.13,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,9.68,44,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,Aetna Commercial Products,Aetna Commercial Products,,15.25,69.3,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,10.21,46.39,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,11.56,52.56,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,CIGNA Commercial,CIGNA Commercial,,10.16,46.2,,,9.68,16.35,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,11,50,,,9.68,16.35,percent of total billed charges,
GAIT/STAIR TRAINING - OP,97116,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,20.22,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,Aetna Commercial Products,Aetna Commercial Products,,18.71,69.3,,,11.88,20.06,percent of total billed charges,
HOT/COLD PACK - OP,97010,CPT,outpatient,,,24,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",12.61,52.56,,,4.15,17.83,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,3.15,52.56,,,2.64,4.46,percent of total billed charges,
INIT 2HR WORK HARDENING - OP,97545,CPT,outpatient,,,504,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",264.9,52.56,,,96.93,374.47,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL ORTHOTIC FIT/TRAIN - OP,97760,CPT,outpatient,,,127,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",66.75,52.56,,,26.99,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INITIAL PROSTH TRAINING - OP,97761,CPT,outpatient,,,127,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",66.75,52.56,,,23.74,101.6,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,260.7,52.56,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,352.68,52.56,,,295.24,498.55,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,12.53,46.39,,,11.88,20.06,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,3.15,52.56,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,352.68,52.56,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,352.68,52.56,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,50.98,52.56,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,630.19,52.56,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,6229.41,52.56,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,6.83,52.56,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,98.81,52.56,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,157.68,52.56,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,59.92,52.56,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,231.79,52.56,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,3.15,52.56,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4.73,52.56,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,227.06,52.56,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,6.31,52.56,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,54.14,52.56,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,278.04,52.56,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4115.97,52.56,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4441.32,52.56,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,391.57,52.56,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,5353.24,52.56,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,9439.78,52.56,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,9439.78,52.56,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,299.07,52.56,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,597.61,52.56,,,500.28,844.79,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,14.19,52.56,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,CIGNA Commercial,CIGNA Commercial,,12.47,46.2,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,United Healthcare Commercial,United Healthcare Commercial,,20.06,74.3,,,11.88,20.06,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,United Healthcare Commercial,United Healthcare Commercial,,16.35,74.3,,,9.68,16.35,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,7.88,52.56,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,7.88,52.56,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4416.09,52.56,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,752.13,52.56,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,752.13,52.56,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,465.16,52.56,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,592.35,52.56,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,413.65,52.56,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,32.59,52.56,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,592.35,52.56,,,495.88,837.36,percent of total billed charges,
MANUAL THERAPY - OP,97140,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,27.35,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,11,50,,,9.68,16.35,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
LIDOCAINE 1% 30 ML - PAIN CL,250,RC,outpatient,1,EA,27,14.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
BOTOX PER UNIT - PAIN CL,J0585,HCPCS,outpatient,1,EA,22,12.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,11,50,,,9.68,16.35,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,15.81,51,,,13.64,23.03,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,24.7,52.56,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,44.68,52.56,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,214.44,52.56,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,642.28,52.56,,,537.68,907.95,percent of total billed charges,
NEUROMUSCULAR RE-ED - OP,97112,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,34.15,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,182.38,52.56,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,92.51,52.56,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,74.11,52.56,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,146.12,52.56,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,110.38,52.56,,,92.4,156.03,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.17,61.84,,,13.64,23.03,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4.73,52.56,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,586.04,52.56,,,490.6,828.45,percent of total billed charges,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GO,199.73,52.56,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GO,199.73,52.56,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GO,199.73,52.56,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GO,117.21,52.56,,,40.68,165.69,percent of total billed charges,for services rendered inside IP hospital location
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,136.66,52.56,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,64.65,52.56,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,83.04,52.56,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,100.39,52.56,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,118.79,52.56,,,99.44,167.92,percent of total billed charges,
PARAFIN BATH - OP,97018,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,5.74,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,5192.93,52.56,,,4347.2,7340.84,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05, Tufts Health Direct , Tufts Health Direct ,,13.95,45,,,13.64,23.03,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,13.64,44,,,13.64,23.03,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GP,199.73,52.56,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GP,199.73,,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GP,199.73,52.56,,,90,282.34,percent of total billed charges,for services rendered inside IP hospital location
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GP,117.21,52.56,,,43.24,165.69,percent of total billed charges,for services rendered inside IP hospital location
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,324.82,52.56,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,798.91,52.56,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,321.67,52.56,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,158.21,52.56,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,209.71,52.56,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,36.79,52.56,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,141.91,52.56,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,36.79,52.56,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,36.79,52.56,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,36.79,52.56,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,28.91,52.56,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,9.46,52.56,,,7.92,13.37,percent of total billed charges,
SELFCARE/HOME-MGMT - OP,97535,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,25.02,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,Aetna Commercial Products,Aetna Commercial Products,,21.48,69.3,,,13.64,23.03,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,602.86,52.56,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,602.86,52.56,,,504.68,852.22,percent of total billed charges,
SPEECH THERAPY TREATMENT - OP,92507,CPT,outpatient,,,406,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),GN,213.39,,,,77.21,301.66,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,413.65,52.56,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4.2,52.56,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
SUBSQ PROST/ORTHOTIC CHECK OUT - OP,97763,CPT,outpatient,,,127,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",66.75,52.56,,,51.27,94.36,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,5.26,52.56,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,3.15,52.56,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,7.88,52.56,,,6.6,11.15,percent of total billed charges,
THEREX - OP,97110,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,29.73,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,3248.21,52.56,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,8661.89,52.56,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,4416.09,52.56,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.82,52.56,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,378.43,52.56,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,370.55,52.56,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,535.59,52.56,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,374.75,52.56,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,260.7,52.56,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,642.28,52.56,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,381.59,52.56,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,754.24,52.56,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,381.59,52.56,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,465.16,52.56,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,465.16,52.56,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,535.59,52.56,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,592.35,52.56,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,480.4,52.56,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,535.59,52.56,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,640.18,52.56,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,265.95,52.56,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,50.46,52.56,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,647.01,52.56,,,541.64,914.63,percent of total billed charges,
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",75.69,52.56,,,11.76,106.99,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.38,46.39,,,13.64,23.03,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.29,52.56,,,13.64,23.03,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,CIGNA Commercial,CIGNA Commercial,,14.32,46.2,,,13.64,23.03,percent of total billed charges,
ULTRASOUND - OP,97035,CPT,outpatient,,,86,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",45.2,52.56,,,9.1,63.9,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,9.46,52.56,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,22.6,52.56,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,170.82,52.56,,,143,241.48,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,80.94,52.56,,,67.76,114.42,percent of total billed charges,
W/C MANAGEMENT - OP,97542,CPT,outpatient,,,103,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",54.14,52.56,,,22.05,76.53,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
WHIRLPOOL - OP,97022,CPT,outpatient,,,154,,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),"GP,GO",80.94,52.56,,,15.9,114.42,percent of total billed charges,for discounted cash price see standard charge methodology pay per visit (any payer)
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,401.03,52.56,,,335.72,566.91,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,United Healthcare Commercial,United Healthcare Commercial,,23.03,74.3,,,13.64,23.03,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,,Anthem ME Medicare Advantage ,Anthem ME Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15570.5915,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19725.40893,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23112.7155,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29589.06328,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23006.32786,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34146.63393,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,43715.82249,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19026.29013,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24102.50054,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28240.21995,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36154.7007,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17381.08122,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22018.4426,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25797.10371,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33025.76412,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18929.40138,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24064.50495,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30008.91452,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24032.2087,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30554.15119,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38101.97452,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19318.85615,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24560.34736,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30628.24258,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15773.86789,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20394.13126,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24539.44979,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28452.99524,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31378.65543,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22772.655,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29442.78027,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35427.08521,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,41075.1292,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,45300.23846,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18218.88391,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23557.26387,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28342.80803,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32862.38309,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36242.09055,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16737.05602,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21638.48673,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26036.47591,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30187.49378,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33291.73322,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,13644.21525,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17844.62738,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22221.71899,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27561.99872,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35303.59955,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19373.94975,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25335.45733,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31551.53535,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,39131.65493,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,50125.67799,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15956.24671,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20867.17631,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25987.08165,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32231.65635,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,41284.10492,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14493.41662,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18952.19874,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23602.85857,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29273.69991,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,37497.84469,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18553.24507,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28572.68133,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28589.77935,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,44029.28608,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21723.9768,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33457.01403,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14449.72169,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18325.27155,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22423.0956,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27474.60887,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21439.0099,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33268.93587,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,40765.46516,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16889.03837,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21420.0121,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26209.35583,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32113.87003,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15703.57606,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19915.38686,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24368.46965,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29858.83195,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,13931.08193,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22292.01082,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33633.69351,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,48995.30928,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19761.50474,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31621.82718,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,47711.05845,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,69499.62774,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15192.53541,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24311.47627,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36679.0398,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,53431.29405,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14176.15347,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22685.26515,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34226.42466,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,49857.8091,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16132.92619,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19924.88576,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24503.35398,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29932.92334,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23827.03253,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29431.3816,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36192.69628,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,44213.56467,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18431.6592,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22766.95566,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27997.04819,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34201.72753,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17460.87195,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21566.29511,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26520.91964,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32398.83693,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14143.85722,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18976.89587,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24381.7681,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26661.50331,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32324.74554,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,45906.26807,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20143.36038,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27024.36117,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34720.36729,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,37968.98997,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,46033.55328,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,65375.20679,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16068.33369,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21558.696,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27698.78284,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30290.08186,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36722.73472,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,52152.74255,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15255.22813,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26296.74568,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28755.06015,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34862.85074,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,49512.04926,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16590.77301,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20612.60588,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24493.85508,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27721.58019,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32531.82149,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25401.94961,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31559.13446,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,37501.64425,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,42446.76988,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,49812.2144,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19744.40672,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24531.85067,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29150.21425,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32993.46787,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38719.40281,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18287.27597,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22719.46118,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26997.76426,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30556.05097,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35858.33512,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15912.55179,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20181.35597,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23779.53805,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29822.73614,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25242.36814,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32016.98128,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,37725.81821,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,47312.10478,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18899.00491,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23971.41576,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28244.01951,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35421.38587,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17643.25077,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22377.50089,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26367.03752,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33067.55926,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15593.38886,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19421.44423,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23192.50623,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27789.97224,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22829.64838,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28433.99744,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33954.75622,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18285.37619,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22774.55478,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27195.34131,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32586.91509,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17042.9205,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21226.23461,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25348.75579,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30373.67215,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16436.89088,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19900.18863,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25780.0057,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27035.75984,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25223.37035,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30537.05318,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,39561.00506,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,41485.48154,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19176.3727,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23215.30358,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30075.4068,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31540.13667,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17979.51171,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21767.67172,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28200.32458,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29571.96527,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15230.531,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18990.19432,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22740.35875,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27189.64197,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28660.07118,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22424.99538,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27960.95239,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33483.61094,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,40034.05012,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,42197.89879,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17913.01943,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22333.80597,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26745.09361,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31977.08592,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33705.88512,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16733.25646,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20863.37676,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24983.99815,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31486.94285,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15458.50452,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17713.5426,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22369.90178,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27715.88085,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24871.91117,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28502.3895,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35995.11923,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,44597.3201,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18475.35412,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21171.14101,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26735.59471,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33124.55264,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16699.06043,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19134.57755,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24165.19326,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29940.52246,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17280.39291,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21921.55385,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24913.70632,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30852.41655,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24201.28906,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30700.4342,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34891.34743,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,43208.5814,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19641.81864,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24917.50588,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,35069.92669,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18473.45434,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23433.77821,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26633.00662,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32982.06919,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15758.66966,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17865.52495,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19886.89017,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22278.71237,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26720.39647,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23095.61749,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26184.6587,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29144.51492,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32651.50759,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,39160.15162,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18532.3475,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21011.55954,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23386.28372,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26199.85693,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,31422.35035,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16896.63749,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19155.47513,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,21321.22358,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23887.82547,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28648.67251,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,15209.63343,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20791.18514,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23654.15261,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29872.13041,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28606.87736,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20717.09375,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,28318.1109,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32216.45812,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,40685.67443,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38962.57457,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17128.41057,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23414.78042,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26638.70596,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33639.39284,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32214.55834,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16349.50103,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22350.90398,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25426.64674,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32110.07047,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30749.82846,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16338.10236,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20496.71934,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23496.47093,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,27930.55592,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38810.59222,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24125.29789,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30265.38473,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,34691.8706,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,41238.51022,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,57303.04435,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18767.92014,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23543.96541,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26988.26536,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32081.57378,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,44580.22209,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17730.64062,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22244.51634,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25496.93858,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30309.07965,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,42116.20828,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17971.91259,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23179.20778,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29087.52154,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,45416.125,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36116.70511,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,46084.84733,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,63002.38239,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22911.33889,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29549.16792,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,37081.79302,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,57897.67529,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,46043.05218,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,58750.67621,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,80318.87111,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20375.13346,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26277.74789,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32976.36985,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,51487.81978,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,40945.9442,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,52245.83174,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,71426.004,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,19778.60275,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,25508.33725,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,32011.28195,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,49981.29476,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,39747.18344,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,50716.50937,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,69336.24672,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14046.96847,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,17825.62958,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,22974.03161,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,29321.1944,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,36665.74134,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,41702.05638,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18598.83978,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,23600.95879,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30419.26686,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38821.9909,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,48545.06158,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,55215.18685,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,16131.02641,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,20468.22265,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,26382.23575,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,33667.88953,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,42101.01004,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,47885.83815,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,14740.38793,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,18703.32764,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,24108.19988,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,30766.92648,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,38472.4315,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,,Anthem NH Medicare Advantage ,Anthem NH Medicare Advantage ,,43759.51741,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,CIGNA Commercial,CIGNA Commercial,,12.47,46.2,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,CIGNA Commercial,CIGNA Commercial,,2565.95,46.2,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,CIGNA Commercial,CIGNA Commercial,,2565.95,46.2,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,CIGNA Commercial,CIGNA Commercial,,336.34,46.2,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,CIGNA Commercial,CIGNA Commercial,,184.34,46.2,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,CIGNA Commercial,CIGNA Commercial,,141.83,46.2,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,CIGNA Commercial,CIGNA Commercial,,314.16,46.2,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,CIGNA Commercial,CIGNA Commercial,,327.56,46.2,,,311.96,526.79,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,CIGNA Commercial,CIGNA Commercial,,38.81,46.2,,,36.96,62.41,percent of total billed charges,
LIDOCAINE 100 MGN/SY - PAIN CL,250,RC,outpatient,1,EA,31,17.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,41.82,51,,,36.08,60.93,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,CIGNA Commercial,CIGNA Commercial,,4.16,46.2,,,3.96,6.69,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,50.71,61.84,,,36.08,60.93,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1, Tufts Health Direct , Tufts Health Direct ,,36.9,45,,,36.08,60.93,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,CIGNA Commercial,CIGNA Commercial,,112.73,46.2,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,CIGNA Commercial,CIGNA Commercial,,329.87,46.2,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,CIGNA Commercial,CIGNA Commercial,,329.87,46.2,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,CIGNA Commercial,CIGNA Commercial,,165.86,46.2,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,CIGNA Commercial,CIGNA Commercial,,165.86,46.2,,,157.96,266.74,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,CIGNA Commercial,CIGNA Commercial,,137.21,46.2,,,130.68,220.67,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,36.08,44,,,36.08,60.93,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,Aetna Commercial Products,Aetna Commercial Products,,56.83,69.3,,,36.08,60.93,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,38.04,46.39,,,36.08,60.93,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,CIGNA Commercial,CIGNA Commercial,,568.72,46.2,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,CIGNA Commercial,CIGNA Commercial,,329.87,46.2,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,CIGNA Commercial,CIGNA Commercial,,329.87,46.2,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,CIGNA Commercial,CIGNA Commercial,,213.44,46.2,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,43.1,52.56,,,36.08,60.93,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,CIGNA Commercial,CIGNA Commercial,,15.71,46.2,,,14.96,25.26,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,CIGNA Commercial,CIGNA Commercial,,37.88,46.2,,,36.08,60.93,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,CIGNA Commercial,CIGNA Commercial,,14.32,46.2,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,CIGNA Commercial,CIGNA Commercial,,237.93,46.2,,,226.6,382.65,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,41,50,,,36.08,60.93,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,CIGNA Commercial,CIGNA Commercial,,744.74,46.2,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,CIGNA Commercial,CIGNA Commercial,,470.78,46.2,,,448.36,757.12,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,United Healthcare Commercial,United Healthcare Commercial,,60.93,74.3,,,36.08,60.93,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,CIGNA Commercial,CIGNA Commercial,,516.52,46.2,,,491.92,830.67,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,41,50,,,36.08,60.93,percent of total billed charges,
LIDOCAINE 5% 2ML - PAIN CL,250,RC,outpatient,1,EA,82,45.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,41,50,,,36.08,60.93,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,CIGNA Commercial,CIGNA Commercial,,176.48,46.2,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,CIGNA Commercial,CIGNA Commercial,,18.94,46.2,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,CIGNA Commercial,CIGNA Commercial,,21.71,46.2,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,CIGNA Commercial,CIGNA Commercial,,136.75,46.2,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,CIGNA Commercial,CIGNA Commercial,,661.12,46.2,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.38,51,,,16.72,28.23,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,23.5,61.84,,,16.72,28.23,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,CIGNA Commercial,CIGNA Commercial,,155.69,46.2,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,CIGNA Commercial,CIGNA Commercial,,57.29,46.2,,,54.56,92.13,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9, Tufts Health Direct , Tufts Health Direct ,,17.1,45,,,16.72,28.23,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,CIGNA Commercial,CIGNA Commercial,,2.77,46.2,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,CIGNA Commercial,CIGNA Commercial,,229.15,46.2,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,CIGNA Commercial,CIGNA Commercial,,310,46.2,,,295.24,498.55,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,16.72,44,,,16.72,28.23,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,CIGNA Commercial,CIGNA Commercial,,2.77,46.2,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,CIGNA Commercial,CIGNA Commercial,,310,46.2,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,CIGNA Commercial,CIGNA Commercial,,310,46.2,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,CIGNA Commercial,CIGNA Commercial,,44.81,46.2,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,CIGNA Commercial,CIGNA Commercial,,553.94,46.2,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,CIGNA Commercial,CIGNA Commercial,,5475.62,46.2,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,CIGNA Commercial,CIGNA Commercial,,6.01,46.2,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,CIGNA Commercial,CIGNA Commercial,,86.86,46.2,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,CIGNA Commercial,CIGNA Commercial,,138.6,46.2,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,CIGNA Commercial,CIGNA Commercial,,52.67,46.2,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,CIGNA Commercial,CIGNA Commercial,,203.74,46.2,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,CIGNA Commercial,CIGNA Commercial,,2.77,46.2,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,CIGNA Commercial,CIGNA Commercial,,4.16,46.2,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,CIGNA Commercial,CIGNA Commercial,,199.58,46.2,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,CIGNA Commercial,CIGNA Commercial,,5.54,46.2,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,CIGNA Commercial,CIGNA Commercial,,47.59,46.2,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,CIGNA Commercial,CIGNA Commercial,,244.4,46.2,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,CIGNA Commercial,CIGNA Commercial,,3617.92,46.2,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,CIGNA Commercial,CIGNA Commercial,,3903.9,46.2,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,CIGNA Commercial,CIGNA Commercial,,344.19,46.2,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,CIGNA Commercial,CIGNA Commercial,,4705.47,46.2,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,CIGNA Commercial,CIGNA Commercial,,8297.52,46.2,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,CIGNA Commercial,CIGNA Commercial,,8297.52,46.2,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,CIGNA Commercial,CIGNA Commercial,,262.88,46.2,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,CIGNA Commercial,CIGNA Commercial,,525.29,46.2,,,500.28,844.79,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,Aetna Commercial Products,Aetna Commercial Products,,26.33,69.3,,,16.72,28.23,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,17.63,46.39,,,16.72,28.23,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,19.97,52.56,,,16.72,28.23,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,CIGNA Commercial,CIGNA Commercial,,17.56,46.2,,,16.72,28.23,percent of total billed charges,
MYOBLOC 100 UNITS - PAIN CL,J0587,HCPCS,outpatient,1,EA,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,CIGNA Commercial,CIGNA Commercial,,6.93,46.2,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,CIGNA Commercial,CIGNA Commercial,,6.93,46.2,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,CIGNA Commercial,CIGNA Commercial,,3881.72,46.2,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,CIGNA Commercial,CIGNA Commercial,,661.12,46.2,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,CIGNA Commercial,CIGNA Commercial,,661.12,46.2,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,CIGNA Commercial,CIGNA Commercial,,408.87,46.2,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,CIGNA Commercial,CIGNA Commercial,,520.67,46.2,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,CIGNA Commercial,CIGNA Commercial,,363.59,46.2,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,CIGNA Commercial,CIGNA Commercial,,28.64,46.2,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,CIGNA Commercial,CIGNA Commercial,,520.67,46.2,,,495.88,837.36,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,9.18,51,,,7.92,13.37,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,United Healthcare Commercial,United Healthcare Commercial,,28.23,74.3,,,16.72,28.23,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,11.13,61.84,,,7.92,13.37,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,CIGNA Commercial,CIGNA Commercial,,21.71,46.2,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,CIGNA Commercial,CIGNA Commercial,,39.27,46.2,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,CIGNA Commercial,CIGNA Commercial,,188.5,46.2,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,CIGNA Commercial,CIGNA Commercial,,564.56,46.2,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,CIGNA Commercial,CIGNA Commercial,,160.31,46.2,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,CIGNA Commercial,CIGNA Commercial,,81.31,46.2,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,CIGNA Commercial,CIGNA Commercial,,65.14,46.2,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,CIGNA Commercial,CIGNA Commercial,,128.44,46.2,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,CIGNA Commercial,CIGNA Commercial,,97.02,46.2,,,92.4,156.03,percent of total billed charges,
LIDOCAINE MPG 1% W/EPI - PAIN CL,250,RC,outpatient,1,EA,38,20.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,CIGNA Commercial,CIGNA Commercial,,4.16,46.2,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,CIGNA Commercial,CIGNA Commercial,,515.13,46.2,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,CIGNA Commercial,CIGNA Commercial,,120.12,46.2,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,CIGNA Commercial,CIGNA Commercial,,56.83,46.2,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,CIGNA Commercial,CIGNA Commercial,,73,46.2,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,CIGNA Commercial,CIGNA Commercial,,88.24,46.2,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,CIGNA Commercial,CIGNA Commercial,,104.41,46.2,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,CIGNA Commercial,CIGNA Commercial,,4564.56,46.2,,,4347.2,7340.84,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,24.99,51,,,21.56,36.41,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,30.3,61.84,,,21.56,36.41,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,CIGNA Commercial,CIGNA Commercial,,285.52,46.2,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,CIGNA Commercial,CIGNA Commercial,,702.24,46.2,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,CIGNA Commercial,CIGNA Commercial,,282.74,46.2,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,CIGNA Commercial,CIGNA Commercial,,139.06,46.2,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,CIGNA Commercial,CIGNA Commercial,,184.34,46.2,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,CIGNA Commercial,CIGNA Commercial,,32.34,46.2,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,CIGNA Commercial,CIGNA Commercial,,124.74,46.2,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,CIGNA Commercial,CIGNA Commercial,,32.34,46.2,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,CIGNA Commercial,CIGNA Commercial,,32.34,46.2,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,CIGNA Commercial,CIGNA Commercial,,32.34,46.2,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,CIGNA Commercial,CIGNA Commercial,,25.41,46.2,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,CIGNA Commercial,CIGNA Commercial,,8.32,46.2,,,7.92,13.37,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Tufts Health Direct , Tufts Health Direct ,,22.05,45,,,21.56,36.41,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,CIGNA Commercial,CIGNA Commercial,,529.91,46.2,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,CIGNA Commercial,CIGNA Commercial,,529.91,46.2,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,CIGNA Commercial,CIGNA Commercial,,363.59,46.2,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,CIGNA Commercial,CIGNA Commercial,,3.7,46.2,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,CIGNA Commercial,CIGNA Commercial,,4.62,46.2,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,CIGNA Commercial,CIGNA Commercial,,2.77,46.2,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,CIGNA Commercial,CIGNA Commercial,,6.93,46.2,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,CIGNA Commercial,CIGNA Commercial,,2855.16,46.2,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,CIGNA Commercial,CIGNA Commercial,,7613.76,46.2,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,CIGNA Commercial,CIGNA Commercial,,3881.72,46.2,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,CIGNA Commercial,CIGNA Commercial,,14.78,46.2,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,CIGNA Commercial,CIGNA Commercial,,332.64,46.2,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,CIGNA Commercial,CIGNA Commercial,,325.71,46.2,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,CIGNA Commercial,CIGNA Commercial,,470.78,46.2,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,CIGNA Commercial,CIGNA Commercial,,329.41,46.2,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,CIGNA Commercial,CIGNA Commercial,,229.15,46.2,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,CIGNA Commercial,CIGNA Commercial,,564.56,46.2,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,CIGNA Commercial,CIGNA Commercial,,335.41,46.2,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,CIGNA Commercial,CIGNA Commercial,,662.97,46.2,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,CIGNA Commercial,CIGNA Commercial,,335.41,46.2,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,CIGNA Commercial,CIGNA Commercial,,408.87,46.2,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,CIGNA Commercial,CIGNA Commercial,,408.87,46.2,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,CIGNA Commercial,CIGNA Commercial,,470.78,46.2,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,CIGNA Commercial,CIGNA Commercial,,520.67,46.2,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,CIGNA Commercial,CIGNA Commercial,,422.27,46.2,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,CIGNA Commercial,CIGNA Commercial,,470.78,46.2,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,CIGNA Commercial,CIGNA Commercial,,562.72,46.2,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,CIGNA Commercial,CIGNA Commercial,,233.77,46.2,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,CIGNA Commercial,CIGNA Commercial,,44.35,46.2,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,CIGNA Commercial,CIGNA Commercial,,568.72,46.2,,,541.64,914.63,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,21.56,44,,,21.56,36.41,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Aetna Commercial Products,Aetna Commercial Products,,33.96,69.3,,,21.56,36.41,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,22.73,46.39,,,21.56,36.41,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,CIGNA Commercial,CIGNA Commercial,,8.32,46.2,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,CIGNA Commercial,CIGNA Commercial,,19.87,46.2,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,CIGNA Commercial,CIGNA Commercial,,150.15,46.2,,,143,241.48,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,25.75,52.56,,,21.56,36.41,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,CIGNA Commercial,CIGNA Commercial,,71.15,46.2,,,67.76,114.42,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9, Tufts Health Direct , Tufts Health Direct ,,8.1,45,,,7.92,13.37,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,CIGNA Commercial,CIGNA Commercial,,352.51,46.2,,,335.72,566.91,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,CIGNA Commercial,CIGNA Commercial,,22.64,46.2,,,21.56,36.41,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,7.92,44,,,7.92,13.37,percent of total billed charges,
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16349.12,,,,15570.5915,16349.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20711.68,,,,19725.40893,20711.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24268.35,,,,23112.7155,24268.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG A1004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31068.52,,,,29589.06328,31068.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24156.64,,,,23006.32786,24156.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30601.74,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35853.97,,,,34146.63393,35853.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG B1004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,45901.61,,,,43715.82249,45901.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19977.6,,,,19026.29013,19977.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25307.63,,,,24102.50054,25307.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29652.23,,,,28240.21995,29652.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG C1004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37962.44,,,,36154.7007,37962.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18250.14,,,,17381.08122,18250.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23119.36,,,,22018.4426,23119.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27086.96,,,,25797.10371,27086.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, lower extremity",CMG D1004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34677.05,,,,33025.76412,34677.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19875.87,,,,18929.40138,19875.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25267.73,,,,24064.50495,25267.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG A1103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31509.36,,,,30008.91452,31509.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25233.82,,,,24032.2087,25233.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32081.86,,,,30554.15119,32081.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG B1103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40007.07,,,,38101.97452,40007.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20284.8,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25788.36,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG C1103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32159.65,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20284.8,,,,19318.85615,20284.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25788.36,,,,24560.34736,25788.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Amputation, other",CMG D1103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32159.65,,,,30628.24258,32159.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16562.56,,,,15773.86789,16562.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21413.84,,,,20394.13126,21413.84,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25766.42,,,,24539.44979,25766.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29875.64,,,,28452.99524,29875.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG A0305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32947.59,,,,31378.65543,32947.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23911.29,,,,22772.655,23911.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30914.92,,,,29442.78027,30914.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37198.44,,,,35427.08521,37198.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,43128.89,,,,41075.1292,43128.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG B0305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,47565.25,,,,45300.23846,47565.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19129.83,,,,18218.88391,19129.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24735.13,,,,23557.26387,24735.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29759.95,,,,28342.80803,29759.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34505.5,,,,32862.38309,34505.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG C0305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38054.2,,,,36242.09055,38054.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17573.91,,,,16737.05602,17573.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22720.41,,,,21638.48673,22720.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27338.3,,,,26036.47591,27338.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31696.87,,,,30187.49378,31696.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, non-traumatic",CMG D0305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34956.32,,,,33291.73322,34956.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,14326.43,,,,13644.21525,14326.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18736.86,,,,17844.62738,18736.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23332.8,,,,22221.71899,23332.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28940.1,,,,27561.99872,28940.1,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG A0205,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37068.78,,,,35303.59955,37068.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20342.65,,,,19373.94975,20342.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26602.23,,,,25335.45733,26602.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33129.11,,,,31551.53535,33129.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,41088.24,,,,39131.65493,41088.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG B0205,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,52631.96,,,,50125.67799,52631.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16754.06,,,,15956.24671,16754.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21910.54,,,,20867.17631,21910.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27286.44,,,,25987.08165,27286.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33843.24,,,,32231.65635,33843.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG C0205,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,43348.31,,,,41284.10492,43348.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15218.09,,,,14493.41662,15218.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19899.81,,,,18952.19874,19899.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24783,,,,23602.85857,24783,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30737.38,,,,29273.69991,30737.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Brain dysfunction, traumatic",CMG D0205,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,39372.74,,,,37497.84469,39372.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19480.91,,,,18553.24507,19480.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG A2102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30001.32,,,,28572.68133,30001.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30019.27,,,,28589.77935,30019.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG B2102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,46230.75,,,,44029.28608,46230.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22810.18,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG C2102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35129.86,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22810.18,,,,21723.9768,22810.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Burns,CMG D2102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35129.86,,,,33457.01403,35129.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15172.21,,,,14449.72169,15172.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19241.54,,,,18325.27155,19241.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23544.25,,,,22423.0956,23544.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG A1404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28848.34,,,,27474.60887,28848.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22510.96,,,,21439.0099,22510.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28549.12,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34932.38,,,,33268.93587,34932.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG B1404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,42803.74,,,,40765.46516,42803.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17733.49,,,,16889.03837,17733.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22491.01,,,,21420.0121,22491.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27519.82,,,,26209.35583,27519.82,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG C1404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33719.56,,,,32113.87003,33719.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16488.75,,,,15703.57606,16488.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20911.16,,,,19915.38686,20911.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25586.89,,,,24368.46965,25586.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Cardiac,CMG D1404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31351.77,,,,29858.83195,31351.77,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,14627.64,,,,13931.08193,14627.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23406.61,,,,22292.01082,23406.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35315.38,,,,33633.69351,35315.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG A1904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,51445.07,,,,48995.30928,51445.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20749.58,,,,19761.50474,20749.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33202.92,,,,31621.82718,33202.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,50096.61,,,,47711.05845,50096.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG B1904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,72974.61,,,,69499.62774,72974.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15952.16,,,,15192.53541,15952.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25527.05,,,,24311.47627,25527.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38512.99,,,,36679.0398,38512.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG C1904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,56102.86,,,,53431.29405,56102.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,14884.96,,,,14176.15347,14884.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23819.53,,,,22685.26515,23819.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35937.75,,,,34226.42466,35937.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Guillian-Barre,CMG D1904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,52350.7,,,,49857.8091,52350.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16939.57,,,,16132.92619,16939.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20921.13,,,,19924.88576,20921.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25728.52,,,,24503.35398,25728.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG A0704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31429.57,,,,29932.92334,31429.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25018.38,,,,23827.03253,25018.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30902.95,,,,29431.3816,30902.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38002.33,,,,36192.69628,38002.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG B0704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,46424.24,,,,44213.56467,46424.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19353.24,,,,18431.6592,19353.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23905.3,,,,22766.95566,23905.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29396.9,,,,27997.04819,29396.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG C0704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35911.81,,,,34201.72753,35911.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18333.92,,,,17460.87195,18333.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22644.61,,,,21566.29511,22644.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27846.97,,,,26520.91964,27846.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Hip fracture,CMG D0704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34018.78,,,,32398.83693,34018.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,14851.05,,,,14143.85722,14851.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19925.74,,,,18976.89587,19925.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25600.86,,,,24381.7681,25600.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27994.58,,,,26661.50331,27994.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33940.98,,,,32324.74554,33940.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG A1806,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,48201.58,,,,45906.26807,48201.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21150.53,,,,20143.36038,21150.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28375.58,,,,27024.36117,28375.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,36456.39,,,,34720.36729,36456.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,39867.44,,,,37968.98997,39867.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,48335.23,,,,46033.55328,48335.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG B1806,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,68643.97,,,,65375.20679,68643.97,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16871.75,,,,16068.33369,16871.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22636.63,,,,21558.696,22636.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29083.72,,,,27698.78284,29083.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31804.59,,,,30290.08186,31804.59,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38558.87,,,,36722.73472,38558.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG C1806,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,54760.38,,,,52152.74255,54760.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16017.99,,,,15255.22813,16017.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21491.63,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27611.58,,,,26296.74568,27611.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30192.81,,,,28755.06015,30192.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,36605.99,,,,34862.85074,36605.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Major Mult. Trauma with brain or spinal cord inj.,CMG D1806,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,51987.65,,,,49512.04926,51987.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17420.31,,,,16590.77301,17420.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21643.24,,,,20612.60588,21643.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25718.55,,,,24493.85508,25718.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29107.66,,,,27721.58019,29107.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG A1705,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34158.41,,,,32531.82149,34158.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26672.05,,,,25401.94961,26672.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33137.09,,,,31559.13446,33137.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,39376.73,,,,37501.64425,39376.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,44569.11,,,,42446.76988,44569.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG B1705,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,52302.83,,,,49812.2144,52302.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20731.63,,,,19744.40672,20731.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25758.44,,,,24531.85067,25758.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30607.72,,,,29150.21425,30607.72,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34643.14,,,,32993.46787,34643.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG C1705,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40655.37,,,,38719.40281,40655.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1701,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19201.64,,,,18287.27597,19201.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1702,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23855.43,,,,22719.46118,23855.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1703,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28347.65,,,,26997.76426,28347.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1704,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32083.85,,,,30556.05097,32083.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Major Mult. Trauma, no brain or spinal cord injury",CMG D1705,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37651.25,,,,35858.33512,37651.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16708.18,,,,15912.55179,16708.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21190.42,,,,20181.35597,21190.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24968.51,,,,23779.53805,24968.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG A0604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31313.87,,,,29822.73614,31313.87,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26504.49,,,,25242.36814,26504.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33617.83,,,,32016.98128,33617.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,39612.11,,,,37725.81821,39612.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG B0604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,49677.71,,,,47312.10478,49677.71,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19843.96,,,,18899.00491,19843.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25169.99,,,,23971.41576,25169.99,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29656.22,,,,28244.01951,29656.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG C0604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37192.46,,,,35421.38587,37192.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18525.41,,,,17643.25077,18525.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23496.38,,,,22377.50089,23496.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27685.39,,,,26367.03752,27685.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Neurological conditions,CMG D0604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34720.94,,,,33067.55926,34720.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16373.06,,,,15593.38886,16373.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20392.52,,,,19421.44423,20392.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24352.13,,,,23192.50623,24352.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG A0904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29179.47,,,,27789.97224,29179.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23971.13,,,,22829.64838,23971.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29855.7,,,,28433.99744,29855.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35652.49,,,,33954.75622,35652.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG B0904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,42719.96,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19199.64,,,,18285.37619,19199.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23913.28,,,,22774.55478,23913.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28555.11,,,,27195.34131,28555.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG C0904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34216.26,,,,32586.91509,34216.26,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0901,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17895.07,,,,17042.9205,17895.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0902,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22287.55,,,,21226.23461,22287.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0903,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26616.19,,,,25348.75579,26616.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Orthopedic - other,CMG D0904,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31892.36,,,,30373.67215,31892.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17258.74,,,,16436.89088,17258.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20895.2,,,,19900.18863,20895.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27069.01,,,,25780.0057,27069.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG A1204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28387.55,,,,27035.75984,28387.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26484.54,,,,25223.37035,26484.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32063.91,,,,30537.05318,32063.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,41539.06,,,,39561.00506,41539.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG B1204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,43559.76,,,,41485.48154,43559.76,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20135.19,,,,19176.3727,20135.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24376.07,,,,23215.30358,24376.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31579.18,,,,30075.4068,31579.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG C1204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33117.14,,,,31540.13667,33117.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1201,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18878.49,,,,17979.51171,18878.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1202,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22856.06,,,,21767.67172,22856.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1203,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29610.34,,,,28200.32458,29610.34,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Osteoarthritis,CMG D1204,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31050.56,,,,29571.96527,31050.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15992.06,,,,15230.531,15992.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19939.7,,,,18990.19432,19939.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23877.38,,,,22740.35875,23877.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28549.12,,,,27189.64197,28549.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG A2005,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30093.07,,,,28660.07118,30093.07,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23546.25,,,,22424.99538,23546.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29359,,,,27960.95239,29359,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35157.79,,,,33483.61094,35157.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,42035.75,,,,40034.05012,42035.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG B2005,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,44307.79,,,,42197.89879,44307.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18808.67,,,,17913.01943,18808.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23450.5,,,,22333.80597,23450.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28082.35,,,,26745.09361,28082.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33575.94,,,,31977.08592,33575.94,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG C2005,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35391.18,,,,33705.88512,35391.18,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2001,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17569.92,,,,16733.25646,17569.92,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2002,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21906.55,,,,20863.37676,21906.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2003,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26233.2,,,,24983.99815,26233.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2004,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31365.74,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Other disabling impairments,CMG D2005,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33061.29,,,,31486.94285,33061.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16231.43,,,,15458.50452,16231.43,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18599.22,,,,17713.5426,18599.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23488.4,,,,22369.90178,23488.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG A1604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29101.67,,,,27715.88085,29101.67,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26115.51,,,,24871.91117,26115.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29927.51,,,,28502.3895,29927.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37794.88,,,,35995.11923,37794.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG B1604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,46827.19,,,,44597.3201,46827.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19399.12,,,,18475.35412,19399.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22229.7,,,,21171.14101,22229.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28072.37,,,,26735.59471,28072.37,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG C1604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34780.78,,,,33124.55264,34780.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1601,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17534.01,,,,16699.06043,17534.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1602,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20091.31,,,,19134.57755,20091.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1603,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25373.45,,,,24165.19326,25373.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pain syndrome,CMG D1604,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31437.55,,,,29940.52246,31437.55,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18144.41,,,,17280.39291,18144.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23017.63,,,,21921.55385,23017.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26159.39,,,,24913.70632,26159.39,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG A1504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32395.04,,,,30852.41655,32395.04,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25411.35,,,,24201.28906,25411.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32235.46,,,,30700.4342,32235.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,36635.91,,,,34891.34743,36635.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG B1504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,45369.01,,,,43208.5814,45369.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20623.91,,,,19641.81864,20623.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26163.38,,,,24917.50588,26163.38,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29734.02,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG C1504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,36823.42,,,,35069.92669,36823.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19397.13,,,,18473.45434,19397.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24605.47,,,,23433.77821,24605.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27964.66,,,,26633.00662,27964.66,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Pulmonary,CMG D1504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34631.17,,,,32982.06919,34631.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16546.6,,,,15758.66966,16546.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18758.8,,,,17865.52495,18758.8,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20881.23,,,,19886.89017,20881.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23392.65,,,,22278.71237,23392.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG A0805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28056.42,,,,26720.39647,28056.42,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24250.4,,,,23095.61749,24250.4,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27493.89,,,,26184.6587,27493.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30601.74,,,,29144.51492,30601.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34284.08,,,,32651.50759,34284.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG B0805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,41118.16,,,,39160.15162,41118.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19458.96,,,,18532.3475,19458.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22062.14,,,,21011.55954,22062.14,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24555.6,,,,23386.28372,24555.6,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27509.85,,,,26199.85693,27509.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG C0805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32993.47,,,,31422.35035,32993.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0801,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17741.47,,,,16896.63749,17741.47,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0802,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20113.25,,,,19155.47513,20113.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0803,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,22387.28,,,,21321.22358,22387.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0804,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25082.22,,,,23887.82547,25082.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Replacement of lower extremity joint,CMG D0805,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30081.11,,,,28648.67251,30081.11,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15970.12,,,,15209.63343,15970.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21830.74,,,,20791.18514,21830.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24836.86,,,,23654.15261,24836.86,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31365.74,,,,29872.13041,31365.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG A1305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30037.22,,,,28606.87736,30037.22,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21752.95,,,,20717.09375,21752.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29734.02,,,,28318.1109,29734.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33827.28,,,,32216.45812,33827.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,42719.96,,,,40685.67443,42719.96,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG B1305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40910.7,,,,38962.57457,40910.7,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17984.83,,,,17128.41057,17984.83,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24585.52,,,,23414.78042,24585.52,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27970.64,,,,26638.70596,27970.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35321.36,,,,33639.39284,35321.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG C1305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33825.29,,,,32214.55834,33825.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1301,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17166.98,,,,16349.50103,17166.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1302,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23468.45,,,,22350.90398,23468.45,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1303,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26697.98,,,,25426.64674,26697.98,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1304,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33715.57,,,,32110.07047,33715.57,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Rheumatoid and other arthritis,CMG D1305,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32287.32,,,,30749.82846,32287.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,17155.01,,,,16338.10236,17155.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21521.56,,,,20496.71934,21521.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24671.29,,,,23496.47093,24671.29,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,29327.08,,,,27930.55592,29327.08,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG A0505,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40751.12,,,,38810.59222,40751.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25331.56,,,,24125.29789,25331.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31778.65,,,,30265.38473,31778.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,36426.46,,,,34691.8706,36426.46,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,43300.44,,,,41238.51022,43300.44,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG B0505,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,60168.2,,,,57303.04435,60168.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19706.32,,,,18767.92014,19706.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24721.16,,,,23543.96541,24721.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,28337.68,,,,26988.26536,28337.68,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33685.65,,,,32081.57378,33685.65,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG C0505,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,46809.23,,,,44580.22209,46809.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0501,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18617.17,,,,17730.64062,18617.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0502,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,23356.74,,,,22244.51634,23356.74,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0503,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26771.79,,,,25496.93858,26771.79,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0504,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31824.53,,,,30309.07965,31824.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, non-traumatic",CMG D0505,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,44222.02,,,,42116.20828,44222.02,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18870.51,,,,17971.91259,18870.51,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24338.17,,,,23179.20778,24338.17,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30541.9,,,,29087.52154,30541.9,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,47686.93,,,,45416.125,47686.93,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0405,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,37922.54,,,,36116.70511,37922.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0406,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,48389.09,,,,46084.84733,48389.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG A0407,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,66152.5,,,,63002.38239,66152.5,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24056.91,,,,22911.33889,24056.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31026.63,,,,29549.16792,31026.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38935.88,,,,37081.79302,38935.88,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,60792.56,,,,57897.67529,60792.56,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0405,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,48345.2,,,,46043.05218,48345.2,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0406,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,61688.21,,,,58750.67621,61688.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG B0407,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,84334.81,,,,80318.87111,84334.81,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21393.89,,,,20375.13346,21393.89,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27591.64,,,,26277.74789,27591.64,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,34625.19,,,,32976.36985,34625.19,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,54062.21,,,,51487.81978,54062.21,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0405,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,42993.24,,,,40945.9442,42993.24,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0406,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,54858.12,,,,52245.83174,54858.12,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG C0407,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,74997.3,,,,71426.004,74997.3,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0401,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,20767.53,,,,19778.60275,20767.53,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0402,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,26783.75,,,,25508.33725,26783.75,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0403,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,33611.85,,,,32011.28195,33611.85,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0404,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,52480.36,,,,49981.29476,52480.36,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0405,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,41734.54,,,,39747.18344,41734.54,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0406,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,53252.33,,,,50716.50937,53252.33,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
"Inpatient Rehab Per Discharge: Spinal cord dysfunction, traumatic",CMG D0407,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,72803.06,,,,69336.24672,72803.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,14749.32,,,,14046.96847,14749.32,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,18716.91,,,,17825.62958,18716.91,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24122.73,,,,22974.03161,24122.73,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0104,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,30787.25,,,,29321.1944,30787.25,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0105,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,38499.03,,,,36665.74134,38499.03,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG A0106,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,43787.16,,,,41702.05638,43787.16,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19528.78,,,,18598.83978,19528.78,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,24781.01,,,,23600.95879,24781.01,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,31940.23,,,,30419.26686,31940.23,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0104,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40763.09,,,,38821.9909,40763.09,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0105,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,50972.31,,,,48545.06158,50972.31,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG B0106,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,57975.95,,,,55215.18685,57975.95,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,16937.58,,,,16131.02641,16937.58,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,21491.63,,,,20468.22265,21491.63,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,27701.35,,,,26382.23575,27701.35,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0104,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,35351.28,,,,33667.88953,35351.28,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0105,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,44206.06,,,,42101.01004,44206.06,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG C0106,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,50280.13,,,,47885.83815,50280.13,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0101,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,15477.41,,,,14740.38793,15477.41,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0102,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,19638.49,,,,18703.32764,19638.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0103,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,25313.61,,,,24108.19988,25313.61,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0104,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,32305.27,,,,30766.92648,32305.27,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0105,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,40396.05,,,,38472.4315,40396.05,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
Inpatient Rehab Per Discharge: Stroke,CMG D0106,HIPPS,inpatient,,,,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,,45947.49,,,,43759.51741,45947.49,case rate,The adjusted base payment rate indicated in the standard_charge|negotiated_dollar data element may be further adjusted for additional factors including transfers and outliers.
EVAL FEEDING - OP,92610,CPT,outpatient,,,504,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,90.78,,,,86.46,374.47,fee schedule,
EVAL FLUENCY - SPEECH - OP,92521,CPT,outpatient,,,422,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,141.26,,,,90,313.55,fee schedule,
EVAL LANGUAGE ONLY - OP,92523,CPT,outpatient,,,422,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,242.16,,,,90,313.55,fee schedule,
EVAL SOUND PROD W/ REC/EXP - OP,92523,CPT,outpatient,,,422,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,242.16,,,,90,313.55,fee schedule,
EVAL SOUND PROD. ONLY - OP,92522,CPT,outpatient,,,422,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,118.09,,,,90,313.55,fee schedule,
EVAL VOICE/RESONANCE - OP,92524,CPT,outpatient,,,422,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GN,116.29,,,,90,313.55,fee schedule,
OT EVAL HIGH - OP,97167,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GO,107.85,,,,90,282.34,fee schedule,
OT EVAL LOW - OP,97165,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GO,107.85,,,,90,282.34,fee schedule,
OT EVAL MOD - OP,97166,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GO,107.85,,,,90,282.34,fee schedule,
OT RE-EVAL - OP,97168,CPT,outpatient,,,223,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GO,74.61,,,,40.68,165.69,fee schedule,
PT EVAL HIGH - OP,97163,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GP,106.76,,,,90,282.34,fee schedule,
PT EVAL LOW - OP,97161,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GP,106.76,,,,90,282.34,fee schedule,
PT EVAL MOD - OP,97162,CPT,outpatient,,,380,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GP,106.76,,,,90,282.34,fee schedule,
PT RE-EVAL - OP,97164,CPT,outpatient,,,223,135,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GP,74.25,,,,43.24,165.69,fee schedule,
TRACTION/MECHANICAL - OP,97012,CPT,outpatient,,,144,,Massachusetts General Brigham Allways Medicare Advantage ,Massachusetts General Brigham Allways Medicare Advantage ,GP|GO,14.84,,follows medicare multiple procedure payment reduction rules,,11.76,106.99,fee schedule,for discounted cash price see follow up visit (any payer)
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,364,50,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,153.5,50,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,340,50,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,354.5,50,,,311.96,526.79,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,42,50,,,36.96,62.41,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,United Healthcare Commercial,United Healthcare Commercial,,36.41,74.3,,,21.56,36.41,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
MIDAZOLAM 2 MG/ML - PAIN CL,250,RC,outpatient,1,EA,49,26.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,24.5,50,,,21.56,36.41,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,26.01,51,,,22.44,37.89,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,122,50,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,Aetna Commercial Products,Aetna Commercial Products,,12.47,69.3,,,7.92,13.37,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,148.5,50,,,130.68,220.67,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,31.54,61.84,,,22.44,37.89,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05, Tufts Health Direct , Tufts Health Direct ,,22.95,45,,,22.44,37.89,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,22.44,44,,,22.44,37.89,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,231,50,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,Aetna Commercial Products,Aetna Commercial Products,,35.34,69.3,,,22.44,37.89,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,17,50,,,14.96,25.26,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,23.66,46.39,,,22.44,37.89,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,257.5,50,,,226.6,382.65,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,26.81,52.56,,,22.44,37.89,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,806,50,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,8.35,46.39,,,7.92,13.37,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,9.46,52.56,,,7.92,13.37,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,CIGNA Commercial,CIGNA Commercial,,23.56,46.2,,,22.44,37.89,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,559,50,,,491.92,830.67,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,25.5,50,,,22.44,37.89,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,United Healthcare Commercial,United Healthcare Commercial,,37.89,74.3,,,22.44,37.89,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,191,50,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,20.5,50,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,148,50,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,25.5,50,,,22.44,37.89,percent of total billed charges,
MORPHINE SULFATE 10 MG/ML 20ML - PAIN CL,68094000162,NDC,outpatient,5,ML,51,28.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,25.5,50,,,22.44,37.89,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,168.5,50,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,62,50,,,54.56,92.13,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,CIGNA Commercial,CIGNA Commercial,,8.32,46.2,,,7.92,13.37,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,United Healthcare Commercial,United Healthcare Commercial,,13.37,74.3,,,7.92,13.37,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
XEOMIN PER UNIT - PAIN CL,J0588,HCPCS,outpatient,1,EA,18,9.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,5.1,51,,,4.4,7.43,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,48.5,50,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,599.5,50,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,5926,50,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,6.5,50,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,94,50,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,150,50,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,57,50,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,220.5,50,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,216,50,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,51.5,50,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,264.5,50,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3915.5,50,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4225,50,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,372.5,50,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,5092.5,50,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,284.5,50,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,568.5,50,,,500.28,844.79,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,5.1,51,,,4.4,7.43,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,31,50,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,6.18,61.84,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,6.18,61.84,,,4.4,7.43,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,42.5,50,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,204,50,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,173.5,50,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,88,50,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,70.5,50,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,139,50,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,105,50,,,92.4,156.03,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,557.5,50,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,130,50,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,61.5,50,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,79,50,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,95.5,50,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,113,50,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4940,50,,,4347.2,7340.84,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,309,50,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,760,50,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,306,50,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,150.5,50,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,135,50,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,27.5,50,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4,50,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,3090,50,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,8240,50,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,360,50,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,352.5,50,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,356.5,50,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,717.5,50,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,609,50,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,48,50,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,162.5,50,,,143,241.48,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,77,50,,,67.76,114.42,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Tufts Health Direct , Tufts Health Direct ,,4.5,45,,,4.4,7.43,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,381.5,50,,,335.72,566.91,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Tufts Health Direct , Tufts Health Direct ,,4.5,45,,,4.4,7.43,percent of total billed charges,
BIPAP MACHINE RENTAL - IP,270,RC,inpatient,,,81,,NONE,NONE,,81,,,,81,81,other,not separately reimbursable by contracted payers
CODE 99 CART - IP,272,RC,inpatient,,,3866,,NONE,NONE,,3866,,,,3866,3866,other,not separately reimbursable by contracted payers
CONT O2 FULL DAY - IP,410,RC,inpatient,,,220,,NONE,NONE,,220,,,,220,220,other,not separately reimbursable by contracted payers
CONT O2 HALF DAY - IP,270,RC,inpatient,,,98,,NONE,NONE,,98,,,,98,98,other,not separately reimbursable by contracted payers
CPAP MACHINE RENTAL - IP,270,RC,inpatient,,,61,,NONE,NONE,,61,,,,61,61,other,not separately reimbursable by contracted payers
CPT - IP,410,RC,inpatient,,,118,,NONE,NONE,,118,,,,118,118,other,not separately reimbursable by contracted payers
EKG,730,RC,inpatient,,,160,,NONE,NONE,,160,,,,160,160,other,not separately reimbursable by contracted payers
GROUP OT TREATMENT - IP,430,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
GROUP PT TREATMENT - IP,420,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
GROUP ST TREATMENT - IP,440,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
HHN - IP,410,RC,inpatient,,,118,,NONE,NONE,,118,,,,118,118,other,not separately reimbursable by contracted payers
"MATTRESS RENTAL, STAGE IV LOW AIRLOSS - IP",270,RC,inpatient,,,121,,NONE,NONE,,121,,,,121,121,other,not separately reimbursable by contracted payers
MODI BARIUM SWALLOW - IP,444,RC,inpatient,,,698,,NONE,NONE,,698,,,,698,698,other,not separately reimbursable by contracted payers
MUCUS CLEARING DEVICE - IP,270,RC,inpatient,,,1272,,NONE,NONE,,1272,,,,1272,1272,other,not separately reimbursable by contracted payers
OT INDIV TREAT 15 MIN - IP,430,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
OVERNIGHT OXIMETRY - IP,460,RC,inpatient,,,637,,NONE,NONE,,637,,,,637,637,other,not separately reimbursable by contracted payers
OXIMETER MON-1/2 DAY - IP,460,RC,inpatient,,,321,,NONE,NONE,,321,,,,321,321,other,not separately reimbursable by contracted payers
PT INDIV TREATMENT 15 MIN - IP,420,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
RESP EVALUATION - IP,410,RC,inpatient,,,130,,NONE,NONE,,130,,,,130,130,other,not separately reimbursable by contracted payers
SMOKING CESSATION > 10 MIN - IP,942,RC,inpatient,,,105,,NONE,NONE,,105,,,,105,105,other,not separately reimbursable by contracted payers
SMOKING CESSATION 3-10 MIN - IP,942,RC,inpatient,,,79,,NONE,NONE,,79,,,,79,79,other,not separately reimbursable by contracted payers
ST INDIV TREAT 15 MIN - IP,440,RC,inpatient,,,109,,NONE,NONE,,109,,,,109,109,other,not separately reimbursable by contracted payers
TILT TABLE - IP,420,RC,inpatient,,,39,,NONE,NONE,,39,,,,39,39,other,not separately reimbursable by contracted payers
ULTRASOUND - IP,430,RC,inpatient,,,121,,NONE,NONE,,121,,,,121,121,other,not separately reimbursable by contracted payers
VITAL CAPACITY - IP,460,RC,inpatient,,,144,,NONE,NONE,,144,,,,144,144,other,not separately reimbursable by contracted payers
WOUND VAC MACHINE RENTAL - IP,270,RC,inpatient,,,430,,NONE,NONE,,430,,,,430,430,other,not separately reimbursable by contracted payers
DRY NEEDLING 1 OR 2 MUSCLES - OP,20560,CPT,outpatient,,,103,110,NONE,NONE,"GP,GO",103,,,,103,103,per diem,
DRY NEEDLING 3 OR MORE MUSCLES - OP,20561,CPT,outpatient,,,115,110,NONE,NONE,"GP,GO",115,,,,115,115,per diem,
DRIVE ASSESSMENT OFF ROAD - OP,439,RC,outpatient,,,250,250,SELF PAY,SELF PAY,,250,,,,250,250,other,cash based service - no negotiated rates
DRIVE ASSESSMENT ON ROAD - OP,439,RC,outpatient,,,250,250,SELF PAY,SELF PAY,,250,,,,250,250,other,cash based service - no negotiated rates
DRIVE EQUIP CHECK 30 MINUTES - OP,439,RC,outpatient,,,70,70,SELF PAY,SELF PAY,,70,,,,70,70,other,cash based service - no negotiated rates
DRIVE EQUIP CHECK 60 MINS - OP,439,RC,outpatient,,,140,140,SELF PAY,SELF PAY,,140,,,,140,140,other,cash based service - no negotiated rates
DRIVE EQUIP CHECK 90 MINUTES - OP,439,RC,outpatient,,,210,210,SELF PAY,SELF PAY,,210,,,,210,210,other,cash based service - no negotiated rates
DRIVE EVAL EXTENDED 120 MIN - OP,439,RC,outpatient,,,300,300,SELF PAY,SELF PAY,,300,,,,300,300,other,cash based service - no negotiated rates
DRIVE EVAL EXTENDED 60 MIN - OP,439,RC,outpatient,,,150,150,SELF PAY,SELF PAY,,150,,,,150,150,other,cash based service - no negotiated rates
DRIVE EVAL EXTENDED 90 MIN - OP,439,RC,outpatient,,,225,225,SELF PAY,SELF PAY,,225,,,,225,225,other,cash based service - no negotiated rates
DRIVE TRAINING 120 - OP,439,RC,outpatient,,,280,280,SELF PAY,SELF PAY,,280,,,,280,280,other,cash based service - no negotiated rates
DRIVE TRAINING 60 - OP,439,RC,outpatient,,,140,140,SELF PAY,SELF PAY,,140,,,,140,140,other,cash based service - no negotiated rates
DRIVE TRAINING 90 - OP,439,RC,outpatient,,,210,210,SELF PAY,SELF PAY,,210,,,,210,210,other,cash based service - no negotiated rates
DRIVE VAN RENTAL FEE - OP,439,RC,outpatient,,,80,80,SELF PAY,SELF PAY,,80,,,,80,80,other,cash based service - no negotiated rates
DRIVE VAN TRANSP ASSMNT 2HR - OP,439,RC,outpatient,,,300,300,SELF PAY,SELF PAY,,300,,,,300,300,other,cash based service - no negotiated rates
DRIVING EVAL - OP,439,RC,outpatient,,,600,600,SELF PAY,SELF PAY,,600,,,,600,600,other,cash based service - no negotiated rates
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,United Healthcare Commercial,United Healthcare Commercial,,20.06,74.3,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,United Healthcare Commercial,United Healthcare Commercial,,4126.62,74.3,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,United Healthcare Commercial,United Healthcare Commercial,,4126.62,74.3,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,United Healthcare Commercial,United Healthcare Commercial,,540.9,74.3,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,United Healthcare Commercial,United Healthcare Commercial,,296.46,74.3,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,United Healthcare Commercial,United Healthcare Commercial,,228.1,74.3,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,United Healthcare Commercial,United Healthcare Commercial,,505.24,74.3,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,United Healthcare Commercial,United Healthcare Commercial,,526.79,74.3,,,311.96,526.79,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,United Healthcare Commercial,United Healthcare Commercial,,62.41,74.3,,,36.96,62.41,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,United Healthcare Commercial,United Healthcare Commercial,,6.69,74.3,,,3.96,6.69,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,United Healthcare Commercial,United Healthcare Commercial,,181.29,74.3,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,United Healthcare Commercial,United Healthcare Commercial,,530.5,74.3,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,United Healthcare Commercial,United Healthcare Commercial,,530.5,74.3,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,United Healthcare Commercial,United Healthcare Commercial,,266.74,74.3,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,United Healthcare Commercial,United Healthcare Commercial,,266.74,74.3,,,157.96,266.74,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,4.4,44,,,4.4,7.43,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,United Healthcare Commercial,United Healthcare Commercial,,220.67,74.3,,,130.68,220.67,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,United Healthcare Commercial,United Healthcare Commercial,,914.63,74.3,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,United Healthcare Commercial,United Healthcare Commercial,,530.5,74.3,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,United Healthcare Commercial,United Healthcare Commercial,,530.5,74.3,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,United Healthcare Commercial,United Healthcare Commercial,,343.27,74.3,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,United Healthcare Commercial,United Healthcare Commercial,,25.26,74.3,,,14.96,25.26,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,United Healthcare Commercial,United Healthcare Commercial,,23.03,74.3,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,United Healthcare Commercial,United Healthcare Commercial,,382.65,74.3,,,226.6,382.65,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,United Healthcare Commercial,United Healthcare Commercial,,1197.72,74.3,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,United Healthcare Commercial,United Healthcare Commercial,,757.12,74.3,,,448.36,757.12,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,4.4,44,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Aetna Commercial Products,Aetna Commercial Products,,6.93,69.3,,,4.4,7.43,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,United Healthcare Commercial,United Healthcare Commercial,,830.67,74.3,,,491.92,830.67,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,United Healthcare Commercial,United Healthcare Commercial,,283.83,74.3,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,United Healthcare Commercial,United Healthcare Commercial,,30.46,74.3,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,United Healthcare Commercial,United Healthcare Commercial,,34.92,74.3,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,United Healthcare Commercial,United Healthcare Commercial,,219.93,74.3,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,United Healthcare Commercial,United Healthcare Commercial,,1063.23,74.3,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,United Healthcare Commercial,United Healthcare Commercial,,250.39,74.3,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,United Healthcare Commercial,United Healthcare Commercial,,92.13,74.3,,,54.56,92.13,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Aetna Commercial Products,Aetna Commercial Products,,6.93,69.3,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.64,46.39,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,4.64,46.39,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,5.26,52.56,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,5.26,52.56,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,CIGNA Commercial,CIGNA Commercial,,4.62,46.2,,,4.4,7.43,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,United Healthcare Commercial,United Healthcare Commercial,,4.46,74.3,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,United Healthcare Commercial,United Healthcare Commercial,,368.53,74.3,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,United Healthcare Commercial,United Healthcare Commercial,,498.55,74.3,,,295.24,498.55,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,United Healthcare Commercial,United Healthcare Commercial,,4.46,74.3,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,United Healthcare Commercial,United Healthcare Commercial,,498.55,74.3,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,United Healthcare Commercial,United Healthcare Commercial,,498.55,74.3,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,United Healthcare Commercial,United Healthcare Commercial,,72.07,74.3,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,United Healthcare Commercial,United Healthcare Commercial,,890.86,74.3,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,United Healthcare Commercial,United Healthcare Commercial,,8806.04,74.3,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,United Healthcare Commercial,United Healthcare Commercial,,9.66,74.3,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,United Healthcare Commercial,United Healthcare Commercial,,139.68,74.3,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,United Healthcare Commercial,United Healthcare Commercial,,222.9,74.3,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,United Healthcare Commercial,United Healthcare Commercial,,84.7,74.3,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,United Healthcare Commercial,United Healthcare Commercial,,327.66,74.3,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,United Healthcare Commercial,United Healthcare Commercial,,4.46,74.3,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,United Healthcare Commercial,United Healthcare Commercial,,6.69,74.3,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,United Healthcare Commercial,United Healthcare Commercial,,320.98,74.3,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,United Healthcare Commercial,United Healthcare Commercial,,8.92,74.3,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,United Healthcare Commercial,United Healthcare Commercial,,76.53,74.3,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,United Healthcare Commercial,United Healthcare Commercial,,393.05,74.3,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,United Healthcare Commercial,United Healthcare Commercial,,5818.43,74.3,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,United Healthcare Commercial,United Healthcare Commercial,,6278.35,74.3,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,United Healthcare Commercial,United Healthcare Commercial,,553.54,74.3,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,United Healthcare Commercial,United Healthcare Commercial,,7567.46,74.3,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,United Healthcare Commercial,United Healthcare Commercial,,13344.28,74.3,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,United Healthcare Commercial,United Healthcare Commercial,,13344.28,74.3,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,United Healthcare Commercial,United Healthcare Commercial,,422.77,74.3,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,United Healthcare Commercial,United Healthcare Commercial,,844.79,74.3,,,500.28,844.79,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,CIGNA Commercial,CIGNA Commercial,,4.62,46.2,,,4.4,7.43,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,United Healthcare Commercial,United Healthcare Commercial,,11.15,74.3,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,United Healthcare Commercial,United Healthcare Commercial,,11.15,74.3,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,United Healthcare Commercial,United Healthcare Commercial,,6242.69,74.3,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,United Healthcare Commercial,United Healthcare Commercial,,1063.23,74.3,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,United Healthcare Commercial,United Healthcare Commercial,,1063.23,74.3,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,United Healthcare Commercial,United Healthcare Commercial,,657.56,74.3,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,United Healthcare Commercial,United Healthcare Commercial,,837.36,74.3,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,United Healthcare Commercial,United Healthcare Commercial,,584.74,74.3,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,United Healthcare Commercial,United Healthcare Commercial,,46.07,74.3,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,United Healthcare Commercial,United Healthcare Commercial,,837.36,74.3,,,495.88,837.36,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,United Healthcare Commercial,United Healthcare Commercial,,34.92,74.3,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,United Healthcare Commercial,United Healthcare Commercial,,63.16,74.3,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,United Healthcare Commercial,United Healthcare Commercial,,303.14,74.3,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,United Healthcare Commercial,United Healthcare Commercial,,907.95,74.3,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,United Healthcare Commercial,United Healthcare Commercial,,257.82,74.3,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,United Healthcare Commercial,United Healthcare Commercial,,130.77,74.3,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,United Healthcare Commercial,United Healthcare Commercial,,104.76,74.3,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,United Healthcare Commercial,United Healthcare Commercial,,206.55,74.3,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,United Healthcare Commercial,United Healthcare Commercial,,156.03,74.3,,,92.4,156.03,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,United Healthcare Commercial,United Healthcare Commercial,,6.69,74.3,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,United Healthcare Commercial,United Healthcare Commercial,,828.45,74.3,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,United Healthcare Commercial,United Healthcare Commercial,,193.18,74.3,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,United Healthcare Commercial,United Healthcare Commercial,,91.39,74.3,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,United Healthcare Commercial,United Healthcare Commercial,,117.39,74.3,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,United Healthcare Commercial,United Healthcare Commercial,,141.91,74.3,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,United Healthcare Commercial,United Healthcare Commercial,,167.92,74.3,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,United Healthcare Commercial,United Healthcare Commercial,,7340.84,74.3,,,4347.2,7340.84,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,United Healthcare Commercial,United Healthcare Commercial,,459.17,74.3,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,United Healthcare Commercial,United Healthcare Commercial,,1129.36,74.3,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,United Healthcare Commercial,United Healthcare Commercial,,454.72,74.3,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,United Healthcare Commercial,United Healthcare Commercial,,223.64,74.3,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,United Healthcare Commercial,United Healthcare Commercial,,296.46,74.3,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,United Healthcare Commercial,United Healthcare Commercial,,52.01,74.3,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,United Healthcare Commercial,United Healthcare Commercial,,200.61,74.3,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,United Healthcare Commercial,United Healthcare Commercial,,52.01,74.3,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,United Healthcare Commercial,United Healthcare Commercial,,52.01,74.3,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,United Healthcare Commercial,United Healthcare Commercial,,52.01,74.3,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,United Healthcare Commercial,United Healthcare Commercial,,40.87,74.3,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,United Healthcare Commercial,United Healthcare Commercial,,13.37,74.3,,,7.92,13.37,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,United Healthcare Commercial,United Healthcare Commercial,,852.22,74.3,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,United Healthcare Commercial,United Healthcare Commercial,,852.22,74.3,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,United Healthcare Commercial,United Healthcare Commercial,,584.74,74.3,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,United Healthcare Commercial,United Healthcare Commercial,,5.94,74.3,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,United Healthcare Commercial,United Healthcare Commercial,,7.43,74.3,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,United Healthcare Commercial,United Healthcare Commercial,,4.46,74.3,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,United Healthcare Commercial,United Healthcare Commercial,,11.15,74.3,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,United Healthcare Commercial,United Healthcare Commercial,,4591.74,74.3,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,United Healthcare Commercial,United Healthcare Commercial,,12244.64,74.3,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,United Healthcare Commercial,United Healthcare Commercial,,6242.69,74.3,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,United Healthcare Commercial,United Healthcare Commercial,,23.78,74.3,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,United Healthcare Commercial,United Healthcare Commercial,,534.96,74.3,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,United Healthcare Commercial,United Healthcare Commercial,,523.82,74.3,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,United Healthcare Commercial,United Healthcare Commercial,,757.12,74.3,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,United Healthcare Commercial,United Healthcare Commercial,,529.76,74.3,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,United Healthcare Commercial,United Healthcare Commercial,,368.53,74.3,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,United Healthcare Commercial,United Healthcare Commercial,,907.95,74.3,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,United Healthcare Commercial,United Healthcare Commercial,,539.42,74.3,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,United Healthcare Commercial,United Healthcare Commercial,,1066.21,74.3,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,United Healthcare Commercial,United Healthcare Commercial,,539.42,74.3,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,United Healthcare Commercial,United Healthcare Commercial,,657.56,74.3,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,United Healthcare Commercial,United Healthcare Commercial,,657.56,74.3,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,United Healthcare Commercial,United Healthcare Commercial,,757.12,74.3,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,United Healthcare Commercial,United Healthcare Commercial,,837.36,74.3,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,United Healthcare Commercial,United Healthcare Commercial,,679.1,74.3,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,United Healthcare Commercial,United Healthcare Commercial,,757.12,74.3,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,United Healthcare Commercial,United Healthcare Commercial,,904.97,74.3,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,United Healthcare Commercial,United Healthcare Commercial,,375.96,74.3,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,United Healthcare Commercial,United Healthcare Commercial,,71.33,74.3,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,United Healthcare Commercial,United Healthcare Commercial,,914.63,74.3,,,541.64,914.63,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,22.44,51,,,19.36,32.69,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,27.21,61.84,,,19.36,32.69,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,United Healthcare Commercial,United Healthcare Commercial,,13.37,74.3,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,United Healthcare Commercial,United Healthcare Commercial,,31.95,74.3,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,United Healthcare Commercial,United Healthcare Commercial,,241.48,74.3,,,143,241.48,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Tufts Health Direct , Tufts Health Direct ,,19.8,45,,,19.36,32.69,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,United Healthcare Commercial,United Healthcare Commercial,,114.42,74.3,,,67.76,114.42,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,United Healthcare Commercial,United Healthcare Commercial,,7.43,74.3,,,4.4,7.43,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,United Healthcare Commercial,United Healthcare Commercial,,566.91,74.3,,,335.72,566.91,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,19.36,44,,,19.36,32.69,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,United Healthcare Commercial,United Healthcare Commercial,,7.43,74.3,,,4.4,7.43,percent of total billed charges,
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,364,50,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,153.5,50,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,340,50,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,354.5,50,,,311.96,526.79,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Aetna Commercial Products,Aetna Commercial Products,,30.49,69.3,,,19.36,32.69,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,42,50,,,36.96,62.41,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,20.41,46.39,,,19.36,32.69,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,23.13,52.56,,,19.36,32.69,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,CIGNA Commercial,CIGNA Commercial,,20.33,46.2,,,19.36,32.69,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,122,50,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,148.5,50,,,130.68,220.67,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,United Healthcare Commercial,United Healthcare Commercial,,32.69,74.3,,,19.36,32.69,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
SENSORCAINE MPG 0.5% 10ML - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,231,50,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,15.81,51,,,13.64,23.03,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,17,50,,,14.96,25.26,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,19.17,61.84,,,13.64,23.03,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,257.5,50,,,226.6,382.65,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05, Tufts Health Direct , Tufts Health Direct ,,13.95,45,,,13.64,23.03,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,806,50,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
DEXAMETHASONE PER MG (10mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,13.64,44,,,13.64,23.03,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,559,50,,,491.92,830.67,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,Aetna Commercial Products,Aetna Commercial Products,,21.48,69.3,,,13.64,23.03,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,14.38,46.39,,,13.64,23.03,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,191,50,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,20.5,50,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,148,50,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,16.29,52.56,,,13.64,23.03,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,CIGNA Commercial,CIGNA Commercial,,14.32,46.2,,,13.64,23.03,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,168.5,50,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,62,50,,,54.56,92.13,percent of total billed charges,
DEXAMETHASONE PER MG (4mg/ml) - PAIN CL,J1100,HCPCS,outpatient,1,EA,10,5.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.89,51,,,17.16,28.98,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,24.12,61.84,,,17.16,28.98,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45, Tufts Health Direct , Tufts Health Direct ,,17.55,45,,,17.16,28.98,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,17.16,44,,,17.16,28.98,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,Aetna Commercial Products,Aetna Commercial Products,,27.03,69.3,,,17.16,28.98,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,United Healthcare Commercial,United Healthcare Commercial,,23.03,74.3,,,13.64,23.03,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,48.5,50,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,599.5,50,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,5926,50,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,6.5,50,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,94,50,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,150,50,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,57,50,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,220.5,50,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,216,50,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,51.5,50,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,264.5,50,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3915.5,50,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4225,50,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,372.5,50,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,5092.5,50,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,284.5,50,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,568.5,50,,,500.28,844.79,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
TRAMADOL 50MG TAB - PAIN CL,51079099120,NDC,outpatient,1,EA,31,17.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,32.64,51,,,28.16,47.55,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,39.58,61.84,,,28.16,47.55,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,18.09,46.39,,,17.16,28.98,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,31,50,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,20.5,52.56,,,17.16,28.98,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2, Tufts Health Direct , Tufts Health Direct ,,28.8,45,,,28.16,47.55,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,28.16,44,,,28.16,47.55,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,CIGNA Commercial,CIGNA Commercial,,18.02,46.2,,,17.16,28.98,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,Aetna Commercial Products,Aetna Commercial Products,,44.35,69.3,,,28.16,47.55,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,42.5,50,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,204,50,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,173.5,50,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,88,50,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,70.5,50,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,139,50,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,105,50,,,92.4,156.03,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,29.69,46.39,,,28.16,47.55,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,557.5,50,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,130,50,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,61.5,50,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,79,50,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,95.5,50,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,113,50,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4940,50,,,4347.2,7340.84,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,33.64,52.56,,,28.16,47.55,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,CIGNA Commercial,CIGNA Commercial,,29.57,46.2,,,28.16,47.55,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,309,50,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,760,50,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,306,50,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,150.5,50,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,135,50,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,27.5,50,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4,50,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,3090,50,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,8240,50,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,360,50,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,352.5,50,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,356.5,50,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,717.5,50,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,609,50,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,48,50,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,United Healthcare Commercial,United Healthcare Commercial,,47.55,74.3,,,28.16,47.55,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
TRIAMCINALONE 40 MG/ML VIAL - PAIN CL,00003029305 ,NDC,outpatient,1,EA,64,35.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,162.5,50,,,143,241.48,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,77,50,,,67.76,114.42,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,381.5,50,,,335.72,566.91,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,United Healthcare Commercial,United Healthcare Commercial,,28.98,74.3,,,17.16,28.98,percent of total billed charges,
Inpatient Rehab Per Diem Level 1,118; 120; 128; 138; 148; 158,RC,inpatient,,,,1375,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,1050,,,,1000,1732.5,per diem,per diem rate for negotiated single case agreement
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Cc,MS-560,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue With Mcc,MS-559,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Aftercare- Musculoskeletal System And Connective Tissue Without Cc/Mcc,MS-561,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Aftercare With Cc/Mcc,MS-949,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Aftercare Without Cc/Mcc,MS-950,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies With Mcc,MS-553,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Bone Diseases And Arthropathies Without Mcc,MS-554,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Cellulitis With Mcc,MS-602,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Cellulitis Without Mcc,MS-603,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Cc,MS-191,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease With Mcc,MS-190,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Chronic Obstructive Pulmonary Disease Without Cc/Mcc,MS-192,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Cc,MS-546,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Connective Tissue Disorders With Mcc,MS-545,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Connective Tissue Disorders Without Cc/Mcc,MS-547,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders With Mcc,MS-056,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Degenerative Nervous System Disorders Without Mcc,MS-057,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Cc,MS-442,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis With Mcc,MS-441,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Disorders Of Liver Except Malignancy- Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc,MS-443,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,MS-065,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction With Mcc,MS-064,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,MS-066,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Medical Back Problems With Mcc,MS-551,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Medical Back Problems Without Mcc,MS-552,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders With Cc,MS-071,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Nonspecific Cerebrovascular Disorders Without Cc/Mcc,MS-072,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Osteomyelitis With Cc,MS-540,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Osteomyelitis With Mcc,MS-539,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Osteomyelitis Without Cc/Mcc,MS-541,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Cc,MS-092,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System With Mcc,MS-091,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Other Disorders Of Nervous System Without Cc/Mcc,MS-093,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Rehabilitation With Cc/Mcc,MS-945,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Rehabilitation Without Cc/Mcc,MS-946,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,MS-555,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,MS-556,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries With Cc/Mcc,MS-052,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Spinal Disorders And Injuries Without Cc/Mcc,MS-053,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis With Mcc,MS-557,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
Inpatient Rehab Per Discharge: Tendonitis- Myositis And Bursitis Without Mcc,MS-558,MS-DRG,inpatient,,,,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15737.43,,,,15428.86,15737.43,case rate,
#2 SIV W/FLUIDS - PAIN CL,272,RC,outpatient,,,27,14.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,13.5,50,,,11.88,20.06,percent of total billed charges,
10/2 EXPRESS FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
15/3 EXPANDER ADD FRACT KIT - PAIN CL,272,RC,outpatient,,,5554,3054.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,2777,50,,,2443.76,4126.62,percent of total billed charges,
7.0mm EXPRESS KIT - PAIN CL,272,RC,outpatient,,,728,400.4,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,364,50,,,320.32,540.9,percent of total billed charges,
8.0mm T-TIP - PAIN CL,272,RC,outpatient,,,399,219.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
ANALYSIS NEUROSTIM NO REPROGRA - PAIN CL,95970,CPT,outpatient,,,307,168.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,153.5,50,,,135.08,228.1,percent of total billed charges,
ANALYSIS PUMP W/ REPROGRAMMING - PAIN CL,62368,CPT,outpatient,,,680,374,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,340,50,,,299.2,505.24,percent of total billed charges,
"ANALYSIS PUMP,REPROG & REFILL - PAIN CL",62369,CPT,outpatient,,,709,389.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,354.5,50,,,311.96,526.79,percent of total billed charges,
ARROW CATH KIT - PAIN CL,C1755,HCPCS,outpatient,,,84,46.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,42,50,,,36.96,62.41,percent of total billed charges,
BASIC SET - PAIN CL,272,RC,outpatient,,,9,4.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
BONE BIOPSY DEVICE - PAIN CL,272,RC,outpatient,,,244,134.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,122,50,,,107.36,181.29,percent of total billed charges,
BOTOX 1 EXTREM/1-4 MUSC - PAIN CL,64642,CPT,outpatient,,,714,392.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX 1 EXTREM; 5+ MUSCLES - PAIN CL,64644,CPT,outpatient,,,714,392.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
BOTOX EA ADD EXTREM;1-4MUSC - PAIN CL,64643,CPT,outpatient,,,359,197.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
BOTOX EACH ADD EXTRMT 5+ - PAIN CL,64645,CPT,outpatient,,,359,197.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,179.5,50,,,157.96,266.74,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
BREVI KATH MINIKIT - PAIN CL,272,RC,outpatient,,,297,163.35,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,148.5,50,,,130.68,220.67,percent of total billed charges,
CADWELL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
CER/THOR TRANS ADDITIONAL LVL - PAIN CL,64480,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CERV/THOR ESI W/FLOUROSCOPY - PAIN CL,62321,CPT,outpatient,,,1231,677.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
CERV/THOR TRANSFORAMINAL - PAIN CL,64479,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 1-5,64646,CPT,outpatient,,,714,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMO OF TRUNK MUSCLES: 6+,64647,CPT,outpatient,,,714,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,357,50,,,314.16,530.5,percent of total billed charges,
CHEMODENERV ECCRINE GLANS - PAIN CL,64650,CPT,outpatient,,,462,254.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,231,50,,,203.28,343.27,percent of total billed charges,
CHIBA NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
COAGUCHECK - PAIN CL,85730,CPT,outpatient,,,34,18.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,17,50,,,14.96,25.26,percent of total billed charges,
CONTIPLEX CONT NB SET - PAIN CL,272,RC,outpatient,,,31,17.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,15.5,50,,,13.64,23.03,percent of total billed charges,
CURETTE - PAIN CL,272,RC,outpatient,,,515,283.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,257.5,50,,,226.6,382.65,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,22.44,51,,,19.36,32.69,percent of total billed charges,
DEST GENI NRV BR W/G NEUR AGT,64624,CPT,outpatient,,,1612,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,806,50,,,709.28,1197.72,percent of total billed charges,
DESTRUCTION BY NEUROLTIC AGENT CELIAC PLEXUS,64680,CPT,outpatient,,,1019,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
ZOFRAN IV 1mg - PAIN CL,J2405,HCPCS,outpatient,1,EA,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,19.38,51,,,16.72,28.23,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,27.21,61.84,,,19.36,32.69,percent of total billed charges,
DISCGRPHY PRSUR MNTR INJECTOR - PAIN CL,272,RC,outpatient,,,1118,614.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,559,50,,,491.92,830.67,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Tufts Health Direct , Tufts Health Direct ,,19.8,45,,,19.36,32.69,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,19.36,44,,,19.36,32.69,percent of total billed charges,
EPIDUROGRAPHY SUPERVISION/REPO - PAIN CL,72275,CPT,outpatient,,,382,210.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,191,50,,,168.08,283.83,percent of total billed charges,
ESI TRAY - PAIN CL,272,RC,outpatient,,,41,22.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,20.5,50,,,18.04,30.46,percent of total billed charges,
ESTIM GUIDANCE - PAIN CL,95873,CPT,outpatient,,,47,25.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
EXPRESS BONE BIOPSY - PAIN CL,272,RC,outpatient,,,296,162.8,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,148,50,,,130.24,219.93,percent of total billed charges,
FACET CYST ASPIRATION/RUPTURE,64999,CPT,outpatient,,,1431,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
FEMORAL/LAT. FEM NB - PAIN CL,64447,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Aetna Commercial Products,Aetna Commercial Products,,30.49,69.3,,,19.36,32.69,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,20.41,46.39,,,19.36,32.69,percent of total billed charges,
FLUOROSCOPY (NEEDLE PLAC. INJ) - PAIN CL,77002,CPT,outpatient,,,337,185.35,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,168.5,50,,,148.28,250.39,percent of total billed charges,
FLUORSCOPY SPINE/PARASPINOUS - PAIN CL,77003,CPT,outpatient,,,124,68.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,62,50,,,54.56,92.13,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,23.5,61.84,,,16.72,28.23,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9, Tufts Health Direct , Tufts Health Direct ,,17.1,45,,,16.72,28.23,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,16.72,44,,,16.72,28.23,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,Aetna Commercial Products,Aetna Commercial Products,,26.33,69.3,,,16.72,28.23,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,17.63,46.39,,,16.72,28.23,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,19.97,52.56,,,16.72,28.23,percent of total billed charges,
GLUCOMETER - PAIN CL,82962,CPT,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,23.13,52.56,,,19.36,32.69,percent of total billed charges,
ICE PACK - PAIN CL,271,RC,outpatient,,,6,3.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ CHRONIC MIGRAINE - PAIN CL,64615,CPT,outpatient,,,496,272.8,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
INJ GENICULAR NERVE BRANCH W/G,64454,CPT,outpatient,,,914,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
INJ MAJOR JOIN/BURSA - PAIN CL,20611,CPT,outpatient,,,671,369.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,CIGNA Commercial,CIGNA Commercial,,20.33,46.2,,,19.36,32.69,percent of total billed charges,
INJECTION SITE - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
INJ-INTERMEDIATE JONIT/BURSA- PAIN CL,20606,CPT,outpatient,,,671,369.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
INJ-SMALL JOINT/BURSA - PAIN CL,20604,CPT,outpatient,,,671,369.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,335.5,50,,,295.24,498.55,percent of total billed charges,
Insulator Needle-Any Size - PAIN CL,272,RC,outpatient,,,97,53.35,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,48.5,50,,,42.68,72.07,percent of total billed charges,
INTRACEPT EACH ADDL VB KIT > 2,278,RC,outpatient,,,1199,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,599.5,50,,,527.56,890.86,percent of total billed charges,
INTRACEPT PROC KITS,278,RC,outpatient,,,11852,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,5926,50,,,5214.88,8806.04,percent of total billed charges,
IOBAN - PAIN CL,271,RC,outpatient,,,13,7.15,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,6.5,50,,,5.72,9.66,percent of total billed charges,
IV CONSC SEDAT 1ST 15 MINUTES - PAIN CL,99152,CPT,outpatient,,,188,103.4,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,94,50,,,82.72,139.68,percent of total billed charges,
IV CONSC SEDAT 1ST 30MIN - PAIN CL,99144,CPT,outpatient,,,300,165,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,150,50,,,132,222.9,percent of total billed charges,
IV CONSC SEDAT EACH ADD 15MIN - PAIN CL,99145,CPT,outpatient,,,114,62.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,57,50,,,50.16,84.7,percent of total billed charges,
IV CONSCIOUS SEDATION - PAIN CL,99153,CPT,outpatient,,,441,242.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,220.5,50,,,194.04,327.66,percent of total billed charges,
IV FLUIDS - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
IV NEEDLE - PAIN CL,272,RC,outpatient,,,9,4.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
IV PUSH INITIAL - PAIN CL,96374,CPT,outpatient,,,432,237.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,216,50,,,190.08,320.98,percent of total billed charges,
KELLY STERILE - PAIN CL,272,RC,outpatient,,,12,6.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,6,50,,,5.28,8.92,percent of total billed charges,
KYPHO CEMENT CARTRIDGES - PAIN CL,272,RC,outpatient,,,103,56.65,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,51.5,50,,,45.32,76.53,percent of total billed charges,
KYPHO GUN AND BONE FILLER - PAIN CL,272,RC,outpatient,,,529,290.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,264.5,50,,,232.76,393.05,percent of total billed charges,
KYPHO KIT W/CEMENT KEX102EBCD - PAIN CL,272,RC,outpatient,,,7831,4307.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3915.5,50,,,3445.64,5818.43,percent of total billed charges,
KYPHO KIT W/CEMENT SYSTEM - PAIN CL,272,RC,outpatient,,,8450,4647.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4225,50,,,3718,6278.35,percent of total billed charges,
KYPHON ASSIST DIRECT CANNULA,272,RC,outpatient,,,745,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,372.5,50,,,327.8,553.54,percent of total billed charges,
KYPHOPLASTY ADDIT'L SITE EA - PAIN CL,22515,CPT,outpatient,,,10185,5601.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,5092.5,50,,,4481.4,7567.46,percent of total billed charges,
KYPHOPLASTY LUMBAR - PAIN CL,22514,CPT,outpatient,,,17960,9878,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
KYPHOPLASTY-THORACIC - PAIN CL,22513,CPT,outpatient,,,17960,9878,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,8980,50,,,7902.4,13344.28,percent of total billed charges,
LEAD 1 -  ACCESSORY KIT - PAIN CL,C1897,HCPCS,outpatient,,,569,312.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,284.5,50,,,250.36,422.77,percent of total billed charges,
LEAD 2 - TWO LEAD TRIAL KIT - PAIN CL,C1897,HCPCS,outpatient,,,1137,625.35,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,568.5,50,,,500.28,844.79,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,United Healthcare Commercial,United Healthcare Commercial,,32.69,74.3,,,19.36,32.69,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
VALIUM SMGM 1M - PAIN CL,250,RC,outpatient,1,EA,44,24.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,22,50,,,19.36,32.69,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,CIGNA Commercial,CIGNA Commercial,,17.56,46.2,,,16.72,28.23,percent of total billed charges,
"LOCM, 150-199 mg/ml, per ML - PAIN CL",Q9965,HCPCS,outpatient,1,EA,15,8.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
"LOCM, 200-249 mg/ml PER ML - PAIN CL",Q9966,HCPCS,outpatient,1,EA,15,8.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
LUMBAR 1ST FRACT KIT - PAIN CL,272,RC,outpatient,,,8402,4621.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
LUMBAR FACET INJ 3+ LEVEL - PAIN CL,64493,CPT,outpatient,,,1431,787.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET INJ SINGLE - PAIN CL,64495,CPT,outpatient,,,1431,787.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,715.5,50,,,629.64,1063.23,percent of total billed charges,
LUMBAR FACET LEVEL 2 - PAIN CL,64494,CPT,outpatient,,,885,486.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
LUMBAR PARAV/TRANFORM ADD LV - PAIN CL,64484,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
LUMBAR PARAV/TRANSFORAM SINGLE - PAIN CL,64483,CPT,outpatient,,,1127,619.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
LUMBAR PUNCTURE DIAGNOSTIC - PAIN CL,62270,CPT,outpatient,,,787,432.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
LUMBAR PUNCTURE TRAY - PAIN CL,270,RC,outpatient,,,62,34.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,31,50,,,27.28,46.07,percent of total billed charges,
LUMBAR/CAUDAL ESI W/FLUORSCOPY - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2, Amerihealth Caritas NH Medicaid MCO , Amerihealth Caritas NH Medicaid MCO ,,32.64,51,,,28.16,47.55,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2, ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) , ANTHEM NH BCBS HMO/POS/PPO/FEP/SHOP QHP Off Exchange only/IND non QHP Off Exchange only ( (Service at HOSPITAL) ,,39.58,61.84,,,28.16,47.55,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,United Healthcare Commercial,United Healthcare Commercial,,28.23,74.3,,,16.72,28.23,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2, Tufts Health Direct , Tufts Health Direct ,,28.8,45,,,28.16,47.55,percent of total billed charges,
NEEDLE EMG GUIDANCE - PAIN CL,95874,CPT,outpatient,,,47,25.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,23.5,50,,,20.68,34.92,percent of total billed charges,
NERVE BLOCK TRAY - PAIN CL,272,RC,outpatient,,,85,46.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,42.5,50,,,37.4,63.16,percent of total billed charges,
NEURO CERV/THOR PAR EA ADD LVL - PAIN CL,64634,CPT,outpatient,,,408,224.4,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,204,50,,,179.52,303.14,percent of total billed charges,
NEUROLYTIC CERV/THOR PAR FACET - PAIN CL,64633,CPT,outpatient,,,1222,672.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
NEW PT HIGH SEVERITY LVL5 - PAIN CL,99205,CPT,outpatient,,,347,190.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,173.5,50,,,152.68,257.82,percent of total billed charges,
NEW PT LOW SEVERITY LVL2 - PAIN CL,99202,CPT,outpatient,,,176,96.8,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,88,50,,,77.44,130.77,percent of total billed charges,
NEW PT MINOR/SELF LIMITED LVL1 - PAIN CL,99201,CPT,outpatient,,,141,77.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,70.5,50,,,62.04,104.76,percent of total billed charges,
NEW PT MOD/HIGH SEVERITY LVL4 - PAIN CL,99204,CPT,outpatient,,,278,152.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,139,50,,,122.32,206.55,percent of total billed charges,
NEW PT MODERATE SEVERITY LVL3 - PAIN CL,99203,CPT,outpatient,,,210,115.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,105,50,,,92.4,156.03,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2, Tufts Health Together Massachusetts Medicaid , Tufts Health Together Massachusetts Medicaid ,,28.16,44,,,28.16,47.55,percent of total billed charges,
OMNISCAN PER ML - PAIN CL,A9579,HCPCS,outpatient,,,9,4.95,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4.5,50,,,3.96,6.69,percent of total billed charges,
ONE STEP OSTEO INTROD BEVEL - PAIN CL,272,RC,outpatient,,,1115,613.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,557.5,50,,,490.6,828.45,percent of total billed charges,
PAIN CLINIC F/U HIGH SEV LVL5 - PAIN CL,99215,CPT,outpatient,,,260,143,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,130,50,,,114.4,193.18,percent of total billed charges,
PAIN CLINIC F/U MINIMAL LVL1 - PAIN CL,99211,CPT,outpatient,,,123,67.65,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,61.5,50,,,54.12,91.39,percent of total billed charges,
PAIN CLINIC F/U MINOR SEV LVL2 - PAIN CL,99212,CPT,outpatient,,,158,86.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,79,50,,,69.52,117.39,percent of total billed charges,
PAIN CLINIC F/U MOD SERV LVL3 - PAIN CL,99213,CPT,outpatient,,,191,105.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,95.5,50,,,84.04,141.91,percent of total billed charges,
PAIN CLINIC F/U MOD/HIGH LVL4 - PAIN CL,99214,CPT,outpatient,,,226,124.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,113,50,,,99.44,167.92,percent of total billed charges,
PERCUTAN. NEUROSTIM TRIAL - PAIN CL,63650,CPT,outpatient,,,9880,5434,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4940,50,,,4347.2,7340.84,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,Aetna Commercial Products,Aetna Commercial Products,,44.35,69.3,,,28.16,47.55,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),ANTHEM  NH INDIVIDUAL QHP PLANS (Service at HOSPITAL),,29.69,46.39,,,28.16,47.55,percent of total billed charges,
PROCEDURAL NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
PUNCTURE OF RESERVOIR FOR INJ - PAIN CL,61070,CPT,outpatient,,,618,339.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,309,50,,,271.92,459.17,percent of total billed charges,
RADIO DISK LUMBAR - PAIN CL,72295,CPT,outpatient,,,1520,836,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,760,50,,,668.8,1129.36,percent of total billed charges,
RECOVERY ROOM 60 MINS - PAIN CL,710,RC,outpatient,,,612,336.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,306,50,,,269.28,454.72,percent of total billed charges,
REFILL IMPLANTED PUMP - PAIN CL,95990,CPT,outpatient,,,301,165.55,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,150.5,50,,,132.44,223.64,percent of total billed charges,
REG BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,399,219.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,199.5,50,,,175.56,296.46,percent of total billed charges,
RF CANNULA - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
"RF CANNULA, DISP - PAIN CL",272,RC,outpatient,,,270,148.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,135,50,,,118.8,200.61,percent of total billed charges,
RF CANNULA2 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA3 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF CANNULA4 - PAIN CL,272,RC,outpatient,,,70,38.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,35,50,,,30.8,52.01,percent of total billed charges,
RF GROUNDING PAD - PAIN CL,272,RC,outpatient,,,55,30.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,27.5,50,,,24.2,40.87,percent of total billed charges,
SACROILIAC JOINT INJ - PAIN CL,27096,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SALINE LOCK - PAIN CL,272,RC,outpatient,,,18,9.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),ANTHEM  NH SHOP QHP EXCHANGE PLANS (Service at HOSPITAL),,33.64,52.56,,,28.16,47.55,percent of total billed charges,
"SP, TX DRAIN OF CSF W/FL OR CT - PAIN CL",62329,CPT,outpatient,,,1147,630.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
"SP,LUMBAR DX W/FLUORO OR CT - PAIN CL",62328,CPT,outpatient,,,1147,630.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,573.5,50,,,504.68,852.22,percent of total billed charges,
SPINAL NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE2 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE3 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE4 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE5 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE6 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE7 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
SPINAL NEEDLE8 - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
"SPINAL PUNCTURE, THERAPEUTIC - PAIN CL",62272,CPT,outpatient,,,787,432.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,393.5,50,,,346.28,584.74,percent of total billed charges,
STERI-STRIPS - PAIN CL,272,RC,outpatient,,,8,4.4,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4,50,,,3.52,5.94,percent of total billed charges,
STIMUPLEX NEEDLE - PAIN CL,272,RC,outpatient,,,39,21.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19.5,50,,,17.16,28.98,percent of total billed charges,
SUP HYPOGASTRIC - PAIN CL,64517,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
SUTURE - PAIN CL,272,RC,outpatient,,,10,5.5,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,5,50,,,4.4,7.43,percent of total billed charges,
TEGADERM 4 X 4 - PAIN CL,272,RC,outpatient,,,6,3.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3,50,,,2.64,4.46,percent of total billed charges,
TEGADERM 6 X 8 - PAIN CL,272,RC,outpatient,,,15,8.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,7.5,50,,,6.6,11.15,percent of total billed charges,
THERM DEST IN BVN LW BK EA >2,64629,CPT,outpatient,,,6180,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,3090,50,,,2719.2,4591.74,percent of total billed charges,
THERM DEST IN BVN LW BK FIRST2,64628,CPT,outpatient,,,16480,,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,8240,50,,,7251.2,12244.64,percent of total billed charges,
THORACIC 1ST FRACT-NEW BALLOON - PAIN CL,272,RC,outpatient,,,8402,4621.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,4201,50,,,3696.88,6242.69,percent of total billed charges,
TOUHY NEEDLE - PAIN CL,272,RC,outpatient,,,32,17.6,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,16,50,,,14.08,23.78,percent of total billed charges,
TPI (1-2 MUSCLE GROUPS) - PAIN CL,20552,CPT,outpatient,,,720,396,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,360,50,,,316.8,534.96,percent of total billed charges,
TPI (3 OR > MUSCLE GRPS) - PAIN CL,20553,CPT,outpatient,,,705,387.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,352.5,50,,,310.2,523.82,percent of total billed charges,
TR BLOCK BRACH PLEX CATH - PAIN CL,64416,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK BRACHIAL PLEXUS SGL - PAIN CL,64415,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK CELIAC PLEXUS - PAIN CL,64530,CPT,outpatient,,,1019,560.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR BLOCK CERVICAL PLEXUS - PAIN CL,64413,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK FACIAL NERVE - PAIN CL,64612,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK GENITOFEMORAL NERVE - PAIN CL,64425,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK INTERCOSTAL NERVE - PAIN CL,64420,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK INTERCOSTAL/MULTI - PAIN CL,64421,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK OCCIPITAL NERVE - PAIN CL,64405,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR BLOCK SCIATIC NERVE - PAIN CL,64445,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK STELLATE GANG - PAIN CL,64510,CPT,outpatient,,,713,392.15,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,356.5,50,,,313.72,529.76,percent of total billed charges,
TR BLOCK SUPRASCAPULA NERVE - PAIN CL,64418,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR BLOCK-AUXILLARY NERVE - PAIN CL,64417,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR CV.SPINAL MUSCLE BOTOX INJ - PAIN CL,64616,CPT,outpatient,,,496,272.8,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,248,50,,,218.24,368.53,percent of total billed charges,
TR DESTRUC INTERCOST NE - PAIN CL,64620,CPT,outpatient,,,1222,672.1,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,611,50,,,537.68,907.95,percent of total billed charges,
TR DESTRUCT FACET NERVE - ADDL LEVEL - PAIN CL,64636,CPT,outpatient,,,726,399.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR DESTRUCT FACET NERVE - PAIN CL,64635,CPT,outpatient,,,1435,789.25,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,717.5,50,,,631.4,1066.21,percent of total billed charges,
TR DESTRUCT OTHER NERVE - PAIN CL,64640,CPT,outpatient,,,726,399.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,363,50,,,319.44,539.42,percent of total billed charges,
TR FACET INJ CER/THOR 2 LEVEL - PAIN CL,64491,CPT,outpatient,,,885,486.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR 3RD+LVL - PAIN CL,64492,CPT,outpatient,,,885,486.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,442.5,50,,,389.4,657.56,percent of total billed charges,
TR FACET JT CERV/THOR SINGLE - PAIN CL,64490,CPT,outpatient,,,1019,560.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ SUBARA DIFF/EPI LUM/CAU - PAIN CL,62323,CPT,outpatient,,,1127,619.85,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,563.5,50,,,495.88,837.36,percent of total billed charges,
TR INJ-INT JNT/BURSA/GA - PAIN CL,20605,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-LUMBAR BLOOD PATCH - PAIN CL,62273,CPT,outpatient,,,914,502.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,457,50,,,402.16,679.1,percent of total billed charges,
TR INJ-LUMBAR DISKOGRAPHY - PAIN CL,62290,CPT,outpatient,,,1019,560.45,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,509.5,50,,,448.36,757.12,percent of total billed charges,
TR INJ-MOTOR JOINT/BURSA - PAIN CL,20610,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR INJ-NEUROLYT-EPI CERV THOR - PAIN CL,62281,CPT,outpatient,,,1218,669.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,609,50,,,535.92,904.97,percent of total billed charges,
TR INJ-SMALL JNT/BURSA - PAIN CL,20600,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV DRUG INFUSION THERAPY - PAIN CL,96365,CPT,outpatient,,,506,278.3,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,253,50,,,222.64,375.96,percent of total billed charges,
TR IV INFUISION EA ADD - PAIN CL,96366,CPT,outpatient,,,96,52.8,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,48,50,,,42.24,71.33,percent of total billed charges,
TR THOR/LUMB SYMP BLOCK - PAIN CL,64520,CPT,outpatient,,,1231,677.05,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,615.5,50,,,541.64,914.63,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,CIGNA Commercial,CIGNA Commercial,,29.57,46.2,,,28.16,47.55,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,NH Healthy Families Medicaid MCO,NH Healthy Families Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,United Healthcare Commercial,United Healthcare Commercial,,47.55,74.3,,,28.16,47.55,percent of total billed charges,
ULTRASOUND NEEDLE - PAIN CL,272,RC,outpatient,,,18,9.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,9,50,,,7.92,13.37,percent of total billed charges,
UNIVERSAL TRAY - PAIN CL,272,RC,outpatient,,,43,23.65,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,21.5,50,,,18.92,31.95,percent of total billed charges,
US GUIDED NEEDLE PLACEMENT - PAIN CL,76942,CPT,outpatient,,,325,178.75,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,162.5,50,,,143,241.48,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
VERT PREP KIT - PAIN CL,272,RC,outpatient,,,154,84.7,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,77,50,,,67.76,114.42,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,Wellsense MA Medicaid MCO,Wellsense MA Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
XPEDE BONE CEMENT W/ MIXER - PAIN CL,272,RC,outpatient,,,763,419.65,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,381.5,50,,,335.72,566.91,percent of total billed charges,
XYLOCAINE 2% 10ML - PAIN CL,63323020805,NDC,outpatient,10,ML,64,35.2,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,32,50,,,28.16,47.55,percent of total billed charges,
METROCLOPRAMIDE 10MG - PAIN CL,J2765,HCPCS,outpatient,1,EA,38,20.9,Wellsense NH Medicaid MCO,Wellsense NH Medicaid MCO,,19,50,,,16.72,28.23,percent of total billed charges,
"CLINIMIX E 5%/15% 2,000 ML BAG(CLINIMIX E 5%-15% SOLUTION)",00338112304 ,NDC,inpatient,1,EA,269.15,,NONE,NONE,,269.15,,,,269.15,269.15,other,not separately reimbursable by contracted payers
ABOBOTULINUMTOXINA 500 UNIT VIAL(DYSPORT),15054050001,NDC,inpatient,1,EA,3006.5,,NONE,NONE,,3006.5,,,,3006.5,3006.5,other,not separately reimbursable by contracted payers
ACETAMINOPHEN 650 MG/20.3 ML CUP(TYLENOL),00121197100 ,NDC,inpatient,20.3,ML,7.15,,NONE,NONE,,7.15,,,,7.15,7.15,other,not separately reimbursable by contracted payers
BUTALBITAL/APAP/CAFFEINE 50/325/40MG TABLET(FIORICET 50/325/40),60687067265,NDC,inpatient,1,EA,5.75,,NONE,NONE,,5.75,,,,5.75,5.75,other,not separately reimbursable by contracted payers
ACETYLCYSTEINE 20% 200 MG/ML (4ML) VIAL(MUCOMYST),63323069404,NDC,inpatient,4,ML,55.9,,NONE,NONE,,55.9,,,,55.9,55.9,other,not separately reimbursable by contracted payers
ACETAZOLAMIDE 250 MG TABLET(DIAMOX),51672402301,NDC,inpatient,1,EA,1.25,,NONE,NONE,,1.25,,,,1.25,1.25,other,not separately reimbursable by contracted payers
ACETAMINOPHEN 325 MG TABLET(TYLENOL),50580045811,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
ACETAMINOPHEN 325 MG TABLET(TYLENOL),69618001001,NDC,inpatient,1,EA,0.05,,NONE,NONE,,0.05,,,,0.05,0.05,other,not separately reimbursable by contracted payers
ACETAMINOPHEN 650 MG SUPPOSITORY(TYLENOL),45802073030,NDC,inpatient,1,EA,1.25,,NONE,NONE,,1.25,,,,1.25,1.25,other,not separately reimbursable by contracted payers
ACYCLOVIR 5% 15GM OINTMENT(ZOVIRAX),00378870006 ,NDC,inpatient,15,GR,17.5,,NONE,NONE,,17.5,,,,17.5,17.5,other,not separately reimbursable by contracted payers
ACYCLOVIR 400 MG TABLET(ZOVIRAX),50268006115,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
OXYMETAZOLINE HCL 0.05% 30ML NASAL SPRAY(AFRIN),45802041059,NDC,inpatient,30,ML,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
ALBUTEROL HFA 90 MCG 8GM(VENTOLIN),00173068224 ,NDC,inpatient,8,GR,79.55,,NONE,NONE,,79.55,,,,79.55,79.55,other,not separately reimbursable by contracted payers
ALBUTEROL SULFATE 90 MCG(PROAIR),00173068220 ,NDC,inpatient,1,EA,22.2,,NONE,NONE,,22.2,,,,22.2,22.2,other,not separately reimbursable by contracted payers
ALBUTEROL SULFATE/IPRATROPIUM 2.5-0.5MG/3ML NEB(DUONEB 2.5-0.5 MG/3 ML),00487020103 ,NDC,inpatient,3,ML,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
ALBUMIN 25% 12.5 GRAM/50 ML VIAL(ALBUMIN),68982064301,NDC,inpatient,50,ML,200.9,,NONE,NONE,,200.9,,,,200.9,200.9,other,not separately reimbursable by contracted payers
ALENDRONATE SODIUM 70 MG TABLET(FOSAMAX),16714063301,NDC,inpatient,1,EA,4,,NONE,NONE,,4,,,,4,4,other,not separately reimbursable by contracted payers
ALLOPURINOL 100 MG TABLET(ZYLOPRIM),51079020520,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
ALLOPURINOL 300 MG TABLET(ZYLOPRIM),63739079610,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
ALPRAZOLAM 0.25 MG TABLET(XANAX),00781106101 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
ALPRAZOLAM 0.5 MG TABLET(XANAX),59762372001,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
ALPRAZOLAM 1 MG TABLET(XANAX),00781107901 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
ALTEPLASE 2 MG/VIAL(CATHFLO ACTIVASE),50242004164,NDC,inpatient,1,EA,617.25,,NONE,NONE,,617.25,,,,617.25,617.25,other,not separately reimbursable by contracted payers
AMANTADINE HCL 100 MG TABLET(SYMMETREL),00832011100 ,NDC,inpatient,1,EA,5.6,,NONE,NONE,,5.6,,,,5.6,5.6,other,not separately reimbursable by contracted payers
AMANTADINE HCL 50 MG/5 ML ORAL SYRINGE(),00121064616 ,NDC,inpatient,5,ML,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
AMIODARONE HCL 100 MG TABLET(PACERONE),00245014401 ,NDC,inpatient,1,EA,9.8,,NONE,NONE,,9.8,,,,9.8,9.8,other,not separately reimbursable by contracted payers
AMIODARONE HCL 200 MG TABLET(PACERONE),00245014701 ,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
AMITRIPTYLINE HCL 10 MG TABLET(ELAVIL),16729017101,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
AMITRIPTYLINE HCL 25 MG TABLET(ELAVIL),57664068888,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
AMITRIPTYLINE HCL 50 MG TABLET(ELAVIL),51079013320,NDC,inpatient,1,EA,2,,NONE,NONE,,2,,,,2,2,other,not separately reimbursable by contracted payers
AMLODIPINE BESYLATE 10 MG TABLET(NORVASC),00904637161 ,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
AMLODIPINE BESYLATE 5 MG TABLET(NORVASC),00904637061 ,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
AMMONIUM LACTATE 12% 226 GM LOTION(LAC-HYDRIN 12% LOTION),00904598426 ,NDC,inpatient,226,GR,13.55,,NONE,NONE,,13.55,,,,13.55,13.55,other,not separately reimbursable by contracted payers
AMOXICILLIN/POTASSIUM CLAVULANATE 250 MG/125 MG TABLET(AUGMENTIN 250-125 TABLET),00781187431 ,NDC,inpatient,1,EA,11.65,,NONE,NONE,,11.65,,,,11.65,11.65,other,not separately reimbursable by contracted payers
AMOXICILLIN/POTASSIUM CLAVULANATE 500 MG/125 MG TABLET(AUGMENTIN 500-125 TABLET),16714047701,NDC,inpatient,1,EA,2.3,,NONE,NONE,,2.3,,,,2.3,2.3,other,not separately reimbursable by contracted payers
AMOXICILLIN/POTASSIUM CLAVULANATE 875 MG/125 MG TABLET(AUGMENTIN 875-125 TABLET),16714047802,NDC,inpatient,1,EA,5.3,,NONE,NONE,,5.3,,,,5.3,5.3,other,not separately reimbursable by contracted payers
AMOXICILLIN TRIHYDRATE 250 MG CAPSULE(AMOXIL),16714029801,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
AMPHETAMINE SALTS 5 MG TABLET(ADDERALL),13107006801,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
AMPICILLIN SODIUM 1 G VIAL(PRINCIPEN),55150011310,NDC,inpatient,1,EA,17,,NONE,NONE,,17,,,,17,17,other,not separately reimbursable by contracted payers
AMPICILLIN SODIUM 2 G VIAL(PRINCIPEN),00781341392 ,NDC,inpatient,2,EA,97.3,,NONE,NONE,,97.3,,,,97.3,97.3,other,not separately reimbursable by contracted payers
ANASTROZOLE 1 MG TABLET(ARIMIDEX),16729003510,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
APIXABAN 2.5 MG TABLET(ELIQUIS),00003089321 ,NDC,inpatient,1,EA,34.7,,NONE,NONE,,34.7,,,,34.7,34.7,other,not separately reimbursable by contracted payers
APIXABAN 5 MG TABLET(ELIQUIS),00003089431 ,NDC,inpatient,1,EA,34.7,,NONE,NONE,,34.7,,,,34.7,34.7,other,not separately reimbursable by contracted payers
ARIPIPRAZOLE 10 MG TABLET(ABILIFY),65862066330,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
ARIPIPRAZOLE 5 MG TABLET(ABILIFY),16729027901,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
DEXTRAN 70/HYPROMELLOSE (NATURAL BALANCE TEARS) 15 ML(NATURAL BALANCE TEARS),57896018105,NDC,inpatient,15,ML,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
ASCORBIC ACID 500 MG TABLET(VITAMIN C),00904052361 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
ASPIRIN/DIPYRIDAMOLE 25 MG/200 MG ER CAPSULE(AGGRENOX),49884000702,NDC,inpatient,1,EA,17.5,,NONE,NONE,,17.5,,,,17.5,17.5,other,not separately reimbursable by contracted payers
ASPIRIN 325 MG TABLET(ASPIRIN),57896090101,NDC,inpatient,1,EA,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
ASPIRIN 325 MG TABLET(BAYER ASPIRIN),66553000101,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
ASPIRIN EC 325 MG TABLET(ECOTRIN),00536123201 ,NDC,inpatient,1,EA,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
ASPIRIN 81 MG CHEWABLE TABLET(BAYER LOW DOSE ASPIRIN),00904679489 ,NDC,inpatient,1,EA,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
ATENOLOL 25 MG TABLET(TENORMIN),00904718761 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
ATENOLOL 25 MG TABLET(TENORMIN),51079075920,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
ATENOLOL 50 MG TABLET(TENORMIN),51079068420,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
ATORVASTATIN CALCIUM 10 MG TABLET(LIPITOR),51079020820,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
ATORVASTATIN CALCIUM 20 MG TABLET(LIPITOR),00904629161 ,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
ATORVASTATIN CALCIUM 40 MG TABLET(LIPITOR),51079021020,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
ATOVAQUONE 750 MG/5 ML ORAL SYRINGE(MEPRON),68462042121,NDC,inpatient,5,ML,33.35,,NONE,NONE,,33.35,,,,33.35,33.35,other,not separately reimbursable by contracted payers
AZATHIOPRINE 50 MG TABLET(IMURAN),68084022901,NDC,inpatient,1,EA,2.4,,NONE,NONE,,2.4,,,,2.4,2.4,other,not separately reimbursable by contracted payers
AZITHROMYCIN 250 MG TABLET(ZITHROMAX),50111078710,NDC,inpatient,1,EA,7.5,,NONE,NONE,,7.5,,,,7.5,7.5,other,not separately reimbursable by contracted payers
"CYANOCOBALAMIN 1,000 MCG TABLET(VITAMIN B12)",77333093810,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
BACITRACIN ZINC PACKET(BACITRACIN ZINC),45802006070,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
BACLOFEN 10 MG TABLET(LIORESAL),63739047910,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
BACLOFEN 5 MG TABLET(LIORESAL),52817031910,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
SULFAMETHOXAZOLE/TRIMETH SS 400MG/80MG TABLET(BACTRIM SS),50268072815,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
BENZONATATE 100 MG CAPSULE(TESSALON),68382024701,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
BENZTROPINE MESYLATE 1 MG TABLET(COGENTIN),68084038801,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
BENZOCAINE 20% 11.9GM GEL(ORAJEL 20%),00573022567A,NDC,inpatient,11.9,GR,21.4,,NONE,NONE,,21.4,,,,21.4,21.4,other,not separately reimbursable by contracted payers
BETHANECHOL CHLORIDE 10 MG TABLET(URECHOLINE),00832051101 ,NDC,inpatient,1,EA,2.25,,NONE,NONE,,2.25,,,,2.25,2.25,other,not separately reimbursable by contracted payers
BICALUTAMIDE 50 MG TABLET(CASODEX),16714081601,NDC,inpatient,1,EA,2.5,,NONE,NONE,,2.5,,,,2.5,2.5,other,not separately reimbursable by contracted payers
BISACODYL 10 MG SUPPOSITORY(MAGIC BULLET),57648000201,NDC,inpatient,1,EA,2.25,,NONE,NONE,,2.25,,,,2.25,2.25,other,not separately reimbursable by contracted payers
BISACODYL EC 5 MG TABLET(DULCOLAX),00904640761 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
BISACODYL 10 MG SUPPOSITORY(DULCOLAX),00574705012 ,NDC,inpatient,1,EA,1.25,,NONE,NONE,,1.25,,,,1.25,1.25,other,not separately reimbursable by contracted payers
BRIMONIDINE (ALPHAGAN) 0.2% 5ML EYE DROPS(ALPHAGAN 0.2% EYE DROPS),70069023101,NDC,inpatient,5,ML,4.3,,NONE,NONE,,4.3,,,,4.3,4.3,other,not separately reimbursable by contracted payers
BUDESONIDE 0.25 MG NEB(PULMICORT),00487960101 ,NDC,inpatient,2,ML,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
BUDESONIDE 0.5 MG NEB(PULMICORT),00487970101 ,NDC,inpatient,2,ML,8.2,,NONE,NONE,,8.2,,,,8.2,8.2,other,not separately reimbursable by contracted payers
BUMETANIDE 1 MG TABLET(BUMEX),00185012901 ,NDC,inpatient,1,EA,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
BUPROPION HCL SR 100 MG TABLET(WELLBUTRIN SR),68084069701,NDC,inpatient,1,EA,2.8,,NONE,NONE,,2.8,,,,2.8,2.8,other,not separately reimbursable by contracted payers
BUPROPION HCL 100 MG TABLET(WELLBUTRIN),60505015701,NDC,inpatient,1,EA,2.5,,NONE,NONE,,2.5,,,,2.5,2.5,other,not separately reimbursable by contracted payers
BUPROPION HCL 150 MG XL TABLET(WELLBUTRIN XL),00904708461 ,NDC,inpatient,1,EA,6.5,,NONE,NONE,,6.5,,,,6.5,6.5,other,not separately reimbursable by contracted payers
BUPROPION HCL SR 150 MG TABLET(WELLBUTRIN SR),50228017501,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
BUSPIRONE HCL 5 MG TABLET(BUSPAR),51079098520,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
CALCITRIOL 0.25 MCG CAPSULE(ROCALTROL),64380072306,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
CALCIUM CARBONATE 1.25 G TABLET(CALCIUM CARBONATE),51645082799,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
CALCIUM CARBONATE 500 MG TABLET(TUMS PEPPERMINT),00536104815 ,NDC,inpatient,1,EA,0.05,,NONE,NONE,,0.05,,,,0.05,0.05,other,not separately reimbursable by contracted payers
CALCIUM CARBONATE 500 MG CHEWABLE TABLET(TUMS CHEWABLE),66553000401,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
CALCIUM ACETATE 667 MG CAPSULE(PHOSLO),00781208102 ,NDC,inpatient,1,EA,2.25,,NONE,NONE,,2.25,,,,2.25,2.25,other,not separately reimbursable by contracted payers
CAPTOPRIL 25 MG TABLET(CAPOTEN),27241016101,NDC,inpatient,1,EA,3,,NONE,NONE,,3,,,,3,3,other,not separately reimbursable by contracted payers
CARBAMIDE PEROXIDE 6.5% 15ML OTIC DROPS(DEBROX EAR DROPS),00904662735 ,NDC,inpatient,15,ML,6.65,,NONE,NONE,,6.65,,,,6.65,6.65,other,not separately reimbursable by contracted payers
CARBIDOPA/LEVODOPA 10 MG/100 MG TABLET(SINEMET 10 MG/100 MG),62756051788,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
CARBIDOPA/LEVODOPA 25MG/100MG TABLET(SINEMET 25/100 MG),60687066101,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
CARBIDOPA/LEVODOPA CR 25 MG/100 MG TABLET(SINEMET CR 25 MG/100 MG),51079097820,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
CARBAMAZEPINE 200 MG TABLET(TEGRETOL),00904617261 ,NDC,inpatient,1,EA,3.15,,NONE,NONE,,3.15,,,,3.15,3.15,other,not separately reimbursable by contracted payers
CARISOPRODOL 350 MG TABLET(SOMA),00591551301 ,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
CARISOPRODOL 350 MG TABLET(SOMA),58657064501,NDC,inpatient,1,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
CARVEDILOL 12.5 MG TABLET(COREG),00904630261 ,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
CARVEDILOL 3.125 MG TABLET(COREG),00904730561 ,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
CEFAZOLIN SODIUM/DEXTROSE 1 GM/50 ML BAG(ANCEF 1 G/50 ML-DEXTROSE),00264310311 ,NDC,inpatient,50,ML,45.95,,NONE,NONE,,45.95,,,,45.95,45.95,other,not separately reimbursable by contracted payers
CEFAZOLIN 1 G VIAL(ANCEF),00409258501 ,NDC,inpatient,1,EA,9.6,,NONE,NONE,,9.6,,,,9.6,9.6,other,not separately reimbursable by contracted payers
CEFAZOLIN SODIUM/DEXTROSE 2 GM/50 ML BAG(ANCEF),00264310511 ,NDC,inpatient,50,ML,51.7,,NONE,NONE,,51.7,,,,51.7,51.7,other,not separately reimbursable by contracted payers
CEFAZOLIN SODIUM 2 GM VIAL(ANCEF),60505623105,NDC,inpatient,1,EA,20.5,,NONE,NONE,,20.5,,,,20.5,20.5,other,not separately reimbursable by contracted payers
CEFDINIR 300 MG CAPSULE(OMNICEF),67877054360,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
CEFEPIME HCL 1 G VIAL(MAXIPIME),25021012166,NDC,inpatient,1,EA,11,,NONE,NONE,,11,,,,11,11,other,not separately reimbursable by contracted payers
CEFEPIME HCL/DEXTROSE 2 GM/50 ML BAG(MAXIPIME 2 GM D5W BAG),00264319511 ,NDC,inpatient,50,ML,104.5,,NONE,NONE,,104.5,,,,104.5,104.5,other,not separately reimbursable by contracted payers
CEFEPIME HCL 2 G VIAL(MAXIPIME),25021012267,NDC,inpatient,1,EA,19.95,,NONE,NONE,,19.95,,,,19.95,19.95,other,not separately reimbursable by contracted payers
CEFTRIAXONE SODIUM 1 G VIAL(ROCEPHIN),00409733304 ,NDC,inpatient,1,EA,14.5,,NONE,NONE,,14.5,,,,14.5,14.5,other,not separately reimbursable by contracted payers
CEFTRIAXONE NA/DEXTROSE 2 GM/50 ML BAG(ROCEPHIN),00264315511 ,NDC,inpatient,50,ML,91.85,,NONE,NONE,,91.85,,,,91.85,91.85,other,not separately reimbursable by contracted payers
CEFTRIAXONE SODIUM 2 GM VIAL(ROCEPHIN),25021010720,NDC,inpatient,1,EA,15.4,,NONE,NONE,,15.4,,,,15.4,15.4,other,not separately reimbursable by contracted payers
CEFUROXIME AXETIL 250 MG TABLET(CEFTIN),67877021520,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
CELECOXIB 100 MG CAPSULE(CELEBREX),59762151601,NDC,inpatient,1,EA,2.1,,NONE,NONE,,2.1,,,,2.1,2.1,other,not separately reimbursable by contracted payers
CEPACOL SORE THROAT LOZENGE(CEPACOL SORE THROAT),00904625549 ,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
CEPHALEXIN 500 MG CAPSULE(KEFLEX),60687016301,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
CEPHALEXIN 250 MG CAPSULE(KELFEX),60687015201,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
CHLORHEXIDINE GLUCONATE 0.12% MOUTHWASH 15ML CUP(PERIDEX),69339013819,NDC,inpatient,15,ML,6.25,,NONE,NONE,,6.25,,,,6.25,6.25,other,not separately reimbursable by contracted payers
CHLORPROMAZINE HCL 25 MG TABLET(THORAZINE),00904713061 ,NDC,inpatient,1,EA,18.25,,NONE,NONE,,18.25,,,,18.25,18.25,other,not separately reimbursable by contracted payers
CHLORTHALIDONE 25 MG TABLET(THALITONE),51079005820,NDC,inpatient,1,EA,6.7,,NONE,NONE,,6.7,,,,6.7,6.7,other,not separately reimbursable by contracted payers
"CHOLECALCIFEROL 1,000 UNIT TABLET (25 MCG)(VITAMIN D 25 MCG (1,000 UNITS))",20555003300,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
CHOLESTYRAMINE/ASPARTAME 4 G PACKET(PREVALITE),00245003660 ,NDC,inpatient,1,EA,7.2,,NONE,NONE,,7.2,,,,7.2,7.2,other,not separately reimbursable by contracted payers
CHOLESTYRAMINE/ASPARTAME 4 GM POWD.PACK(PREVALITE),42806027095,NDC,inpatient,1,EA,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
"CHOLECALCIFEROL (125 MCG) 5,000 UNIT(VITAMIN D3 (125 MCG))",50268086615,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
CINACALCET HCL 30 MG TABLET(SENSIPAR),55513007330,NDC,inpatient,1,EA,94.15,,NONE,NONE,,94.15,,,,94.15,94.15,other,not separately reimbursable by contracted payers
CIPROFLOXACIN HCL 250 MG TABLET(CIPRO),58657067501,NDC,inpatient,1,EA,0.55,,NONE,NONE,,0.55,,,,0.55,0.55,other,not separately reimbursable by contracted payers
CIPROFLOXACIN LACTATE/D5W 400 MG/200 ML BAG(CIPRO),00409330024 ,NDC,inpatient,200,ML,12.65,,NONE,NONE,,12.65,,,,12.65,12.65,other,not separately reimbursable by contracted payers
CIPROFLOXACIN HCL 500 MG TABLET(CIPRO),00904724361 ,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
CIPROFLOXACIN HCL 0.3% 5ML EYE DROPS(CILOXAN OPHTHALMIC 0.3%),61314065605,NDC,inpatient,5,ML,9.8,,NONE,NONE,,9.8,,,,9.8,9.8,other,not separately reimbursable by contracted payers
CITALOPRAM HYDROBROMIDE 10 MG TABLET(CELEXA),00904608461 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
CITALOPRAM HYDROBROMIDE 20 MG TABLET(CELEXA),00904608561 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
CLINDAMYCIN HCL 150 MG CAPSULE(CLEOCIN),00904595961 ,NDC,inpatient,1,EA,1.2,,NONE,NONE,,1.2,,,,1.2,1.2,other,not separately reimbursable by contracted payers
CLOBETASOL PROPIONATE 0.05% 15GM CREAM(TEMOVATE 0.05% CREAM),69238153205,NDC,inpatient,15,GR,15.75,,NONE,NONE,,15.75,,,,15.75,15.75,other,not separately reimbursable by contracted payers
CLONIDINE HCL 0.1 MG WEEKLY PATCH(CATAPRES-TTS 1),00378087199 ,NDC,inpatient,1,EA,92.75,,NONE,NONE,,92.75,,,,92.75,92.75,other,not separately reimbursable by contracted payers
CLONIDINE HCL 0.1 MG TABLET(CATAPRES),60687011301,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
CLONIDINE HCL 0.2 MG WEEKLY PATCH(CATAPRES-TTS 2),51862045404,NDC,inpatient,1,EA,78.2,,NONE,NONE,,78.2,,,,78.2,78.2,other,not separately reimbursable by contracted payers
CLONIDINE HCL 0.3 MG WEEKLY PATCH(CATAPRES-TTS 3),00378087399 ,NDC,inpatient,1,EA,216.65,,NONE,NONE,,216.65,,,,216.65,216.65,other,not separately reimbursable by contracted payers
CLONAZEPAM 0.5 MG TABLET(KLONOPIN),00093083201 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
CLONAZEPAM 1 MG TABLET(KLONOPIN),51079088220,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
CLOPIDOGREL BISULFATE 75 MG TABLET(PLAVIX),00904629461 ,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
CLOTRIMAZOLE 10 MG TROCHE(MYCELEX),00574010770 ,NDC,inpatient,1,EA,4.55,,NONE,NONE,,4.55,,,,4.55,4.55,other,not separately reimbursable by contracted payers
CLOTRIMAZOLE/BETAMETHASONE 1%-0.05% 15GM CREAM(LOTRISONE CREAM 1%-0.05%),16714049601,NDC,inpatient,15,GR,76.7,,NONE,NONE,,76.7,,,,76.7,76.7,other,not separately reimbursable by contracted payers
CLOTRIMAZOLE 1% 15GM CREAM(LOTRIMIN 1% CREAM),51672200201,NDC,inpatient,15,GR,17.85,,NONE,NONE,,17.85,,,,17.85,17.85,other,not separately reimbursable by contracted payers
COLCHICINE 0.6 MG TABLET(COLCRYS),64764011901,NDC,inpatient,1,EA,25.2,,NONE,NONE,,25.2,,,,25.2,25.2,other,not separately reimbursable by contracted payers
COLLAGENASE CLOSTRIDIUM HIST. 30GM OINTMENT(SANTYL),50484001030,NDC,inpatient,30,GR,1058.25,,NONE,NONE,,1058.25,,,,1058.25,1058.25,other,not separately reimbursable by contracted payers
TIMOLOL MAL/DORZOLAM (COSOPT) 10ML EYE DROPS(COSOPT),42571014726,NDC,inpatient,10,ML,17.5,,NONE,NONE,,17.5,,,,17.5,17.5,other,not separately reimbursable by contracted payers
"CYANOCOBALAMIN 1,000 MCG VIAL(VITAMIN B-12)",00517003125 ,NDC,inpatient,1,ML,24.5,,NONE,NONE,,24.5,,,,24.5,24.5,other,not separately reimbursable by contracted payers
CYCLOSPORINE 100 MG CAPSULE(SANDIMMUNE),60505013400,NDC,inpatient,1,EA,43,,NONE,NONE,,43,,,,43,43,other,not separately reimbursable by contracted payers
"CYCLOSPORINE, MODIFIED 100 MG CAPSULE(NEORAL)",00078024815 ,NDC,inpatient,1,EA,37.45,,NONE,NONE,,37.45,,,,37.45,37.45,other,not separately reimbursable by contracted payers
CYCLOBENZAPRINE HCL 10 MG TABLET(FLEXERIL),51079064420,NDC,inpatient,1,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
CYCLOSPORINE 0.05% EYE DROPS DROPERETTE(RESTASIS 0.05%),00378876058 ,NDC,inpatient,1,EA,13.45,,NONE,NONE,,13.45,,,,13.45,13.45,other,not separately reimbursable by contracted payers
CYCLOSPORINE 25 MG CAPSULE(SANDIMMUNE),60505013300,NDC,inpatient,1,EA,10.8,,NONE,NONE,,10.8,,,,10.8,10.8,other,not separately reimbursable by contracted payers
CYCLOSPORINE 0.05% DROPERETTE(RESTASIS 0.05%),00023916330 ,NDC,inpatient,1,EA,37.7,,NONE,NONE,,37.7,,,,37.7,37.7,other,not separately reimbursable by contracted payers
CYCLOBENZAPRINE HCL 5 MG TABLET(FLEXERIL),59746021106,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
"CYCLOSPORINE, MODIFIED 25 MG CAPSULE(NEORAL)",00078024615 ,NDC,inpatient,1,EA,9.4,,NONE,NONE,,9.4,,,,9.4,9.4,other,not separately reimbursable by contracted payers
DAPTOMYCIN IN 0.9 % SOD CHLOR 350 MG/50 ML(CUBICIN),00338071224 ,NDC,inpatient,50,ML,115.5,,NONE,NONE,,115.5,,,,115.5,115.5,other,not separately reimbursable by contracted payers
DAPTOMYCIN IN 0.9 % SOD CHLOR 500 MG/50 ML BAG(CUBICIN),00338071424 ,NDC,inpatient,50,ML,136.5,,NONE,NONE,,136.5,,,,136.5,136.5,other,not separately reimbursable by contracted payers
DAPTOMYCIN 500 MG VIAL(CUBICIN),70594003401,NDC,inpatient,1,EA,210,,NONE,NONE,,210,,,,210,210,other,not separately reimbursable by contracted payers
DESMOPRESSIN ACETATE 0.1 MG TABLET(DDAVP),23155048901,NDC,inpatient,1,EA,3.7,,NONE,NONE,,3.7,,,,3.7,3.7,other,not separately reimbursable by contracted payers
DEXAMETHASONE 1 MG TABLET(DECADRON),00054817425 ,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
DEXAMETHASONE 4 MG TABLET(DECADRON),00054817525 ,NDC,inpatient,1,EA,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
DEXAMETHASONE SOD PHOSPHATE 4 MG/ML VIAL(DECADRON),63323016516,NDC,inpatient,1,EA,3.05,,NONE,NONE,,3.05,,,,3.05,3.05,other,not separately reimbursable by contracted payers
GLUCOSE (DEXTROSE) 4 GM CHEWABLE TABLET(TRUEPLUS GLUCOSE),56151161051,NDC,inpatient,1,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
"DEXTROSE 5 % AND 0.9 % NACL 1,000 ML BAG(DEXTROSE 5%-0.9% NACL IV SOLN)",00264761000 ,NDC,inpatient,1,EA,13.3,,NONE,NONE,,13.3,,,,13.3,13.3,other,not separately reimbursable by contracted payers
"DEXTROSE 5 %-0.45 % NACL 1,000 ML BAG(DEXTROSE 5%-0.45% NACL IV SOLN)",00264761200 ,NDC,inpatient,1,EA,10.75,,NONE,NONE,,10.75,,,,10.75,10.75,other,not separately reimbursable by contracted payers
GLUCOSE GEL TUBE(GLUTOSE-15),00574007030 ,NDC,inpatient,1,EA,11.1,,NONE,NONE,,11.1,,,,11.1,11.1,other,not separately reimbursable by contracted payers
"DEXTROSE 5%-WATER 1,000 ML BAG(DEXTROSE 5%)",00264751000 ,NDC,inpatient,1,EA,14.1,,NONE,NONE,,14.1,,,,14.1,14.1,other,not separately reimbursable by contracted payers
DEXTROSE 5%-WATER 500 ML BAG(DEXTROSE 5%),63323062475,NDC,inpatient,1,EA,11.2,,NONE,NONE,,11.2,,,,11.2,11.2,other,not separately reimbursable by contracted payers
DIAZEPAM 2 MG TABLET(VALIUM),51079028420,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
DIAZEPAM 5 MG TABLET(VALIUM),51079028520,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
DICLOFENAC SODIUM 1% TOPICAL GEL (VOLTAREN)(VOLTAREN),45802095301,NDC,inpatient,100,GR,42.9,,NONE,NONE,,42.9,,,,42.9,42.9,other,not separately reimbursable by contracted payers
DICYCLOMINE HCL 10 MG CAPSULE(BENTYL),51079011820,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
DIGOXIN 125 MCG TABLET(LANOXIN),00904592161 ,NDC,inpatient,1,EA,4.75,,NONE,NONE,,4.75,,,,4.75,4.75,other,not separately reimbursable by contracted payers
DIGOXIN 250 MCG TABLET(LANOXIN),00904592261 ,NDC,inpatient,1,EA,4.75,,NONE,NONE,,4.75,,,,4.75,4.75,other,not separately reimbursable by contracted payers
DILTIAZEM HCL 24H-ER 120MG CAPSULE(CARDIZEM CD),60687019501,NDC,inpatient,1,EA,2.85,,NONE,NONE,,2.85,,,,2.85,2.85,other,not separately reimbursable by contracted payers
DILTIAZEM HCL 24H-ER 180MG CAPSULE(CARDIZEM CD),60687020601,NDC,inpatient,1,EA,2.85,,NONE,NONE,,2.85,,,,2.85,2.85,other,not separately reimbursable by contracted payers
DILTIAZEM HCL 30 MG TABLET(CARDIZEM),51079074520,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
DIPHENOXYLATE/ATROPINE 2.5/0.025MG TABLET(LOMOTIL),59762106101,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
DIPHENHYDRAMINE HCL 25 MG TABLET(BENADRYL),00904555124 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
DIPHENHYDRAMINE HCL 50 MG/ML VIAL(BENADRYL),63323066416,NDC,inpatient,1,ML,2.9,,NONE,NONE,,2.9,,,,2.9,2.9,other,not separately reimbursable by contracted payers
DIVALPROEX SODIUM DR 125MG SPRINKLES CAPSULE(DEPAKOTE SPRINKLES),68084031301,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
DIVALPROEX SODIUM DR 250MG TABLET(DEPAKOTE DR),00832712301 ,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
DIVALPROEX SODIUM ER 500MG TABLET(DEPAKOTE ER),51079076708,NDC,inpatient,1,EA,8.75,,NONE,NONE,,8.75,,,,8.75,8.75,other,not separately reimbursable by contracted payers
DOCOSANOL 10% 2GM CREAM(ABREVA),00135020001 ,NDC,inpatient,2,GR,61.95,,NONE,NONE,,61.95,,,,61.95,61.95,other,not separately reimbursable by contracted payers
DOCUSATE SODIUM 100 MG TABLET(COLACE),00904675060 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
DOCUSATE SODIUM 283 MG/5 ML ENEMA(ENEMEEZ),17433987603,NDC,inpatient,5,ML,6.55,,NONE,NONE,,6.55,,,,6.55,6.55,other,not separately reimbursable by contracted payers
DOCUSATE SODIUM 100 MG/10 ML ORAL CUP(COLACE),00121187000 ,NDC,inpatient,10,ML,6.5,,NONE,NONE,,6.5,,,,6.5,6.5,other,not separately reimbursable by contracted payers
DONEPEZIL HCL 10 MG TABLET(ARICEPT),60687030301,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
DONEPEZIL HCL 5 MG TABLET(ARICEPT),60687029201,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
DORZOLAMIDE HCL 2% 10ML EYE DROPS(TRUSOPT 2%),42571014126,NDC,inpatient,10,ML,11.9,,NONE,NONE,,11.9,,,,11.9,11.9,other,not separately reimbursable by contracted payers
DOXAZOSIN MESYLATE 1 MG TABLET(CARDURA),00904552261 ,NDC,inpatient,1,EA,3,,NONE,NONE,,3,,,,3,3,other,not separately reimbursable by contracted payers
DOXAZOSIN MESYLATE 4 MG TABLET(CARDURA),00904552461 ,NDC,inpatient,1,EA,3.05,,NONE,NONE,,3.05,,,,3.05,3.05,other,not separately reimbursable by contracted payers
DOXEPIN HCL 25 MG CAPSULE(SILENOR),51079043720,NDC,inpatient,1,EA,2.45,,NONE,NONE,,2.45,,,,2.45,2.45,other,not separately reimbursable by contracted payers
DOXYCYCLINE HYCLATE 100 MG TABLET(PERIOSTAT),00904043006 ,NDC,inpatient,1,EA,7.7,,NONE,NONE,,7.7,,,,7.7,7.7,other,not separately reimbursable by contracted payers
DULOXETINE HCL DR 20 MG CAPSULE(CYMBALTA),51991074690,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
DULOXETINE HCL DR 30 MG CAPSULE(CYMBALTA),43547038011,NDC,inpatient,1,EA,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
ASPIRIN EC 81 MG TABLET(ECOTRIN),63739021202,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
VENLAFAXINE HCL ER 75 MG CAPSULE(EFFEXOR XR),68084070901,NDC,inpatient,1,EA,1.95,,NONE,NONE,,1.95,,,,1.95,1.95,other,not separately reimbursable by contracted payers
JARDIANCE (EMPAGLIFLOZIN) 10 MG TABLET(JARDIANCE),00597015237 ,NDC,inpatient,1,EA,71.3,,NONE,NONE,,71.3,,,,71.3,71.3,other,not separately reimbursable by contracted payers
EMPAGLIFLOZIN (JARDIANCE) 25 MG TABLET(JARDIANCE),00597015330 ,NDC,inpatient,1,EA,71.3,,NONE,NONE,,71.3,,,,71.3,71.3,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 100 MG/ML SYRINGE(LOVENOX),00075802010 ,NDC,inpatient,1,ML,74.8,,NONE,NONE,,74.8,,,,74.8,74.8,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 120 MG/0.8 ML SYRINGE(LOVENOX),00075291201 ,NDC,inpatient,0.8,ML,104.35,,NONE,NONE,,104.35,,,,104.35,104.35,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 150 MG/ML SYRINGE(LOVENOX),00075291501A,NDC,inpatient,1,ML,130.45,,NONE,NONE,,130.45,,,,130.45,130.45,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 30 MG/0.3 ML SYRINGE(LOVENOX),00075062430 ,NDC,inpatient,0.3,ML,26.05,,NONE,NONE,,26.05,,,,26.05,26.05,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 40 MG/0.4 ML SYRINGE(LOVENOX),00075801410 ,NDC,inpatient,0.4,ML,29.9,,NONE,NONE,,29.9,,,,29.9,29.9,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 60 MG/0.6 ML SYRINGE(LOVENOX),00075801610 ,NDC,inpatient,0.6,ML,44.9,,NONE,NONE,,44.9,,,,44.9,44.9,other,not separately reimbursable by contracted payers
ENOXAPARIN SODIUM 80 MG/0.8 ML SYRINGE(LOVENOX),00075801810 ,NDC,inpatient,0.8,ML,59.85,,NONE,NONE,,59.85,,,,59.85,59.85,other,not separately reimbursable by contracted payers
ENTACAPONE 200 MG TABLET(COMTAN),60687018821,NDC,inpatient,1,EA,14.45,,NONE,NONE,,14.45,,,,14.45,14.45,other,not separately reimbursable by contracted payers
EPINEPHRINE 0.3 MG/0.3 ML (EPI-PEN)(EPI-PEN 0.3 MG/0.3 ML),49502050002,NDC,inpatient,0.3,ML,1065.1,,NONE,NONE,,1065.1,,,,1065.1,1065.1,other,not separately reimbursable by contracted payers
"EPOETIN ALFA-EPBX (RETACRIT) 10,000 UNIT/ML VIAL(RETACRIT)",00069130810 ,NDC,inpatient,1,ML,386.05,,NONE,NONE,,386.05,,,,386.05,386.05,other,not separately reimbursable by contracted payers
"EPOETIN ALFA-EPBX (RETACRIT) 2,000 UNIT/ML VIAL(RETACRIT)",00069130510 ,NDC,inpatient,1,ML,77.25,,NONE,NONE,,77.25,,,,77.25,77.25,other,not separately reimbursable by contracted payers
"EPOETIN ALFA-EPBX 20,000 UNIT/ML VIAL(RETACRIT)",00069131110 ,NDC,inpatient,1,ML,772.1,,NONE,NONE,,772.1,,,,772.1,772.1,other,not separately reimbursable by contracted payers
"EPOETIN ALFA-EPBX 3,000 UNIT/ML VIAL(RETACRIT)",00069130610 ,NDC,inpatient,1,ML,115.85,,NONE,NONE,,115.85,,,,115.85,115.85,other,not separately reimbursable by contracted payers
"EPOETIN ALFA-EPBX 4,000 UNIT/ML VIAL(RETACRIT)",00069130710 ,NDC,inpatient,1,ML,154.45,,NONE,NONE,,154.45,,,,154.45,154.45,other,not separately reimbursable by contracted payers
"ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG CAPSULE(DRISDOL)",42291026601,NDC,inpatient,1,EA,4.55,,NONE,NONE,,4.55,,,,4.55,4.55,other,not separately reimbursable by contracted payers
"ERGOCALCIFEROL 1,250 MCG/6.25 ML ORAL SYRINGE(CALCIFEROL (VITAMIN D2))",47781064726,NDC,inpatient,6.25,ML,22.1,,NONE,NONE,,22.1,,,,22.1,22.1,other,not separately reimbursable by contracted payers
ERTAPENEM SODIUM 1 G VIAL(INVANZ),42023022110,NDC,inpatient,1,EA,409.75,,NONE,NONE,,409.75,,,,409.75,409.75,other,not separately reimbursable by contracted payers
ERYTHROMYCIN BASE 0.5% 3.5GM EYE OINTMENT(ILOTYCIN),24208091055,NDC,inpatient,3.5,GR,15.2,,NONE,NONE,,15.2,,,,15.2,15.2,other,not separately reimbursable by contracted payers
ESCITALOPRAM OXALATE 10 MG TABLET(LEXAPRO),00904642661 ,NDC,inpatient,1,EA,0.55,,NONE,NONE,,0.55,,,,0.55,0.55,other,not separately reimbursable by contracted payers
ESCITALOPRAM OXALATE 20 MG TABLET(LEXAPRO),43547028210,NDC,inpatient,1,EA,0.55,,NONE,NONE,,0.55,,,,0.55,0.55,other,not separately reimbursable by contracted payers
EZETIMIBE 10 MG TABLET(ZETIA),00591371305 ,NDC,inpatient,1,EA,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
EZETIMIBE 10 MG TABLET(ZETIA),68382077316,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
FAMOTIDINE 20 MG TABLET(PEPCID),51079096620,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
"FENOFIBRATE,MICRONIZED 145 MG TABLET(TRICOR)",00378306677 ,NDC,inpatient,1,EA,2.3,,NONE,NONE,,2.3,,,,2.3,2.3,other,not separately reimbursable by contracted payers
"FENOFIBRATE,MICRONIZED 48 MG TABLET(TRICOR)",00378306577 ,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
FENTANYL 100 MCG 72HR PATCH(DURAGESIC),00378912498 ,NDC,inpatient,1,EA,96.5,,NONE,NONE,,96.5,,,,96.5,96.5,other,not separately reimbursable by contracted payers
FENTANYL 12 MCG 72HR PATCH(DURAGESIC),00378911998 ,NDC,inpatient,1,EA,56.85,,NONE,NONE,,56.85,,,,56.85,56.85,other,not separately reimbursable by contracted payers
FENTANYL 25 MCG 72HR PATCH(DURAGESIC),00378912198 ,NDC,inpatient,1,EA,25,,NONE,NONE,,25,,,,25,25,other,not separately reimbursable by contracted payers
FENTANYL 50 MCG 72HR PATCH(DURAGESIC),00378912298 ,NDC,inpatient,1,EA,44.35,,NONE,NONE,,44.35,,,,44.35,44.35,other,not separately reimbursable by contracted payers
FENTANYL 75 MCG 72HR PATCH(DURAGESIC),00378912398 ,NDC,inpatient,1,EA,70.1,,NONE,NONE,,70.1,,,,70.1,70.1,other,not separately reimbursable by contracted payers
FERROUS SULFATE 300 MG/5 ML CUP(FER-IRON),00121053005 ,NDC,inpatient,5,ML,11.9,,NONE,NONE,,11.9,,,,11.9,11.9,other,not separately reimbursable by contracted payers
FERROUS GLUCONATE 324 MG TABLET(FERGON),00574050811 ,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
FERROUS SULFATE 325 MG TABLET(FEOSOL),51645076099,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
FINASTERIDE 5 MG TABLET(PROSCAR),16729009001,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
FISH OIL 1000 MG CAPSULE(FISHOIL 1000 MG),48433011001,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
FLECAINIDE ACETATE 100 MG TABLET(TAMBOCOR),00054001120 ,NDC,inpatient,1,EA,3.3,,NONE,NONE,,3.3,,,,3.3,3.3,other,not separately reimbursable by contracted payers
FLUCONAZOLE 100 MG TABLET(DIFLUCAN),00904650061 ,NDC,inpatient,1,EA,5,,NONE,NONE,,5,,,,5,5,other,not separately reimbursable by contracted payers
FLUDROCORTISONE ACETATE 0.1 MG TABLET(FLORINEF),68084028801,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
FLU VACC TS2024-25(65 YR +)/PF 180 MCG/0.5 ML ML(FLUZONE HIGH-DOSE TRIVALENT 2024-25),49281012465,NDC,inpatient,0.5,ML,254.15,,NONE,NONE,,254.15,,,,254.15,254.15,other,not separately reimbursable by contracted payers
FLUOXETINE HCL 10 MG TABLET(PROZAC),49884033501,NDC,inpatient,1,EA,4.05,,NONE,NONE,,4.05,,,,4.05,4.05,other,not separately reimbursable by contracted payers
FLUOCINONIDE 0.05% 15GM CREAM(LIDEX),51672138601,NDC,inpatient,15,GR,52.5,,NONE,NONE,,52.5,,,,52.5,52.5,other,not separately reimbursable by contracted payers
FLUOXETINE HCL 20 MG CAPSULE(PROZAC),00904734661 ,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
FLUTICASONE PROPIONATE 50 MCG NASAL SPRAY(FLONASE),60505082901,NDC,inpatient,1,EA,63,,NONE,NONE,,63,,,,63,63,other,not separately reimbursable by contracted payers
FLUTICASONE/VILANTEROL 100-25 MCG (BREO)(BREO ELLIPTA 100-25 MCG INH),00173085914 ,NDC,inpatient,1,EA,19.6,,NONE,NONE,,19.6,,,,19.6,19.6,other,not separately reimbursable by contracted payers
FLUTICASONE/VILANTEROL 200-25 MCG (BREO)(BREO ELLIPTA 200-25 MCG INH),00173088214 ,NDC,inpatient,1,EA,19.6,,NONE,NONE,,19.6,,,,19.6,19.6,other,not separately reimbursable by contracted payers
FLU VACC TS2024-25(6MOS UP)/PF 45 MCG/0.5 ML ML(),49281042450,NDC,inpatient,0.5,ML,69.8,,NONE,NONE,,69.8,,,,69.8,69.8,other,not separately reimbursable by contracted payers
FOLIC ACID 1 MG TABLET(FOLICET),53746036101,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
"FOLIC ACID/MV,IRON,MIN CHEWABLE TABLET(CENTRUM CHEWABLE)",00005487460 ,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
FONDAPARINUX SODIUM 2.5 MG/0.5 ML SYRINGE(ARIXTRA),67457058210,NDC,inpatient,0.5,ML,87.05,,NONE,NONE,,87.05,,,,87.05,87.05,other,not separately reimbursable by contracted payers
FUROSEMIDE 40 MG/4 ML VIAL(LASIX),63323028004,NDC,inpatient,4,ML,9.8,,NONE,NONE,,9.8,,,,9.8,9.8,other,not separately reimbursable by contracted payers
FUROSEMIDE 20 MG TABLET(LASIX),00054829725 ,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
FUROSEMIDE 40 MG TABLET(LASIX),00054829925 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
FUROSEMIDE 80 MG TABLET(LASIX),00054830125 ,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
GABAPENTIN 100 MG CAPSULE(NEURONTIN),60687058001,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
GABAPENTIN 300 MG CAPSULE(NEURONTIN),63739023610,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
GABAPENTIN 400 MG CAPSULE(NEURONTIN),00904666761 ,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
GEMFIBROZIL 600 MG TABLET(LOPID),60687022401,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
GENTAMICIN SULFATE 0.3% 5ML EYE DROPS(GARAMYCIN),24208058060,NDC,inpatient,5,ML,25,,NONE,NONE,,25,,,,25,25,other,not separately reimbursable by contracted payers
GLIMEPIRIDE 2 MG TABLET(AMARYL),68084032601,NDC,inpatient,1,EA,1.9,,NONE,NONE,,1.9,,,,1.9,1.9,other,not separately reimbursable by contracted payers
GLIPIZIDE XL 2.5MG TABLET(GLUCOTROL XL),16714089401,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
GLIPIZIDE 5 MG TABLET(GLUCOTROL),51079081020,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
GLIPIZIDE XL 5 MG TABLET(GLUCOTROL XL),00049017402 ,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
GLUCOSAMINE SULFATE 500 MG CAPSULE(GLUCOSAMINE),43292055857,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
GLYBURIDE 2.5 MG TABLET(DIABETA),00093834301 ,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
GLYBURIDE 5 MG TABLET(DIABETA),00093834401 ,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
GUAIFENESIN 200 MG/10 ML CUP(ROBITUSSIN),00121148800 ,NDC,inpatient,10,ML,5.65,,NONE,NONE,,5.65,,,,5.65,5.65,other,not separately reimbursable by contracted payers
GUAIFENESIN/D-METHORPHAN 200 MG/20MG 10 ML CUP(ROBITUSSIN-DM),00121127600 ,NDC,inpatient,10,ML,8.1,,NONE,NONE,,8.1,,,,8.1,8.1,other,not separately reimbursable by contracted payers
GUAIFENESIN/CODEINE 100MG/10MG-5ML CUP(GUAIATUSSIN AC),00121177540 ,NDC,inpatient,5,ML,11.85,,NONE,NONE,,11.85,,,,11.85,11.85,other,not separately reimbursable by contracted payers
GUAIFENESIN 12H-ER 600 MG TABLET(MUCINEX ER),00904671839 ,NDC,inpatient,1,EA,3.15,,NONE,NONE,,3.15,,,,3.15,3.15,other,not separately reimbursable by contracted payers
HALOPERIDOL 0.5 MG TABLET(HALDOL),51079073320,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
HALOPERIDOL 2 MG TABLET(HALDOL),00378021401 ,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
TRIAMTERENE/HCTZ 37.5MG/25MG TABLET(MAXZIDE 37.5 MG/25 MG),60505265601,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
PREPARATION H SUPPOSITORY(PREPARATION H SUPP),00536118612 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
"HEPARIN SODIUM,PORCINE 1,000 UNIT/ML (10ML) VIAL(HEPARIN)",71288040211,NDC,inpatient,10,ML,13.9,,NONE,NONE,,13.9,,,,13.9,13.9,other,not separately reimbursable by contracted payers
HEPARIN SODIUM 10 UNITS/ML (5ML) FLUSH(HEP-LOCK),08290306414 ,NDC,inpatient,5,ML,2.8,,NONE,NONE,,2.8,,,,2.8,2.8,other,not separately reimbursable by contracted payers
"HEPARIN SODIUM/D5W 25,000 UNIT/250 ML BAG(HEPARIN-D5W 25,000 UNIT/250 ML)",00264958720 ,NDC,inpatient,250,ML,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
"HEPARIN SODIUM,PORCINE 5,000 UNITS/ML VIAL(HEPARIN)",25021040201,NDC,inpatient,1,ML,5.25,,NONE,NONE,,5.25,,,,5.25,5.25,other,not separately reimbursable by contracted payers
MULTIVITAMIN TABLET(TAB-A-VITE),00904053061 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
HYDRALAZINE HCL 10 MG TABLET(APRESOLINE),51079007420,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
HYDROCORTISONE 10 MG TABLET(CORTEF),42543014101,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
HYDROCHLOROTHIAZIDE 12.5 MG TABLET(HYDRODIURIL),16729018201,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
HYDROCODONE BIT/ACETAMINOPHEN 5/325MG TABLET(NORCO 5/325),00406012362 ,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
HYDROXYCHLOROQUINE SULFATE 200 MG TABLET(PLAQUENIL),68084026901,NDC,inpatient,1,EA,6.85,,NONE,NONE,,6.85,,,,6.85,6.85,other,not separately reimbursable by contracted payers
HYDROCORTISONE ACETATE 25 MG SUPPOSITORY(ANUSOL HC),00574709012 ,NDC,inpatient,1,EA,40.4,,NONE,NONE,,40.4,,,,40.4,40.4,other,not separately reimbursable by contracted payers
HYDROXYZINE HCL 25 MG TABLET(ATARAX),16714008210,NDC,inpatient,1,EA,0.65,,NONE,NONE,,0.65,,,,0.65,0.65,other,not separately reimbursable by contracted payers
HYDRALAZINE HCL 25 MG TABLET(APRESOLINE),63739032710,NDC,inpatient,1,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
HYDROMORPHONE HCL 2 MG/ML SYRINGE(DILAUDID),00409131230 ,NDC,inpatient,1,ML,11.8,,NONE,NONE,,11.8,,,,11.8,11.8,other,not separately reimbursable by contracted payers
HYDROMORPHONE HCL 2 MG TABLET(DILAUDID),42858030125,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
HYDROMORPHONE HCL 1 MG TABLET (HALF OF A 2MG TABLET)(DILAUDID),00406324301 ,NDC,inpatient,0.5,EA,0.55,,NONE,NONE,,0.55,,,,0.55,0.55,other,not separately reimbursable by contracted payers
HYDROCORTISONE 1% CREAM 30G(HYTONE 1% CREAM),00168001531 ,NDC,inpatient,30,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
HYDROXYZINE HCL 10 MG TABLET(ATARAX),16714008110,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
HYDROCHLOROTHIAZIDE 25 MG TABLET(HYDRODIURIL),16729018301,NDC,inpatient,1,EA,0.05,,NONE,NONE,,0.05,,,,0.05,0.05,other,not separately reimbursable by contracted payers
IBUPROFEN 100 MG/5 ML CUP(MOTRIN),68094060059,NDC,inpatient,5,ML,3,,NONE,NONE,,3,,,,3,3,other,not separately reimbursable by contracted payers
IBUPROFEN 400 MG TABLET(MOTRIN),00904585361 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
IBUPROFEN 600 MG TABLET(MOTRIN),65162046510,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
IMIPRAMINE HCL 25 MG TABLET(TOFRANIL),64380017001,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
INDOMETHACIN 25 MG CAPSULE(INDOCIN),68462040601,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
HUMULIN N 100 UNIT/ML KWIKPEN(HUMULIN N KWIKPEN),00002880559 ,NDC,inpatient,3,ML,99,,NONE,NONE,,99,,,,99,99,other,not separately reimbursable by contracted payers
HUMULIN 70-30 100 UNIT/ML PEN(HUMULIN 70/30 PEN),00002880359 ,NDC,inpatient,3,ML,99,,NONE,NONE,,99,,,,99,99,other,not separately reimbursable by contracted payers
HUMALOG MIX 75/25 (100 UNITS/ML) PEN(HUMALOG MIX 75-25 KWIKPEN),00002879759 ,NDC,inpatient,3,ML,111.4,,NONE,NONE,,111.4,,,,111.4,111.4,other,not separately reimbursable by contracted payers
HUMULIN 70/30 (INSULIN NPH HUM/REG 100 UNIT/ML) 3ML VIAL(HUMULIN 70-30 VIAL),00002871517 ,NDC,inpatient,3,ML,46.85,,NONE,NONE,,46.85,,,,46.85,46.85,other,not separately reimbursable by contracted payers
HUMALOG (INSULIN LISPRO 100 UNIT/ML) 3ML PEN(HUMALOG PEN 100 UNITS/ML),00002879959 ,NDC,inpatient,3,ML,111.4,,NONE,NONE,,111.4,,,,111.4,111.4,other,not separately reimbursable by contracted payers
HUMULIN R (INSULIN REGULAR 100 UNIT/ML) 3ML VIAL(HUMULIN R 100 UNIT/ML),00002021301 ,NDC,inpatient,3,ML,46.85,,NONE,NONE,,46.85,,,,46.85,46.85,other,not separately reimbursable by contracted payers
LANTUS (INSULIN GLARGINE 100 UNITS/ML) 3 ML PEN(LANTUS SOLOSTAR),00088221905 ,NDC,inpatient,3,ML,67.5,,NONE,NONE,,67.5,,,,67.5,67.5,other,not separately reimbursable by contracted payers
HUMULIN U-500 UNIT/ML KWIKPEN(HUMULIN R U-500 KWIKPEN),00002882427 ,NDC,inpatient,3,ML,1004.85,,NONE,NONE,,1004.85,,,,1004.85,1004.85,other,not separately reimbursable by contracted payers
IPRATROPIUM BROMIDE 0.5MG/2.5ML NEB(ATROVENT 0.02% NEB),00487980101 ,NDC,inpatient,2.5,ML,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
IRON SUCROSE COMPLEX 100 MG/5 ML VIAL(VENOFER),00517234010 ,NDC,inpatient,5,ML,220.75,,NONE,NONE,,220.75,,,,220.75,220.75,other,not separately reimbursable by contracted payers
IRON SUCROSE COMPLEX 200 MG/10 ML VIAL(VENOFER),00517231005 ,NDC,inpatient,10,ML,441.35,,NONE,NONE,,441.35,,,,441.35,441.35,other,not separately reimbursable by contracted payers
ISOSORBIDE MONONITRATE 20 MG TABLET(ISMO),00228262011 ,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
ISOSORBIDE MONONITRATE ER 30MG TABLET(IMDUR),00904644961 ,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
ISOSORBIDE MONONITRATE ER 60MG TABLET(IMDUR),00904645061 ,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
ISOSORBIDE DINITRATE 20 MG TABLET(ISODITRATE),68084008301,NDC,inpatient,1,EA,3.2,,NONE,NONE,,3.2,,,,3.2,3.2,other,not separately reimbursable by contracted payers
KETOCONAZOLE 2% 120ML SHAMPOO(NIZORAL 2% SHAMPOO),45802046564,NDC,inpatient,120,ML,0.65,,NONE,NONE,,0.65,,,,0.65,0.65,other,not separately reimbursable by contracted payers
KETOCONAZOLE 2% 15GM CREAM(NIZORAL 2% CREAM),00168009930 ,NDC,inpatient,15,GR,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
KETOTIFEN FUMARATE 0.025% 5ML EYE DROPS(ZADITOR 0.025%),00536125240 ,NDC,inpatient,5,ML,7.45,,NONE,NONE,,7.45,,,,7.45,7.45,other,not separately reimbursable by contracted payers
LABETALOL HCL 100 MG TABLET(TRANDATE),51079092820,NDC,inpatient,1,EA,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
LABETALOL HCL 200 MG TABLET(TRANDATE),23155072401,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
LACOSAMIDE 10MG/1ML ORAL SYRINGE(VIMPAT),00131541072 ,NDC,inpatient,1,ML,80,,NONE,NONE,,80,,,,80,80,other,not separately reimbursable by contracted payers
LACOSAMIDE 50 MG TABLET(VIMPAT),00131247735 ,NDC,inpatient,1,EA,41.25,,NONE,NONE,,41.25,,,,41.25,41.25,other,not separately reimbursable by contracted payers
LACTOBACILLUS RHAMNOSUS GG 10 CFUS CAPSULE(CULTURELLE 10B CFUS),49100040007,NDC,inpatient,1,EA,3.65,,NONE,NONE,,3.65,,,,3.65,3.65,other,not separately reimbursable by contracted payers
LACTULOSE 20 G/30 ML CUP(ENULOSE),00121115400 ,NDC,inpatient,30,ML,5.3,,NONE,NONE,,5.3,,,,5.3,5.3,other,not separately reimbursable by contracted payers
LAMOTRIGINE 100 MG TABLET(LAMICTAL),68084031901,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
LAMOTRIGINE 200 MG TABLET(LAMICTAL),51079086620,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
LAMOTRIGINE 25 MG TABLET(LAMICTAL),68084031801,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
LANSOPRAZOLE CAP 30 MG CAPSULE.DR(PREVACID),64764054411A,NDC,inpatient,1,EA,48.45,,NONE,NONE,,48.45,,,,48.45,48.45,other,not separately reimbursable by contracted payers
LATANOPROST (XALATAN) 0.005% 2.5ML EYE DROPS(XALATAN 0.005%),61314054701,NDC,inpatient,2.5,ML,15,,NONE,NONE,,15,,,,15,15,other,not separately reimbursable by contracted payers
LEFLUNOMIDE 20 MG TABLET(ARAVA),62332006230,NDC,inpatient,1,EA,3.85,,NONE,NONE,,3.85,,,,3.85,3.85,other,not separately reimbursable by contracted payers
LEVETIRACETAM 250 MG/2.5 ML CUP(KEPPRA),16714035801,NDC,inpatient,2.5,ML,0.9,,NONE,NONE,,0.9,,,,0.9,0.9,other,not separately reimbursable by contracted payers
LEVETIRACETAM 250 MG TABLET(KEPPRA),68084085901,NDC,inpatient,1,EA,0.9,,NONE,NONE,,0.9,,,,0.9,0.9,other,not separately reimbursable by contracted payers
LEVETIRACETAM 500 MG/5 ML CUP(KEPPRA 500 MG/5ML),00121479940 ,NDC,inpatient,5,ML,20.15,,NONE,NONE,,20.15,,,,20.15,20.15,other,not separately reimbursable by contracted payers
LEVETIRACETAM 500 MG TABLET(KEPPRA),51079082120,NDC,inpatient,1,EA,2.05,,NONE,NONE,,2.05,,,,2.05,2.05,other,not separately reimbursable by contracted payers
LEVOTHYROXINE SODIUM 100 MCG TABLET(SYNTHROID),51079044220,NDC,inpatient,1,EA,2,,NONE,NONE,,2,,,,2,2,other,not separately reimbursable by contracted payers
LEVOFLOXACIN 250 MG TABLET(LEVAQUIN),00904635161 ,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
LEVOTHYROXINE SODIUM 25 MCG TABLET(SYNTHROID),51079044420,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
LEVOTHYROXINE SODIUM 50 MCG TABLET(SYNTHROID),51079044020,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
LEVOFLOXACIN/DEXTROSE 750MG/150ML BAG(LEVAQUIN),00143972024 ,NDC,inpatient,150,ML,21.85,,NONE,NONE,,21.85,,,,21.85,21.85,other,not separately reimbursable by contracted payers
LEVOFLOXACIN 750 MG TABLET(LEVAQUIN),00904635361 ,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
LEVOTHYROXINE SODIUM 75 MCG TABLET(SYNTHROID),51079044101,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
LEVOTHYROXINE SODIUM 88 MCG TABLET(LEVOXYL),60687048601,NDC,inpatient,1,EA,2.05,,NONE,NONE,,2.05,,,,2.05,2.05,other,not separately reimbursable by contracted payers
LIDOCAINE HCL 1% 10 MG/ML (30ML) VIAL(XYLOCAINE 1%),00409427902 ,NDC,inpatient,30,EA,11.45,,NONE,NONE,,11.45,,,,11.45,11.45,other,not separately reimbursable by contracted payers
LIDOCAINE (ASPERCREME) 4% PATCH(ASPERCREME PATCH),00536120215 ,NDC,inpatient,1,EA,4.4,,NONE,NONE,,4.4,,,,4.4,4.4,other,not separately reimbursable by contracted payers
LIDOCAINE/PRILOCAINE 2.5%/2.5% CREAM 5 G(EMLA CREAM),62332058204,NDC,inpatient,5,GR,5.8,,NONE,NONE,,5.8,,,,5.8,5.8,other,not separately reimbursable by contracted payers
LIDOCAINE HCL 2% 20 MG/ML (5ML) VIAL(XYLOCAINE 2%),63323020805,NDC,inpatient,5,ML,12.05,,NONE,NONE,,12.05,,,,12.05,12.05,other,not separately reimbursable by contracted payers
LIDOCAINE/PRILOCAINE 2.5% CREAM 30GM(EMLA),00168035730 ,NDC,inpatient,30,GR,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
LIDOCAINE HCL 2% 5ML JELLY(XYLOCAINE),25021067376,NDC,inpatient,5,ML,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
ASPERCREME (W/4% LIDOCAINE) 76.5GM CREAM(ASPERCREME CREAM),41167005877,NDC,inpatient,76.5,ML,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
LINAGLIPTIN 5 MG TABLET(TRADJENTA),00597014061 ,NDC,inpatient,1,EA,61.25,,NONE,NONE,,61.25,,,,61.25,61.25,other,not separately reimbursable by contracted payers
LINEZOLID 600 MG TABLET(ZYVOX),00904655304 ,NDC,inpatient,1,EA,21.7,,NONE,NONE,,21.7,,,,21.7,21.7,other,not separately reimbursable by contracted payers
"LIPASE/PROTEASE/AMYLASE DR 12,000 UNITS CAPSULE(CREON DR 12,000 UNITS CAPSULE)",00032004770 ,NDC,inpatient,1,EA,14.55,,NONE,NONE,,14.55,,,,14.55,14.55,other,not separately reimbursable by contracted payers
"LIPASE/PROTEASE/AMYLASE 1 EACH TABLET(VIOKACE 10,440-39,150 UNITS TAB)",73562010410,NDC,inpatient,1,EA,14.85,,NONE,NONE,,14.85,,,,14.85,14.85,other,not separately reimbursable by contracted payers
LISINOPRIL 10 MG TABLET(ZESTRIL),00904679861 ,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
LISINOPRIL 20 MG TABLET(ZESTRIL),00904679961 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
LISINOPRIL 5 MG TABLET(ZESTRIL),00904679761 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
LITHIUM CARBONATE 300 MG TABLET(ESKALITH),00054852825 ,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
LOPERAMIDE HCL 2 MG CAPSULE(IMMODIUM),51079069020,NDC,inpatient,1,EA,2.6,,NONE,NONE,,2.6,,,,2.6,2.6,other,not separately reimbursable by contracted payers
LOPERAMIDE HCL 2 MG TABLET(IMODIUM A-D),10135015801,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
LORAZEPAM 0.5 MG TABLET(ATIVAN),51079041720,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
LORATADINE 10 MG TABLET(CLARITIN),51079024620,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
LORATADINE 10 MG TABLET(CLARITIN),11523716002,NDC,inpatient,1,EA,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
LORAZEPAM 1 MG TABLET(ATIVAN),69315090501,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
LOSARTAN POTASSIUM 25 MG TABLET(COZAAR),00904704761 ,NDC,inpatient,1,EA,2.05,,NONE,NONE,,2.05,,,,2.05,2.05,other,not separately reimbursable by contracted payers
LOSARTAN POTASSIUM 50 MG TABLET(COZAAR),63739068610,NDC,inpatient,1,EA,1.9,,NONE,NONE,,1.9,,,,1.9,1.9,other,not separately reimbursable by contracted payers
MAG HYDROX/AL HYDROX/SIMETH 30ML CUP(MAALOX PLUS),00121176130 ,NDC,inpatient,30,ML,11.1,,NONE,NONE,,11.1,,,,11.1,11.1,other,not separately reimbursable by contracted payers
MAGNESIUM SULFATE/D5W 1 GM/100 ML BAG(MAGNESIUM-D5W 1 GM/100 ML SOLN),63323010826,NDC,inpatient,100,ML,17.25,,NONE,NONE,,17.25,,,,17.25,17.25,other,not separately reimbursable by contracted payers
MAGNESIUM CITRATE 300ML BOTTLE(CITRATE OF MAGNESIA),70677111101,NDC,inpatient,300,ML,7.45,,NONE,NONE,,7.45,,,,7.45,7.45,other,not separately reimbursable by contracted payers
MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION(MILK OF MAGNESIA),00363094940 ,NDC,inpatient,5,ML,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
MAGNESIUM OXIDE 400 MG TABLET(MAG-OX),10006070028,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
MECLIZINE HCL 12.5 MG TABLET(ANTIVERT),50268052215,NDC,inpatient,1,EA,1.7,,NONE,NONE,,1.7,,,,1.7,1.7,other,not separately reimbursable by contracted payers
MEGESTROL ACETATE 400 MG/10 ML CUP(MEGACE),68094006362,NDC,inpatient,10,ML,16.7,,NONE,NONE,,16.7,,,,16.7,16.7,other,not separately reimbursable by contracted payers
MEGESTROL ACETATE 40 MG TABLET(MEGACE),00904723661 ,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
MELATONIN 3 MG TABLET(MELATONIN),20555003601,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
MELOXICAM 7.5 MG TABLET(MOBIC),50268052515,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
MEMANTINE HCL 5 MG TABLET(NAMENDA),00904650561 ,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
MENTHOL/CAMPHOR (SARNA) 0.5%-0.5% 222ML LOTION(SARNA),00536126812 ,NDC,inpatient,222,ML,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
MEROPENEM 500 MG VIAL(MERREM),55150020720,NDC,inpatient,1,EA,21,,NONE,NONE,,21,,,,21,21,other,not separately reimbursable by contracted payers
MEROPENEM 1 G VIAL(MERREM),55150020830,NDC,inpatient,1,EA,38.5,,NONE,NONE,,38.5,,,,38.5,38.5,other,not separately reimbursable by contracted payers
MESALAMINE CR 250MG CAPSULE(PENTASA),54092018981,NDC,inpatient,1,EA,10.65,,NONE,NONE,,10.65,,,,10.65,10.65,other,not separately reimbursable by contracted payers
MESALAMINE DR 800MG TABLET(ASACOL HD),68382043528,NDC,inpatient,1,EA,26,,NONE,NONE,,26,,,,26,26,other,not separately reimbursable by contracted payers
METAXALONE 800 MG TABLET(SKELAXIN),50268053015,NDC,inpatient,1,EA,7.85,,NONE,NONE,,7.85,,,,7.85,7.85,other,not separately reimbursable by contracted payers
PSYLLIUM SEED/SUCROSE (SF) PACKET(PSYLLIUM SUGAR FREE PACKET),37000002404,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
METFORMIN HCL XR 500 MG TABLET(GLUCOPHAGE XR),70010049101,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
METFORMIN HCL 500 MG TABLET(GLUCOPHAGE),00904716261 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
METFORMIN HCL 850 MG TABLET(GLUCOPHAGE 850MG),60687014301,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
"METHYLPREDNISOLONE SOD SUCC 1,000 MG VIAL(SOLU-MEDROL)",63323026530,NDC,inpatient,1,EA,119.8,,NONE,NONE,,119.8,,,,119.8,119.8,other,not separately reimbursable by contracted payers
METHYLNALTREXONE BROMIDE 12 MG/0.6 ML SYRINGE(RELISTOR),65649055107,NDC,inpatient,0.6,ML,561.1,,NONE,NONE,,561.1,,,,561.1,561.1,other,not separately reimbursable by contracted payers
METHENAMINE HIPPURATE 1 GM TABLET(HIPREX),65862078201,NDC,inpatient,1,EA,2.8,,NONE,NONE,,2.8,,,,2.8,2.8,other,not separately reimbursable by contracted payers
METHYL SALICYLATE/MENTHOL (BENGAY) OINT 85G(BENGAY),00536134957 ,NDC,inpatient,85,GR,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
METHYLPREDNISOLONE SOD SUCC 40 MG VIAL(SOLU-MEDROL),00009003928 ,NDC,inpatient,1,EA,22.65,,NONE,NONE,,22.65,,,,22.65,22.65,other,not separately reimbursable by contracted payers
METHYLPREDNISOLONE 4 MG TABLET(MEDROL),42806040001,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
METHOCARBAMOL 500 MG TABLET(ROBAXIN),70010075401,NDC,inpatient,1,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
METHYLPREDNISOLONE SOD SUCC/PF 500 MG/4 ML(SOLU-MEDROL 500 MG VIAL),00009000302 ,NDC,inpatient,4,ML,165.85,,NONE,NONE,,165.85,,,,165.85,165.85,other,not separately reimbursable by contracted payers
METHYLPREDNISOLONE SOD SUCC 500 MG VIAL(SOLU-MEDROL),00009075801 ,NDC,inpatient,1,EA,85,,NONE,NONE,,85,,,,85,85,other,not separately reimbursable by contracted payers
METHADONE HCL 5 MG TABLET(DOLOPHINE),00406575562 ,NDC,inpatient,1,EA,1.1,,NONE,NONE,,1.1,,,,1.1,1.1,other,not separately reimbursable by contracted payers
METHIMAZOLE 5 MG TABLET(TAPAZOLE),23155007001,NDC,inpatient,1,EA,0.55,,NONE,NONE,,0.55,,,,0.55,0.55,other,not separately reimbursable by contracted payers
METHYLPHENIDATE HCL 5 MG TABLET(RITALIN),00078043905A,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
METHOCARBAMOL 750 MG TABLET(ROBAXIN),00904705861 ,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
METHYLNALTREXONE BROMIDE 8 MG/0.4 ML SYRINGE(RELISTOR),65649055204,NDC,inpatient,0.4,ML,561.1,,NONE,NONE,,561.1,,,,561.1,561.1,other,not separately reimbursable by contracted payers
METHADONE HCL 10 MG TABLET(DOLOPHINE),00904741761 ,NDC,inpatient,1,EA,0.9,,NONE,NONE,,0.9,,,,0.9,0.9,other,not separately reimbursable by contracted payers
METHOTREXATE SODIUM 2.5 MG TABLET(RHEUMATREX),51079067005,NDC,inpatient,1,EA,9.7,,NONE,NONE,,9.7,,,,9.7,9.7,other,not separately reimbursable by contracted payers
METOPROLOL TARTRATE 100 MG TABLET(LOPRESSOR),51079080220,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
METOCLOPRAMIDE HCL 10 MG TABLET(REGLAN),51079088820,NDC,inpatient,1,EA,2.8,,NONE,NONE,,2.8,,,,2.8,2.8,other,not separately reimbursable by contracted payers
METOPROLOL TARTRATE 25 MG TABLET(LOPRESSOR),51079025520,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
METOPROLOL SUCCINATE ER 50MG TABLET(TOPROL XL),00904632361 ,NDC,inpatient,1,EA,3.7,,NONE,NONE,,3.7,,,,3.7,3.7,other,not separately reimbursable by contracted payers
METOPROLOL SUCCINATE 50 MG TAB.ER.24H(),00378459610 ,NDC,inpatient,1,EA,2.65,,NONE,NONE,,2.65,,,,2.65,2.65,other,not separately reimbursable by contracted payers
METOPROLOL TARTRATE 50 MG TABLET(LOPRESSOR),51079080120,NDC,inpatient,50,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
METOCLOPRAMIDE HCL 10 MG/10 ML CUP(REGLAN),00121157610 ,NDC,inpatient,10,ML,14.2,,NONE,NONE,,14.2,,,,14.2,14.2,other,not separately reimbursable by contracted payers
METOCLOPRAMIDE HCL 5 MG/5 ML ML(REGLAN),62559019016,NDC,inpatient,5,ML,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
METOLAZONE 5 MG TABLET(ZAROXOLYN),00185005501 ,NDC,inpatient,1,EA,2.4,,NONE,NONE,,2.4,,,,2.4,2.4,other,not separately reimbursable by contracted payers
METOCLOPRAMIDE HCL 5 MG/ML VIAL(REGLAN),00703450204 ,NDC,inpatient,1,ML,11.75,,NONE,NONE,,11.75,,,,11.75,11.75,other,not separately reimbursable by contracted payers
METRONIDAZOLE 500MG/100ML BAG(FLAGYL),00409015224 ,NDC,inpatient,100,ML,7.4,,NONE,NONE,,7.4,,,,7.4,7.4,other,not separately reimbursable by contracted payers
METRONIDAZOLE 500 MG TABLET(FLAGYL),29300022701,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
"CALCITONIN,SALMON,SYNTHETIC 200U/ML NASAL SPRAY(MIACALCIN)",60505082306,NDC,inpatient,1,EA,70.85,,NONE,NONE,,70.85,,,,70.85,70.85,other,not separately reimbursable by contracted payers
MICONAZOLE NITRATE 200 MG/SUPP (3 SUPP) KIT(MONISTAT 3),49348035543,NDC,inpatient,1,EA,32.4,,NONE,NONE,,32.4,,,,32.4,32.4,other,not separately reimbursable by contracted payers
MICONAZOLE NITRATE 2% (MITRAZOL) 85GM POWDER(DESENEX),11701003816,NDC,inpatient,85,GR,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
MIDODRINE HCL 5 MG TABLET(PROAMATINE),51079045320,NDC,inpatient,1,EA,4,,NONE,NONE,,4,,,,4,4,other,not separately reimbursable by contracted payers
"MINERAL OIL/PETROLATUM, WHITE CREAM 120 G(DERMACERIN)",61924017804,NDC,inpatient,120,GR,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
MIRABEGRON ER 25 MG TABLET(MYRBETRIQ),00469260130 ,NDC,inpatient,1,EA,53.7,,NONE,NONE,,53.7,,,,53.7,53.7,other,not separately reimbursable by contracted payers
MIRABEGRON ER 50 MG TABLET(MYRBETRIQ),00469260230 ,NDC,inpatient,1,EA,53.7,,NONE,NONE,,53.7,,,,53.7,53.7,other,not separately reimbursable by contracted payers
MIRTAZAPINE 7.5 MG TABLET (1/2 OF A 15 MG TABLET)(REMERON),00378351501 ,NDC,inpatient,0.5,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
MIRTAZAPINE 15 MG TABLET(REMERON),00904651961 ,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
MODAFINIL 100 MG TABLET(PROVIGIL),68084062121,NDC,inpatient,1,EA,38.5,,NONE,NONE,,38.5,,,,38.5,38.5,other,not separately reimbursable by contracted payers
"MAGNESIUM HYDROXIDE 2,400 MG/30 ML CUP(MILK OF MAGNESIA)",00121043130 ,NDC,inpatient,30,ML,6.85,,NONE,NONE,,6.85,,,,6.85,6.85,other,not separately reimbursable by contracted payers
MORPHINE SULFATE IR 10 MG/5 ML CUP(MSIR),68094000162,NDC,inpatient,5,ML,4.8,,NONE,NONE,,4.8,,,,4.8,4.8,other,not separately reimbursable by contracted payers
MORPHINE SULFATE 15 MG IR TABLET(MSIR),00054023524 ,NDC,inpatient,1,EA,2.7,,NONE,NONE,,2.7,,,,2.7,2.7,other,not separately reimbursable by contracted payers
MORPHINE SA 15 MG TABLET(MS CONTIN),00406831562 ,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
MORPHINE SULFATE IR 2 MG/ML SYRINGE(MSIR),00409189001 ,NDC,inpatient,1,ML,7.5,,NONE,NONE,,7.5,,,,7.5,7.5,other,not separately reimbursable by contracted payers
MORPHINE SA 30 MG TABLET(MS CONTIN),00406833062 ,NDC,inpatient,1,EA,5.6,,NONE,NONE,,5.6,,,,5.6,5.6,other,not separately reimbursable by contracted payers
MUPIROCIN 2% OINTMENT 22 G(BACTROBAN),51672131200,NDC,inpatient,22,GR,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
MYCOPHENOLATE MOFETIL 250 MG CAPSULE(CELLCEPT),51079072120,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
"NYSTATIN/TRIAMCINOLONE 100,000 U/GM-1% CREAM 30 G(MYCOLOG)",45802088094,NDC,inpatient,30,GR,3.45,,NONE,NONE,,3.45,,,,3.45,3.45,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 0.9% 10 ML VIAL(SODIUM CHLORIDE),63323018610,NDC,inpatient,10,ML,3.6,,NONE,NONE,,3.6,,,,3.6,3.6,other,not separately reimbursable by contracted payers
NADOLOL 20 MG TABLET(CORGARD),51079081220,NDC,inpatient,1,EA,18.1,,NONE,NONE,,18.1,,,,18.1,18.1,other,not separately reimbursable by contracted payers
"NAPH,MB-DB/K PH,MBDB POWDER PACKET(NEUTRA-PHOS)",60258000601,NDC,inpatient,1,EA,1.9,,NONE,NONE,,1.9,,,,1.9,1.9,other,not separately reimbursable by contracted payers
NAPROXEN 250 MG TABLET(NAPROSYN),50268059415,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
RENO CAPS/NEPHROCAPS/WESCAPS/VIRT-CAPS CAPSULE(NEPHROCAPS),60258016201,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
NIACIN ER 500MG TABLET(NIASPAN),47335053981,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
NICOTINE 14 MG PATCH(NICODERM),43598044774,NDC,inpatient,1,EA,6.25,,NONE,NONE,,6.25,,,,6.25,6.25,other,not separately reimbursable by contracted payers
NICOTINE 21 MG PATCH(NICODERM),43598044874,NDC,inpatient,1,EA,6.25,,NONE,NONE,,6.25,,,,6.25,6.25,other,not separately reimbursable by contracted payers
NICOTINE 7MG PATCH(NICODERM),43598044674,NDC,inpatient,1,EA,6.25,,NONE,NONE,,6.25,,,,6.25,6.25,other,not separately reimbursable by contracted payers
NIFEDIPINE 30 MG ER TABLET(PROCARDIA XL),68084059701,NDC,inpatient,1,EA,5.25,,NONE,NONE,,5.25,,,,5.25,5.25,other,not separately reimbursable by contracted payers
NIMODIPINE 30 MG CAPSULE(NIMOTOP),63739079733,NDC,inpatient,1,EA,10.05,,NONE,NONE,,10.05,,,,10.05,10.05,other,not separately reimbursable by contracted payers
NITROGLYCERIN 0.4 MG SL TABLET(NITROSTAT),68462063945,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
NITROFURANTOIN MONOHYD/M-CRYST 100 MG CAPSULE(MACROBID),00185012201 ,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
NITROGLYCERIN 0.1 MG PATCH(NITRO-DUR),00378910293 ,NDC,inpatient,1,EA,2.15,,NONE,NONE,,2.15,,,,2.15,2.15,other,not separately reimbursable by contracted payers
NITROGLYCERIN 0.4 MG PATCH(NITRO-DUR),00378911293 ,NDC,inpatient,1,EA,2.9,,NONE,NONE,,2.9,,,,2.9,2.9,other,not separately reimbursable by contracted payers
NITROGLYCERIN 0.3 MG PATCH(NITRO-DUR),50742051530,NDC,inpatient,1,EA,185.5,,NONE,NONE,,185.5,,,,185.5,185.5,other,not separately reimbursable by contracted payers
NORTRIPTYLINE HCL 10 MG CAPSULE(PAMELOR),50268060315,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
NORTRIPTYLINE HCL 25 MG CAPSULE(PAMELOR),51672400205,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
NITROGLYCERIN 2% PASTE(NITRO-BID),00281032608 ,NDC,inpatient,1,EA,8.5,,NONE,NONE,,8.5,,,,8.5,8.5,other,not separately reimbursable by contracted payers
"NYSTATIN 100,000 UNIT/GM CREAM 30 G(NYSTATIN CREAM)",45802005911,NDC,inpatient,30,GR,2.45,,NONE,NONE,,2.45,,,,2.45,2.45,other,not separately reimbursable by contracted payers
"NYSTATIN 500,000 UNITS/5 ML CUP(NYSTATIN 500,000 UNITS/5 ML)",63739016010,NDC,inpatient,5,ML,4.85,,NONE,NONE,,4.85,,,,4.85,4.85,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 0.65% 45ML NASAL SPRAY(OCEAN),00904386575 ,NDC,inpatient,45,ML,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
OFLOXACIN 0.3% 5ML EYE DROPS(OCUFLOX),70756060730,NDC,inpatient,5,ML,10.5,,NONE,NONE,,10.5,,,,10.5,10.5,other,not separately reimbursable by contracted payers
OLANZAPINE 10 MG VIAL(ZYPREXA),00781910572 ,NDC,inpatient,1,EA,116.2,,NONE,NONE,,116.2,,,,116.2,116.2,other,not separately reimbursable by contracted payers
OLANZAPINE 5MG ODT TABLET(ZYPREXA ODT),60505327500,NDC,inpatient,1,EA,6.3,,NONE,NONE,,6.3,,,,6.3,6.3,other,not separately reimbursable by contracted payers
ONDANSETRON 4 MG ODT TABLET(ZOFRAN),65862039010,NDC,inpatient,1,EA,2.15,,NONE,NONE,,2.15,,,,2.15,2.15,other,not separately reimbursable by contracted payers
ONDANSETRON HCL/PF 4 MG/2 ML VIAL(ZOFRAN),23155054841,NDC,inpatient,2,ML,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
OSELTAMIVIR PHOSPHATE 30 MG CAPSULE(TAMIFLU),47781046813,NDC,inpatient,1,EA,32.8,,NONE,NONE,,32.8,,,,32.8,32.8,other,not separately reimbursable by contracted payers
OSELTAMIVIR PHOSPHATE 75 MG CAPSULE(TAMIFLU),70710101002,NDC,inpatient,1,EA,11.2,,NONE,NONE,,11.2,,,,11.2,11.2,other,not separately reimbursable by contracted payers
OXCARBAZEPINE 300 MG TABLET(TRILEPTAL),68462013801,NDC,inpatient,1,EA,1.95,,NONE,NONE,,1.95,,,,1.95,1.95,other,not separately reimbursable by contracted payers
OXYBUTYNIN CHLORIDE 5 MG TABLET(DITROPAN),00904702761 ,NDC,inpatient,1,EA,2.1,,NONE,NONE,,2.1,,,,2.1,2.1,other,not separately reimbursable by contracted payers
OXYBUTYNIN CHLORIDE XL 5 MG TABLET(DITROPAN XL),63739054833,NDC,inpatient,1,EA,10.15,,NONE,NONE,,10.15,,,,10.15,10.15,other,not separately reimbursable by contracted payers
OXYCODONE HCL 10 MG TABLET(ROXICODONE),42858000210,NDC,inpatient,1,EA,2.3,,NONE,NONE,,2.3,,,,2.3,2.3,other,not separately reimbursable by contracted payers
OXYCODONE SR 10 MG TABLET(OXYCONTIN),59011041020,NDC,inpatient,1,EA,19.15,,NONE,NONE,,19.15,,,,19.15,19.15,other,not separately reimbursable by contracted payers
OXYCODONE HCL 15 MG TABLET(ROXICODONE),00406851562 ,NDC,inpatient,1,EA,3.5,,NONE,NONE,,3.5,,,,3.5,3.5,other,not separately reimbursable by contracted payers
OXYCODONE SR 20 MG TABLET(OXYCONTIN),59011042020,NDC,inpatient,1,EA,35.7,,NONE,NONE,,35.7,,,,35.7,35.7,other,not separately reimbursable by contracted payers
OXYCODONE SR 40 MG TABLET(OXYCONTIN),59011044020,NDC,inpatient,1,EA,61.15,,NONE,NONE,,61.15,,,,61.15,61.15,other,not separately reimbursable by contracted payers
OXYCODONE HCL 5 MG/5 ML CUP(ROXICODONE),64950035455,NDC,inpatient,5,ML,20.65,,NONE,NONE,,20.65,,,,20.65,20.65,other,not separately reimbursable by contracted payers
OXYCODONE HCL 5 MG TABLET(ROXICODONE),00406055262 ,NDC,inpatient,1,EA,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
OXYCODONE HCL 2.5 MG TABLET (1/2 OF A 5MG TABLET)(ROXICODONE),13107005501,NDC,inpatient,0.5,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
PANTOPRAZOLE SODIUM DR 40 MG TABLET(PROTONIX),66993006880,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
PAROXETINE HCL 10 MG TABLET(PAXIL),68084004401,NDC,inpatient,1,EA,3,,NONE,NONE,,3,,,,3,3,other,not separately reimbursable by contracted payers
PAROXETINE HCL 20 MG TABLET(PAXIL),68084004501,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
PENICILLIN V POTASSIUM 250 MG TABLET(BEEPEN VK),57237004001,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
OXYCODONE HCL/ACETAMINOPHEN 5/325MG TABLET(PERCOCET 5/325MG),00406051262 ,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
PHENYTOIN SODIUM ER 100MG CAPSULE(DILANTIN),00071036924 ,NDC,inpatient,1,EA,5.9,,NONE,NONE,,5.9,,,,5.9,5.9,other,not separately reimbursable by contracted payers
PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE(DILANTIN),00378156001 ,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
PHENYTOIN 100 MG/4 ML CUP(DILANTIN),60687027566,NDC,inpatient,4,ML,23.45,,NONE,NONE,,23.45,,,,23.45,23.45,other,not separately reimbursable by contracted payers
PHENYTOIN SODIUM ER 30 MG CAPSULE(DILANTIN),00071374066 ,NDC,inpatient,1,EA,5.1,,NONE,NONE,,5.1,,,,5.1,5.1,other,not separately reimbursable by contracted payers
HEMORRHOIDAL OINTMENT 57 GRAMS(PREPARATION H),49348019878,NDC,inpatient,57,GR,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
PHENOBARBITAL 30 MG TABLET(IONAMIN),00904657561 ,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
PHENOBARBITAL 32.4 MG TABLET(IONAMIN),00603516632 ,NDC,inpatient,1,EA,1.8,,NONE,NONE,,1.8,,,,1.8,1.8,other,not separately reimbursable by contracted payers
PHENYTOIN CHEWABLE 50 MG TABLET(DILANTIN),51672414601,NDC,inpatient,1,EA,1.5,,NONE,NONE,,1.5,,,,1.5,1.5,other,not separately reimbursable by contracted payers
PHENAZOPYRIDINE HCL 100 MG TABLET(PYRIDIUM),10135062001,NDC,inpatient,1,EA,2.25,,NONE,NONE,,2.25,,,,2.25,2.25,other,not separately reimbursable by contracted payers
K-PHOS NEUTRAL 250 MG TABLET(PHOSPHA 250 NEUTRAL),00486112501 ,NDC,inpatient,1,EA,2.4,,NONE,NONE,,2.4,,,,2.4,2.4,other,not separately reimbursable by contracted payers
PHYTONADIONE 5 MG TABLET(VITAMIN K),16714097302,NDC,inpatient,1,EA,131.3,,NONE,NONE,,131.3,,,,131.3,131.3,other,not separately reimbursable by contracted payers
PILOCARPINE HCL 5 MG TABLET(SALAGEN),00228280111 ,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
PIOGLITAZONE HCL 15 MG TABLET(ACTOS),33342005410,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
PIPERACILL NA/TAZOBACTAM NA 3.375 GM VIAL(ZOSYN),00409337813 ,NDC,inpatient,1,EA,42.45,,NONE,NONE,,42.45,,,,42.45,42.45,other,not separately reimbursable by contracted payers
POLYETHYLENE GLYCOL 3350 17G PACKET(MIRALAX),00904693181 ,NDC,inpatient,1,EA,4.55,,NONE,NONE,,4.55,,,,4.55,4.55,other,not separately reimbursable by contracted payers
POTASSIUM CHLORIDE ER 10 MEQ CAPSULE(K-DUR),60687065301,NDC,inpatient,1,EA,3,,NONE,NONE,,3,,,,3,3,other,not separately reimbursable by contracted payers
POTASSIUM CHLORIDE 10 MEQ/100 ML BAG(KCL),00338070948 ,NDC,inpatient,100,ML,13.85,,NONE,NONE,,13.85,,,,13.85,13.85,other,not separately reimbursable by contracted payers
POTASSIUM CHLORIDE 20 MEQ/15 ML CUP(K-SOL),60687062864,NDC,inpatient,15,ML,60.95,,NONE,NONE,,60.95,,,,60.95,60.95,other,not separately reimbursable by contracted payers
PRAMIPEXOLE DI-HCL 0.25 MG TABLET(MIRAPEX),68462033190,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
PRAMIPEXOLE DI-HCL 0.5 MG TABLET(MIRAPEX),68462033290,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
PRAZOSIN HCL 1 MG CAPSULE(MINIPRESS),00093406701 ,NDC,inpatient,1,EA,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
PREDNISONE 10 MG TABLET(DELTASONE),00054001720 ,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
PREDNISONE 1 MG TABLET(DELTASONE),00054873925 ,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
PREDNISONE 1 MG TABLET(),00054474131 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
PREDNISONE 20 MG TABLET(DELTASONE),00054001820 ,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
PREDNISOLONE ACETATE 5 ML DROPS.SUSP(),50090056100,NDC,inpatient,5,ML,193.65,,NONE,NONE,,193.65,,,,193.65,193.65,other,not separately reimbursable by contracted payers
PREDNISOLONE ACETATE 1% 5ML EYE DROPS(PRED FORTE 1%),61314063705A,NDC,inpatient,5,ML,31,,NONE,NONE,,31,,,,31,31,other,not separately reimbursable by contracted payers
PREDNISONE 5 MG TABLET(DELTASONE),00054872425 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
PREGABALIN 100 MG CAPSULE(LYRICA),00904700161 ,NDC,inpatient,1,EA,2.95,,NONE,NONE,,2.95,,,,2.95,2.95,other,not separately reimbursable by contracted payers
PREGABALIN 25 MG CAPSULE(LYRICA),00904699104 ,NDC,inpatient,1,EA,4.65,,NONE,NONE,,4.65,,,,4.65,4.65,other,not separately reimbursable by contracted payers
PREGABALIN 50 MG CAPSULE(LYRICA),00904699261 ,NDC,inpatient,1,EA,2.65,,NONE,NONE,,2.65,,,,2.65,2.65,other,not separately reimbursable by contracted payers
LANSOPRAZOLE ODT 30 MG TABLET(PREVACID ODT),68382077277,NDC,inpatient,1,EA,22.15,,NONE,NONE,,22.15,,,,22.15,22.15,other,not separately reimbursable by contracted payers
PRIMIDONE 250 MG TABLET(MYSOLINE),53746054501,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
PRIMIDONE 50 MG TABLET(MYSOLINE),68084020201,NDC,inpatient,1,EA,2.85,,NONE,NONE,,2.85,,,,2.85,2.85,other,not separately reimbursable by contracted payers
PROCHLORPERAZINE MALEATE 10 MG TABLET(COMPAZINE),70954068910,NDC,inpatient,1,EA,1.85,,NONE,NONE,,1.85,,,,1.85,1.85,other,not separately reimbursable by contracted payers
PROCHLORPERAZINE MALEATE 25 MG SUPPOSITORY(COMPAZINE),00574722612 ,NDC,inpatient,1,EA,30.5,,NONE,NONE,,30.5,,,,30.5,30.5,other,not separately reimbursable by contracted payers
PROCHLORPERAZINE MALEATE 5 MG TABLET(COMPAZINE),00378510501 ,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
PROCHLORPERAZINE EDISYLATE 10 MG/2 ML VIAL(COMPAZINE),55390007710,NDC,inpatient,2,ML,16.1,,NONE,NONE,,16.1,,,,16.1,16.1,other,not separately reimbursable by contracted payers
PROPRANOLOL HCL 20 MG TABLET(INDERAL),60687059801,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
PSEUDOEPHEDRINE HCL 30 MG TABLET(SUDAFED),00904505359 ,NDC,inpatient,1,EA,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
PSYLLIUM HUSK/ASPARTAME (REGULOID) POWDER(REGULOID),80681004201,NDC,inpatient,284,GR,29.5,,NONE,NONE,,29.5,,,,29.5,29.5,other,not separately reimbursable by contracted payers
PYRIDOXINE HCL (VITAMIN B6) 50 MG TABLET(VITAMIN B-6),77333094010,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
PYRIDOSTIGMINE BROMIDE 60 MG TABLET(MESTINON),00115351101 ,NDC,inpatient,1,EA,2.9,,NONE,NONE,,2.9,,,,2.9,2.9,other,not separately reimbursable by contracted payers
QUETIAPINE FUMARATE 25 MG TABLET(SEROQUEL),00904663861 ,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
RANOLAZINE 12H-ER 500 MG TABLET(RANEXA),60687054921,NDC,inpatient,1,EA,4.9,,NONE,NONE,,4.9,,,,4.9,4.9,other,not separately reimbursable by contracted payers
RIFAMPIN 300 MG CAPSULE(RIMACTANE),60687058601,NDC,inpatient,1,EA,6.55,,NONE,NONE,,6.55,,,,6.55,6.55,other,not separately reimbursable by contracted payers
RIFAXIMIN 550 MG TABLET(XIFAXIN),65649030303,NDC,inpatient,1,EA,190.6,,NONE,NONE,,190.6,,,,190.6,190.6,other,not separately reimbursable by contracted payers
RISPERIDONE 0.25 MG TABLET(RISPERDAL),43547033906,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
RISPERIDONE 1 MG TABLET(RISPERDAL),00904736261 ,NDC,inpatient,1,EA,1.25,,NONE,NONE,,1.25,,,,1.25,1.25,other,not separately reimbursable by contracted payers
METHYLPHENIDATE HCL 5 MG TABLET(RITALIN),31722017301,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
RIVASTIGMINE TARTRATE 1.5 MG CAPSULE(EXELON),55111035260,NDC,inpatient,1,EA,2.05,,NONE,NONE,,2.05,,,,2.05,2.05,other,not separately reimbursable by contracted payers
RIVAROXABAN 10 MG TABLET(XARELTO),50458058030,NDC,inpatient,1,EA,66.5,,NONE,NONE,,66.5,,,,66.5,66.5,other,not separately reimbursable by contracted payers
RIVAROXABAN 15 MG TABLET(XARELTO),50458057810,NDC,inpatient,1,EA,66.5,,NONE,NONE,,66.5,,,,66.5,66.5,other,not separately reimbursable by contracted payers
RIVAROXABAN 20 MG TABLET(XARELTO),50458057910,NDC,inpatient,1,EA,66.5,,NONE,NONE,,66.5,,,,66.5,66.5,other,not separately reimbursable by contracted payers
ROPINIROLE HCL 0.25 MG TABLET(REQUIP),00904637361 ,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
ROPINIROLE HCL 1 MG TABLET(REQUIP),00904637461 ,NDC,inpatient,1,EA,2,,NONE,NONE,,2,,,,2,2,other,not separately reimbursable by contracted payers
ROSUVASTATIN CALCIUM 10 MG TABLET(CRESTOR),60687024501,NDC,inpatient,1,EA,4.9,,NONE,NONE,,4.9,,,,4.9,4.9,other,not separately reimbursable by contracted payers
ROSUVASTATIN CALCIUM 40 MG TABLET(CRESTOR),16714099101,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
SACUBITRIL/VALSARTAN 24MG-26MG TABLET(ENTRESTO 24 MG-26 MG TABLET),00078065920 ,NDC,inpatient,1,EA,40.15,,NONE,NONE,,40.15,,,,40.15,40.15,other,not separately reimbursable by contracted payers
SACUBITRIL/VALSARTAN 97MG-103MG TABLET(ENTRESTO 97 MG-103 MG TABLET),00078069620 ,NDC,inpatient,1,EA,40.15,,NONE,NONE,,40.15,,,,40.15,40.15,other,not separately reimbursable by contracted payers
SACUBITRIL/VALSARTAN 49MG-51MG TABLET(ENTRESTO 49 MG-51 MG TABLET),00078077720 ,NDC,inpatient,1,EA,40.15,,NONE,NONE,,40.15,,,,40.15,40.15,other,not separately reimbursable by contracted payers
BIOTENE MOUTH SPRAY 44.3 ML(BIOTENE MOISTURIZING MOUTH SPRAY),04858200115 ,NDC,inpatient,44.3,ML,15.65,,NONE,NONE,,15.65,,,,15.65,15.65,other,not separately reimbursable by contracted payers
SCOPOLAMINE HYDROBROMIDE 1MG 72HR PATCH(TRANSDERM-SCOP),10019055304,NDC,inpatient,1,EA,74.55,,NONE,NONE,,74.55,,,,74.55,74.55,other,not separately reimbursable by contracted payers
SENNOSIDES 8.6 MG TABLET(SENOKOT),00904725261 ,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
SENNOSIDES 17.6 MG/10 ML CUP(SENOKOT),57896046208,NDC,inpatient,10,ML,1.55,,NONE,NONE,,1.55,,,,1.55,1.55,other,not separately reimbursable by contracted payers
QUETIAPINE FUMARATE 100 MG TABLET(SEROQUEL),00904664061 ,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
SERTRALINE HCL 25 MG TABLET(ZOLOFT),60687023101,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
SERTRALINE HCL 50 MG TABLET(ZOLOFT),60687024201,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
SEVELAMER CARBONATE 800 MG TABLET(RENVELA),16714081401,NDC,inpatient,1,EA,7.35,,NONE,NONE,,7.35,,,,7.35,7.35,other,not separately reimbursable by contracted payers
SILVER SULFADIAZINE 1% CREAM 20 G(SILVADENE),61570013120,NDC,inpatient,20,GR,1.6,,NONE,NONE,,1.6,,,,1.6,1.6,other,not separately reimbursable by contracted payers
SIMETHICONE 80 MG CHEWABLE TABLET(GAS-X),69618003301,NDC,inpatient,1,EA,0.1,,NONE,NONE,,0.1,,,,0.1,0.1,other,not separately reimbursable by contracted payers
MONTELUKAST SODIUM 10 MG TABLET(SINGULAIR),68084087501,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
FLEET ENEMA(FLEET ENEMA),00132020140 ,NDC,inpatient,133,ML,3.9,,NONE,NONE,,3.9,,,,3.9,3.9,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 0.9% 500 ML BAG(SODIUM CHLORIDE 0.9% IV SOLN),00264780010 ,NDC,inpatient,1,EA,11.85,,NONE,NONE,,11.85,,,,11.85,11.85,other,not separately reimbursable by contracted payers
SODIUM BICARBONATE 325 MG TABLET (HALF OF A 650MG)(SODIUM BICARBONATE),66553000801A,NDC,inpatient,0.5,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
SODIUM ZIRCONIUM CYCLOSILICATE 10 GM PACKET(LOKELMA),00310111030 ,NDC,inpatient,1,EA,95.75,,NONE,NONE,,95.75,,,,95.75,95.75,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 1 G TABLET(SODIUM CHLORIDE),00223176001 ,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 0.9% 20 ML VIAL(SODIUM CHLORDIE PF),63323018620,NDC,inpatient,20,ML,7.35,,NONE,NONE,,7.35,,,,7.35,7.35,other,not separately reimbursable by contracted payers
SODIUM CHLORIDE 0.9% FOR INHALATION 3 ML VIAL.NEB(BLAIREX 0.09%),00378698501 ,NDC,inpatient,3,ML,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
SODIUM HYPOCHLORITE 0.125% (1/4 STRENGTH) 473ML(DAKIN'S QUARTER STRENGTH),39328006412,NDC,inpatient,473,ML,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
SODIUM ZIRCONIUM CYCLOSILICATE 5 GM PACKET(LOKELMA),00310110539 ,NDC,inpatient,1,EA,95.75,,NONE,NONE,,95.75,,,,95.75,95.75,other,not separately reimbursable by contracted payers
SODIUM BICARBONATE 650 MG TABLET(NEUT),66553000801,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
METHYLPREDNISOLONE SOD SUCC 125 MG VIAL(SOLU-MEDROL),00009004722 ,NDC,inpatient,1,EA,36.5,,NONE,NONE,,36.5,,,,36.5,36.5,other,not separately reimbursable by contracted payers
SOTALOL HCL 80 MG TABLET(BETAPACE),68084065401,NDC,inpatient,1,EA,4.45,,NONE,NONE,,4.45,,,,4.45,4.45,other,not separately reimbursable by contracted payers
SPIRONOLACTONE 25 MG TABLET(ALDACTONE),51079010320,NDC,inpatient,1,EA,0.65,,NONE,NONE,,0.65,,,,0.65,0.65,other,not separately reimbursable by contracted payers
SUCRALFATE 1 G TABLET(CARAFATE),51079075320,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
SULFAMETHOXAZOLE/TRIMETHOPRIM 800MG/160MG TABLET(BACTRIM DS),00904272561 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
SULFAMETHOXAZOLE/TRIMETHOPRIM 800MG-160MG/20ML CUP(BACTRIM 800MG-160MG/20 ML),65862049647,NDC,inpatient,20,ML,6.4,,NONE,NONE,,6.4,,,,6.4,6.4,other,not separately reimbursable by contracted payers
SULFASALAZINE 500 MG TABLET(SULFAZINE),59762500005,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
SULFASALAZINE 500 MG TABLET(AZULFIDINE),00093323401 ,NDC,inpatient,1,EA,0.7,,NONE,NONE,,0.7,,,,0.7,0.7,other,not separately reimbursable by contracted payers
SUMATRIPTAN SUCCINATE 50 MG TABLET(IMITREX),16714079701,NDC,inpatient,1,EA,6.2,,NONE,NONE,,6.2,,,,6.2,6.2,other,not separately reimbursable by contracted payers
TACROLIMUS 0.5 MG CAPSULE(PROGRAF),68084044901,NDC,inpatient,1,EA,6.95,,NONE,NONE,,6.95,,,,6.95,6.95,other,not separately reimbursable by contracted payers
TACROLIMUS 0.5 MG CAPSULE(PROGRAF),00781210201 ,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
TACROLIMUS 1 MG CAPSULE(PROGRAF),16729004201,NDC,inpatient,1,EA,2.05,,NONE,NONE,,2.05,,,,2.05,2.05,other,not separately reimbursable by contracted payers
TAMOXIFEN CITRATE 10 MG TABLET(NOLVADEX),00378014491 ,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
TAMSULOSIN HCL 0.4 MG ER CAPSULE(FLOMAX),72603011502,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
TAMSULOSIN HCL ER 0.4 MG CAPSULE(FLOMAX),63739056710,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
TEMAZEPAM 7.5 MG CAPSULE(RESTORIL),00904643604 ,NDC,inpatient,1,EA,12.25,,NONE,NONE,,12.25,,,,12.25,12.25,other,not separately reimbursable by contracted payers
TERAZOSIN HCL 1 MG CAPSULE(HYTRIN),51079093620,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
TERAZOSIN HCL 5 MG CAPSULE(HYTRIN),59746038506,NDC,inpatient,1,EA,0.65,,NONE,NONE,,0.65,,,,0.65,0.65,other,not separately reimbursable by contracted payers
THIAMINE HCL 100 MG TABLET(VITAMIN B-1),51645090599,NDC,inpatient,1,EA,0.15,,NONE,NONE,,0.15,,,,0.15,0.15,other,not separately reimbursable by contracted payers
TIMOLOL MALEATE 0.5% 5ML EYE DROPS(TIMOPTIC 0.5%),61314022705,NDC,inpatient,5,ML,33.8,,NONE,NONE,,33.8,,,,33.8,33.8,other,not separately reimbursable by contracted payers
TIZANIDINE HCL 2 MG TABLET(ZANAFLEX),60505025103,NDC,inpatient,1,EA,0.6,,NONE,NONE,,0.6,,,,0.6,0.6,other,not separately reimbursable by contracted payers
TIZANIDINE HCL 4 MG TABLET(ZANAFLEX),68084064501,NDC,inpatient,1,EA,2.25,,NONE,NONE,,2.25,,,,2.25,2.25,other,not separately reimbursable by contracted payers
TOPIRAMATE 100 MG TABLET(TOPAMAX),68084034401,NDC,inpatient,1,EA,1.65,,NONE,NONE,,1.65,,,,1.65,1.65,other,not separately reimbursable by contracted payers
TOPIRAMATE 25 MG TABLET(TOPAMAX),68084034201,NDC,inpatient,1,EA,1.05,,NONE,NONE,,1.05,,,,1.05,1.05,other,not separately reimbursable by contracted payers
METOPROLOL SUCCINATE ER 25MG TABLET(TOPROL XL),60687039001,NDC,inpatient,1,EA,3.4,,NONE,NONE,,3.4,,,,3.4,3.4,other,not separately reimbursable by contracted payers
TORSEMIDE 20 MG TABLET(DEMADEX),31722053101,NDC,inpatient,1,EA,0.75,,NONE,NONE,,0.75,,,,0.75,0.75,other,not separately reimbursable by contracted payers
TORSEMIDE 20 MG TABLET(DEMADEX),68084053901,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
TRAMADOL HCL 25 MG TABLET (1/2 OF A 50MG TABLET)(ULTRAM),29300035501,NDC,inpatient,0.5,EA,0.2,,NONE,NONE,,0.2,,,,0.2,0.2,other,not separately reimbursable by contracted payers
TRAMADOL HCL 50 MG TABLET(ULTRAM),51079099120,NDC,inpatient,1,EA,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
TRAZODONE HCL 50 MG TABLET(DESYREL),00904686861 ,NDC,inpatient,1,EA,0.45,,NONE,NONE,,0.45,,,,0.45,0.45,other,not separately reimbursable by contracted payers
TRAZODONE HCL 25 MG TABLET (1/2 OF A 50MG TABLET)(),50111056001,NDC,inpatient,0.5,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
TRIAMCINOLONE ACETONIDE 40 MG/ML VIAL(KENALOG-40),00003029305 ,NDC,inpatient,1,EA,32.8,,NONE,NONE,,32.8,,,,32.8,32.8,other,not separately reimbursable by contracted payers
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80 G(KENALOG 0.1% CREAM),00168000480 ,NDC,inpatient,80,GR,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
UBIDECARENONE (COQ10) 100 MG CAPSULE(COENZYME Q-10),57896087503,NDC,inpatient,1,EA,0.5,,NONE,NONE,,0.5,,,,0.5,0.5,other,not separately reimbursable by contracted payers
UMECLIDINIUM BRM/VILANTEROL TR 62.5-25 MCG INHALER(ANORO ELLIPTA),00173086906 ,NDC,inpatient,1,EA,28.55,,NONE,NONE,,28.55,,,,28.55,28.55,other,not separately reimbursable by contracted payers
UMECLIDINIUM BROMIDE 62.5 MCG/INHALATION(INCRUSE ELLIPTA),00173087306 ,NDC,inpatient,1,EA,37.55,,NONE,NONE,,37.55,,,,37.55,37.55,other,not separately reimbursable by contracted payers
AMPICILLIN SODIUM/SULBACTAM NA 1.5G VIAL(UNASYN),55150011620,NDC,inpatient,1,EA,9.6,,NONE,NONE,,9.6,,,,9.6,9.6,other,not separately reimbursable by contracted payers
AMPICILLIN SODIUM/SULBACTAM NA 3 G VIAL(UNASYN),67457034910,NDC,inpatient,1,EA,13.9,,NONE,NONE,,13.9,,,,13.9,13.9,other,not separately reimbursable by contracted payers
URSODIOL 300 MG CAPSULE(ACTIGALL),60687010001,NDC,inpatient,1,EA,20.85,,NONE,NONE,,20.85,,,,20.85,20.85,other,not separately reimbursable by contracted payers
VALACYCLOVIR HCL 500 MG TABLET(VALTREX),16714069803,NDC,inpatient,1,EA,2.6,,NONE,NONE,,2.6,,,,2.6,2.6,other,not separately reimbursable by contracted payers
VALGANCICLOVIR 450MG TABLET(VALCYTE),55111076260,NDC,inpatient,1,EA,82.05,,NONE,NONE,,82.05,,,,82.05,82.05,other,not separately reimbursable by contracted payers
VALPROIC ACID 500MG/10ML CUP(DEPAKENE),00121467500 ,NDC,inpatient,10,ML,8.75,,NONE,NONE,,8.75,,,,8.75,8.75,other,not separately reimbursable by contracted payers
VALSARTAN 320 MG TABLET(DIOVAN),00378581577 ,NDC,inpatient,1,EA,2,,NONE,NONE,,2,,,,2,2,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 1.25 GM VIAL(VANCOCIN),67457082399,NDC,inpatient,1,EA,70.35,,NONE,NONE,,70.35,,,,70.35,70.35,other,not separately reimbursable by contracted payers
VANCOMYCIN/WATER FOR INJ 1.25 GM/250 ML BAG(VANCOMYCIN 1.25 GM/250 ML BAG),70594005702,NDC,inpatient,250,ML,66.5,,NONE,NONE,,66.5,,,,66.5,66.5,other,not separately reimbursable by contracted payers
VANCOMYCIN 1.5 GM/300 ML IV SOLUTION(VANCOCIN),70594004302,NDC,inpatient,300,ML,80.5,,NONE,NONE,,80.5,,,,80.5,80.5,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 1.5 GM VIAL(),67457082499,NDC,inpatient,1,EA,84.45,,NONE,NONE,,84.45,,,,84.45,84.45,other,not separately reimbursable by contracted payers
VANCOMYCIN 1.75 GM/350 ML IV SOLUTION(VANCOCIN),70594005802,NDC,inpatient,350,ML,91,,NONE,NONE,,91,,,,91,91,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 125 MG CAPSULE(VANCOCIN),62559039020,NDC,inpatient,1,EA,8.75,,NONE,NONE,,8.75,,,,8.75,8.75,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 125 MG/2.5 ML ORALSYR(VANCOCIN),00409433201A,NDC,inpatient,2.5,ML,1.2,,NONE,NONE,,1.2,,,,1.2,1.2,other,not separately reimbursable by contracted payers
VANCOMYCIN 1 GM/200 ML IV SOLUTION(VANCOCIN),70594004201,NDC,inpatient,200,ML,0.3,,NONE,NONE,,0.3,,,,0.3,0.3,other,not separately reimbursable by contracted payers
VANCOMYCIN 2 GM/400 ML IV SOLUTION(VANCOCIN),70594004402,NDC,inpatient,400,ML,98,,NONE,NONE,,98,,,,98,98,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 2 GM VIAL(),72078006699,NDC,inpatient,1,EA,149.8,,NONE,NONE,,149.8,,,,149.8,149.8,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 750 MG VIAL(),00409653101 ,NDC,inpatient,1,EA,23.4,,NONE,NONE,,23.4,,,,23.4,23.4,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 1 G/VIAL(VANCOCIN),63323028420,NDC,inpatient,1,EA,55.65,,NONE,NONE,,55.65,,,,55.65,55.65,other,not separately reimbursable by contracted payers
VANCOMYCIN HCL 500 MG/VIAL(VANCOCIN),00409653401 ,NDC,inpatient,1,EA,19.05,,NONE,NONE,,19.05,,,,19.05,19.05,other,not separately reimbursable by contracted payers
VENLAFAXINE HCL 25 MG TABLET(EFFEXOR),57664039288,NDC,inpatient,1,EA,1.15,,NONE,NONE,,1.15,,,,1.15,1.15,other,not separately reimbursable by contracted payers
VENLAFAXINE HCL ER 37.5 MG CAPSULE(EFFEXOR XR),68084069801,NDC,inpatient,1,EA,1.75,,NONE,NONE,,1.75,,,,1.75,1.75,other,not separately reimbursable by contracted payers
VENLAFAXINE HCL ER 75 MG CAPSULE(EFFEXOR XR),68084070911,NDC,inpatient,1,EA,1.85,,NONE,NONE,,1.85,,,,1.85,1.85,other,not separately reimbursable by contracted payers
VENLAFAXINE HCL 75 MG TABLET(EFFEXOR),68084085601,NDC,inpatient,1,EA,3.3,,NONE,NONE,,3.3,,,,3.3,3.3,other,not separately reimbursable by contracted payers
VERAPAMIL HCL ER 240 MG CAPSULE(VERAPAMIL ER),00378644001 ,NDC,inpatient,1,EA,6.05,,NONE,NONE,,6.05,,,,6.05,6.05,other,not separately reimbursable by contracted payers
VERAPAMIL HCL 80 MG TABLET(CALAN),23155002601,NDC,inpatient,1,EA,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
VIT A/VIT C/VIT E/ZINC/COPPER 1 CAPSULE(PRESERVISION AREDS),24208053210,NDC,inpatient,1,EA,0.8,,NONE,NONE,,0.8,,,,0.8,0.8,other,not separately reimbursable by contracted payers
VITAMIN B COMPLEX SOFTGEL CAPSULE(VITAMIN B COMPLEX),00536478701 ,NDC,inpatient,1,EA,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
VITAMIN E 400 UNITS CAPSULE(VITAMIN E),77333095110,NDC,inpatient,1,EA,0.95,,NONE,NONE,,0.95,,,,0.95,0.95,other,not separately reimbursable by contracted payers
PHYTONADIONE 10 MG/ML AMPUL(AQUA MEPHYTON),00409915701 ,NDC,inpatient,1,ML,33.25,,NONE,NONE,,33.25,,,,33.25,33.25,other,not separately reimbursable by contracted payers
WARFARIN SODIUM 1 MG TABLET(COUMADIN),00832121101 ,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
WARFARIN SODIUM 2.5 MG TABLET(COUMADIN),00832121301 ,NDC,inpatient,1,EA,1.4,,NONE,NONE,,1.4,,,,1.4,1.4,other,not separately reimbursable by contracted payers
WARFARIN SODIUM 2 MG TABLET(COUMADIN),00832121201 ,NDC,inpatient,1,EA,1.35,,NONE,NONE,,1.35,,,,1.35,1.35,other,not separately reimbursable by contracted payers
WARFARIN SODIUM 5 MG TABLET(COUMADIN),00832121601 ,NDC,inpatient,1,EA,1.45,,NONE,NONE,,1.45,,,,1.45,1.45,other,not separately reimbursable by contracted payers
ZINC SULFATE 220 MG CAPSULE(ZINC SULFATE),77333098310,NDC,inpatient,1,EA,0.85,,NONE,NONE,,0.85,,,,0.85,0.85,other,not separately reimbursable by contracted payers
ZINC OXIDE (TRIPLE PASTE) 12.8% OINTMENT(TRIPLE PASTE),16864002101,NDC,inpatient,60,GR,0.4,,NONE,NONE,,0.4,,,,0.4,0.4,other,not separately reimbursable by contracted payers
ZINC OXIDE (EPC) 30.6% CREAM 92 G(SECURA EXTRA PROTECTIVE),00536131628 ,NDC,inpatient,92,GR,0.25,,NONE,NONE,,0.25,,,,0.25,0.25,other,not separately reimbursable by contracted payers
ZOLPIDEM TARTRATE 5 MG TABLET(AMBIEN),00904608261 ,NDC,inpatient,1,EA,0.35,,NONE,NONE,,0.35,,,,0.35,0.35,other,not separately reimbursable by contracted payers
ZONISAMIDE 100 MG CAPSULE(ZONEGRAN),68462013001,NDC,inpatient,1,EA,1.3,,NONE,NONE,,1.3,,,,1.3,1.3,other,not separately reimbursable by contracted payers
PIPERACILL NA/TAZOBACTAM NA 2.25 GM VIAL(ZOSYN),63323098121,NDC,inpatient,1,EA,32.4,,NONE,NONE,,32.4,,,,32.4,32.4,other,not separately reimbursable by contracted payers
PIPERACILL NA/TAZOBACTAM NA 4.5 GM VIAL(ZOSYN),55150012150,NDC,inpatient,1,EA,38.85,,NONE,NONE,,38.85,,,,38.85,38.85,other,not separately reimbursable by contracted payers