hospital_name last_updated_on version hospital_location hospital_address license_number|TN "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." "Trustpoint Hospital, LLC" 12/31/2024 2.0.0 "Mufreesboro, Tennessee" 1009 North Thompson Lane license_ 0000000184 | TN TRUE description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement standard_charge | gross standard_charge|discounted_cash modifiers standard_charge|min standard_charge | max standard_charge|[payer_AETNA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_AETNA]|[plan_HMO/PPO]|negotiated_percentage standard_charge|[payer_AETNA]|[plan_HMO/PPO]|negotiated_algorithm estimated_amount|[payer_AETNA]|[plan_HMO/PPO] standard_charge|[payer_AETNA]|[plan_HMO/PPO]|methodology additional_payer_notes|[payer_AETNA]|[plan_HMO/PPO] standard_charge|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE] standard_charge|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_AETNA MAN MEDICARE|MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS UHC|HMO/PPO]|negotiated_dollar standard_charge|[payer_ALL SAVERS UHC|HMO/PPO]|negotiated_percentage standard_charge|[payer_ALL SAVERS UHC|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_ALL SAVERS UHC|HMO/PPO] standard_charge|[payer_ALL SAVERS UHC|HMO/PPO]|methodology additional_payer_notes|[payer_ALL SAVERS UHC|HMO/PPO] standard_charge|[payer_AMBETTER|HMO/PPO]|negotiated_dollar standard_charge|[payer_AMBETTER|HMO/PPO]|negotiated_percentage standard_charge|[payer_AMBETTER|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_AMBETTER|HMO/PPO] standard_charge|[payer_AMBETTER|HMO/PPO]|methodology additional_payer_notes|[payer_AMBETTER|HMO/PPO] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS FEDERAL|BLUE CROSS]|negotiated_percentage standard_charge|[payer_BCBS FEDERAL|BLUE CROSS]|negotiated_algorithm estimated_amount|[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS FEDERAL|BLUE CROSS]|methodology additional_payer_notes|[payer_BCBS FEDERAL|BLUE CROSS] standard_charge|[payer_BCBS OF TENNESSEE|BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS OF TENNESSEE|BLUE CROSS]|negotiated_percentage standard_charge|[payer_BCBS OF TENNESSEE|BLUE CROSS]|negotiated_algorithm estimated_amount|[payer_BCBS OF TENNESSEE|BLUE CROSS] standard_charge|[payer_BCBS OF TENNESSEE|BLUE CROSS]|methodology additional_payer_notes|[payer_BCBS OF TENNESSEE|BLUE CROSS] standard_charge|[payer_BLUE ADVANTAGE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_BLUE ADVANTAGE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_BLUE ADVANTAGE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_BLUE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BLUE ADVANTAGE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_BLUE ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_BLUECARE|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_BLUECARE|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_BLUECARE|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_BLUECARE|MANAGED MEDICAID] standard_charge|[payer_BLUECARE|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_BLUECARE|MANAGED MEDICAID] standard_charge|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_BLUECARE COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_BLUECARE PLUS|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_BLUECARE PLUS|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_BLUECARE PLUS|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_BLUECARE PLUS|MANAGED MEDICARE] standard_charge|[payer_BLUECARE PLUS|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_BLUECARE PLUS|MANAGED MEDICARE] standard_charge|[payer_CHAMPVA|VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_CHAMPVA|VETERANS ADMIN]|negotiated_percentage standard_charge|[payer_CHAMPVA|VETERANS ADMIN]|negotiated_algorithm estimated_amount|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CHAMPVA|VETERANS ADMIN]|methodology additional_payer_notes|[payer_CHAMPVA|VETERANS ADMIN] standard_charge|[payer_CIGNA|HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA|HMO/PPO]|negotiated_percentage standard_charge|[payer_CIGNA|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_CIGNA|HMO/PPO] standard_charge|[payer_CIGNA|HMO/PPO]|methodology additional_payer_notes|[payer_CIGNA|HMO/PPO] standard_charge|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_HEALTHSPRING ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_HUMANA|HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA|HMO/PPO]|negotiated_percentage standard_charge|[payer_HUMANA|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA|HMO/PPO]|methodology additional_payer_notes|[payer_HUMANA|HMO/PPO] standard_charge|[payer_HUMANA MEDICARE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_HUMANA MEDICARE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_HUMANA MEDICARE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_HUMANA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_HUMANA MEDICARE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_HUMANA MEDICARE|MANAGED MEDICARE] standard_charge|[payer_MEDICARE|MEDICARE]|negotiated_dollar standard_charge|[payer_MEDICARE|MEDICARE]|negotiated_percentage standard_charge|[payer_MEDICARE|MEDICARE]|negotiated_algorithm estimated_amount|[payer_MEDICARE|MEDICARE] standard_charge|[payer_MEDICARE|MEDICARE]|methodology additional_payer_notes|[payer_MEDICARE|MEDICARE] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO]|negotiated_dollar standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO]|negotiated_percentage standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO]|methodology additional_payer_notes|[payer_OPTUM BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_OPTUM OSCAR|HMO/PPO]|negotiated_dollar standard_charge|[payer_OPTUM OSCAR|HMO/PPO]|negotiated_percentage standard_charge|[payer_OPTUM OSCAR|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_OPTUM OSCAR|HMO/PPO] standard_charge|[payer_OPTUM OSCAR|HMO/PPO]|methodology additional_payer_notes|[payer_OPTUM OSCAR|HMO/PPO] standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO]|negotiated_dollar standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO]|negotiated_percentage standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_OXFORD HEALTH PLANS|HMO/PPO] standard_charge|[payer_OXFORD HEALTH PLANS|HMO/PPO]|methodology additional_payer_notes|[payer_OXFORD HEALTH PLANS|HMO/PPO] standard_charge|[payer_SUREST|HMO/PPO]|negotiated_dollar standard_charge|[payer_SUREST|HMO/PPO]|negotiated_percentage standard_charge|[payer_SUREST|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_SUREST|HMO/PPO] standard_charge|[payer_SUREST|HMO/PPO]|methodology additional_payer_notes|[payer_SUREST|HMO/PPO] standard_charge|[payer_TRICARE EAST|TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE EAST|TRICARE]|negotiated_percentage standard_charge|[payer_TRICARE EAST|TRICARE]|negotiated_algorithm estimated_amount|[payer_TRICARE EAST|TRICARE] standard_charge|[payer_TRICARE EAST|TRICARE]|methodology additional_payer_notes|[payer_TRICARE EAST|TRICARE] standard_charge|[payer_UHC ADVANTAGE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UHC ADVANTAGE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_UHC ADVANTAGE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_UHC ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_UHC ADVANTAGE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_UHC ADVANTAGE|MANAGED MEDICARE] standard_charge|[payer_UHC COMMERCIAL|HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC COMMERCIAL|HMO/PPO]|negotiated_percentage standard_charge|[payer_UHC COMMERCIAL|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UHC COMMERCIAL|HMO/PPO] standard_charge|[payer_UHC COMMERCIAL|HMO/PPO]|methodology additional_payer_notes|[payer_UHC COMMERCIAL|HMO/PPO] standard_charge|[payer_UHC COMMERICAL|HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC COMMERICAL|HMO/PPO]|negotiated_percentage standard_charge|[payer_UHC COMMERICAL|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UHC COMMERICAL|HMO/PPO] standard_charge|[payer_UHC COMMERICAL|HMO/PPO]|methodology additional_payer_notes|[payer_UHC COMMERICAL|HMO/PPO] standard_charge|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID] standard_charge|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_UHC COMMUNITY PLAN|MANAGED MEDICAID] standard_charge|[payer_UHC COVERKIDS|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_UHC COVERKIDS|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_UHC COVERKIDS|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_UHC COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_UHC COVERKIDS|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_UHC COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] standard_charge|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_UHC DUAL COMPLETE|MANAGED MEDICARE] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO]|negotiated_percentage standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_UHC SHARED SERVICES|HMO/PPO]|methodology additional_payer_notes|[payer_UHC SHARED SERVICES|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO]|negotiated_dollar standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO]|negotiated_percentage standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UHC STUDENT RESOURCES|HMO/PPO] standard_charge|[payer_UHC STUDENT RESOURCES|HMO/PPO]|methodology additional_payer_notes|[payer_UHC STUDENT RESOURCES|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO]|negotiated_dollar standard_charge|[payer_UMR|HMO/PPO]|negotiated_percentage standard_charge|[payer_UMR|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UMR|HMO/PPO] standard_charge|[payer_UMR|HMO/PPO]|methodology additional_payer_notes|[payer_UMR|HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO]|negotiated_dollar standard_charge|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO]|negotiated_percentage standard_charge|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO]|negotiated_algorithm estimated_amount|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO]|methodology additional_payer_notes|[payer_UNITED BEHAVIORAL HEALTH|HMO/PPO] standard_charge|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE] standard_charge|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_WELLCARE HEALTH PLANS|MANAGED MEDICARE] standard_charge|[payer_WELLPOINT|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_WELLPOINT|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_WELLPOINT|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_WELLPOINT|MANAGED MEDICAID] standard_charge|[payer_WELLPOINT|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_WELLPOINT|MANAGED MEDICAID] standard_charge|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID]|negotiated_percentage standard_charge|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID]|negotiated_algorithm estimated_amount|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID]|methodology additional_payer_notes|[payer_WELLPOINT COVERKIDS|MANAGED MEDICAID] standard_charge|[payer_WELLPOINT|MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_WELLPOINT|MANAGED MEDICARE]|negotiated_percentage standard_charge|[payer_WELLPOINT|MANAGED MEDICARE]|negotiated_algorithm estimated_amount|[payer_WELLPOINT|MANAGED MEDICARE] standard_charge|[payer_WELLPOINT|MANAGED MEDICARE]|methodology additional_payer_notes|[payer_WELLPOINT|MANAGED MEDICARE] additional_generic_notes R&B REHAB (P)-M/S 118 RC facility inpatient 3996 1350 416.15 2405 1150 per diem 1850 per diem 1100 per diem 2405 per diem 1071 per diem 1071 per diem 1850 per diem 416.15 per diem 416.15 per diem 1850 per diem 1300 per diem 1480 per diem 1850 per diem 1850 per diem 1850 per diem 1100 per diem 1850 per diem 1850 per diem 1100 per diem 1100 per diem 1850 per diem 1100 per diem 1100 per diem 1100 per diem 1100 per diem 1850 per diem R&B ADU - DOWN (SP) 124 RC facility inpatient 2700 900 725 1265 1150 per diem 920 per diem 1000 per diem 1196 per diem 1125 per diem 1125 per diem 1125 per diem 725 per diem 760 per diem 920 per diem 920 per diem 1206 per diem 810 per diem 1150 per diem 920 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 961 per diem 1265 per diem 1000 per diem 1000 per diem 750 per diem 750 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 920 per diem 800 per diem 800 per diem 920 per diem R&B DETOX (SP) - M/S 126 RC facility inpatient 2700 900 725 1265 1000 per diem 1196 per diem 1125 per diem 1125 per diem 1125 per diem 725 per diem 760 per diem 920 per diem 1206 per diem 1150 per diem 920 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 1265 per diem 1000 per diem 1000 per diem 750 per diem 750 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 800 per diem 800 per diem 920 per diem R&B DETOX - ADULT 126 RC facility inpatient 2700 900 725 1265 1000 per diem 1196 per diem 1125 per diem 1125 per diem 1125 per diem 725 per diem 760 per diem 920 per diem 1206 per diem 1150 per diem 920 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 1265 per diem 1000 per diem 1000 per diem 750 per diem 750 per diem 920 per diem 1000 per diem 1000 per diem 1000 per diem 1000 per diem 800 per diem 800 per diem ECT - INPATIENT ANC 901 RC facility inpatient 1700 750 459.67 1039 594 per diem 469 per diem 584 per diem 610 per diem 788 per diem 788 per diem 788 per diem 475 per diem 475 per diem 475 per diem 1039 per diem 469 per diem 750 per diem 459.67 per diem 469 per diem 584 per diem 584 per diem 584 per diem 584 per diem per diem 584 per diem 584 per diem 584 per diem 480 per diem 480 per diem 584 per diem 584 per diem 584 per diem 584 per diem 584 per diem 459.67 per diem 485 per diem 485 per diem 469 per diem ECT - OUTPATIENT 901 RC facility outpatient 1700 750 475 1039 594 per diem 662 per diem 584 per diem 860 per diem 788 per diem 788 per diem 788 per diem 475 per diem 475 per diem 475 per diem 1039 per diem 662 per diem 750 per diem 662 per diem 662 per diem 584 per diem 584 per diem 584 per diem 584 per diem per diem 584 per diem 584 per diem 584 per diem 480 per diem 480 per diem 584 per diem 584 per diem 584 per diem 584 per diem 584 per diem 662 per diem 485 per diem 485 per diem 662 per diem IOP PSYCH ADOL PROG 905 RC facility outpatient 501 200 140 325 275 per diem 238 per diem 325 per diem 282 per diem 282 per diem 160 per diem 160 per diem 248.13 per diem 286 per diem 300 per diem per diem 238 per diem 238 per diem 238 per diem 238 per diem per diem 238 per diem 238 per diem 238 per diem 140 per diem 140 per diem 238 per diem 238 per diem 238 per diem 238 per diem 238 per diem 165 per diem 165 per diem IOP PSYCH ADULT PROG 905 RC facility outpatient 501 200 140 325 275 per diem 238 per diem 325 per diem 282 per diem 282 per diem 160 per diem 160 per diem 248.13 per diem 286 per diem 300 per diem per diem 238 per diem 238 per diem 238 per diem 238 per diem per diem 238 per diem 238 per diem 238 per diem 140 per diem 140 per diem 238 per diem 238 per diem 238 per diem 238 per diem 238 per diem 165 per diem 165 per diem IOP TELE MED PROGRAM 905 RC facility outpatient 501 200 140 325 275 per diem 238 per diem 325 per diem 282 per diem 282 per diem 160 per diem 160 per diem 248.13 per diem 286 per diem 300 per diem per diem 238 per diem 238 per diem 238 per diem 238 per diem per diem 238 per diem 238 per diem 238 per diem 140 per diem 140 per diem 238 per diem 238 per diem 238 per diem 238 per diem 238 per diem 165 per diem 165 per diem PHP PSYCH ADOL PROG 912 RC facility outpatient 900 375 248.13 635 635 per diem 373 per diem 450 per diem 248.13 per diem 562 per diem 450 per diem per diem per diem 373 per diem 373 per diem 373 per diem 373 per diem per diem 373 per diem 373 per diem 373 per diem 250 per diem 250 per diem 373 per diem 373 per diem 373 per diem 373 per diem 373 per diem 290 per diem 290 per diem per diem PHP PSYCH ADULT PROG 912 RC facility outpatient 900 375 248.13 635 635 per diem 373 per diem 450 per diem 248.13 per diem 562 per diem 450 per diem per diem per diem 373 per diem 373 per diem 373 per diem 373 per diem per diem 373 per diem 373 per diem 373 per diem 250 per diem 250 per diem 373 per diem 373 per diem 373 per diem 373 per diem 373 per diem 290 per diem 290 per diem per diem IOP GROUP 1 915 RC facility outpatient 167 234 550 234 per diem 550 per diem 550 per diem 550 per diem 242 per diem 242 per diem per diem 248.13 per diem per diem 300 per diem 234 per diem 234 per diem 234 per diem 238 per diem 234 per diem 234 per diem IOP TELEMED GROUP 1 915 RC facility outpatient 167 234 550 234 per diem 550 per diem 550 per diem 550 per diem 242 per diem 242 per diem per diem 248.13 per diem per diem 300 per diem 234 per diem 234 per diem 234 per diem 238 per diem 234 per diem 234 per diem PHP PSY 915 RC facility outpatient 180 238 550 329 per diem 550 per diem 550 per diem 550 per diem 242 per diem 242 per diem 242 per diem 248.13 per diem per diem 300 per diem 329 per diem 329 per diem 329 per diem 238 per diem 329 per diem 329 per diem 1:1 SVCS ADOL/CHILD 1124 RC facility outpatient 300 300 300 300 per diem 300 per diem