hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|OK,"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.",,,,,,,,,,,,,,,,
"Oakwood Springs, LLC",9/22/2025,2.0.0,Oakwood Springs,13101 Memorial Springs Court Oklahoma City OK 73114,2384,TRUE,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,standard_charge|gross,standard_charge|discounted_cash,payer_name,plan_name,standard_charge|negotiated_dollar,estimated_amount,standard_charge|min,standard_charge|max,standard_charge|methodology,additional_generic_notes
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,6Degrees Health,Commercial,895,895,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",443,443,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",443,443,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Alliance Coal Health Plan,Commercial,550,550,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,American Behavioral,Commercial,580,580,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,BCBS,Blue Advantage PPO,240,240,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,BCBS,BlueLincs HMO,240,240,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,BCBS,BluePreferred Network,250,250,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,BCBS,"Blue Choice PPO, Federal Employees (FEP)",275,275,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,BCBS,BlueTraditional,305,305,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Beacon,Commercial,527,527,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Beacon,"Commercial, Medicare Advantage",527,527,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Behavioral Health System,Commercial,486,486,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Bright Health,Commercial,450,450,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Community Care,"Commercial PPO, HMO",347.49,347.49,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Evernorth/Cigna,Commercial,401,401,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,First Choice Health Network,Commercial,670,670,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Friday Health Plan,Commercial,450,450,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Friday Health Plan,Medicare Advantage,450,450,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Healthspring,Medicare Advantage,401,401,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Humana Behavioral Health,Commercial,445,445,175.122,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Magellan,"Commercial, Summit, Pinnacle",459,459,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,6Degrees Health,Commercial,895,895,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",443,443,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",443,443,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Alliance Coal Health Plan,Commercial,550,550,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,American Behavioral,Commercial,580,580,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,BCBS,Blue Advantage PPO,240,240,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,BCBS,BlueLincs HMO,240,240,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,BCBS,BluePreferred Network,250,250,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,BCBS,"Blue Choice PPO, Federal Employees (FEP)",275,275,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,BCBS,BlueTraditional,305,305,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Beacon,Commercial,527,527,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Beacon,"Commercial, Medicare Advantage",527,527,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Behavioral Health System,Commercial,486,486,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Bright Health,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Community Care,"Commercial PPO, HMO",347.49,347.49,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Evernorth/Cigna,Commercial,401,401,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,First Choice Health Network,Commercial,670,670,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Friday Health Plan,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Friday Health Plan,Medicare Advantage,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Healthspring,Medicare Advantage,401,401,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Humana Behavioral Health,Commercial,445,445,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Magellan,"Commercial, Summit, Pinnacle",459,459,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,6Degrees Health,Commercial,895,895,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",443,443,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",443,443,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Alliance Coal Health Plan,Commercial,550,550,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,American Behavioral,Commercial,580,580,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,BCBS,Blue Advantage PPO,240,240,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,BCBS,BlueLincs HMO,240,240,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,BCBS,BluePreferred Network,250,250,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,BCBS,"Blue Choice PPO, Federal Employees (FEP)",275,275,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,BCBS,BlueTraditional,305,305,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Beacon,Commercial,527,527,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Beacon,"Commercial, Medicare Advantage",527,527,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Behavioral Health System,Commercial,486,486,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Bright Health,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Community Care,"Commercial PPO, HMO",347.49,347.49,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Evernorth/Cigna,Commercial,401,401,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,First Choice Health Network,Commercial,670,670,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Friday Health Plan,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Friday Health Plan,Medicare Advantage,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Healthspring,Medicare Advantage,401,401,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Humana Behavioral Health,Commercial,445,445,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Magellan,"Commercial, Summit, Pinnacle",459,459,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Magellan,Navigator (Medicare Advantage),459,459,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Magellan,Navigator (Medicare Advantage),459,459,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Magellan,Navigator (Medicare Advantage),459,459,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Mercy Managed Health Network,Direct Employer Network,420.24999999999989,420.24999999999989,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Mercy Managed Health Network,Direct Employer Network,420.24999999999989,420.24999999999989,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Mercy Managed Health Network,Direct Employer Network,420.24999999999989,420.24999999999989,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,MHN,Commercial,468,468,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,MHN,Commercial,468,468,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,MHN,Commercial,468,468,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Mines & Associates,Commercial,585,585,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Mines & Associates,Commercial,585,585,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Mines & Associates,Commercial,585,585,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Oklahoma Health Network,Commercial,350,350,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Oklahoma Health Network,Commercial,350,350,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Oklahoma Health Network,Commercial,350,350,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Rivus,Commercial,450,450,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Rivus,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Rivus,Commercial,450,450,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Stillwater Collaborative Care,Commercial,464,464,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Stillwater Collaborative Care,Commercial,464,464,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Stillwater Collaborative Care,Commercial,464,464,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,United Behavioral Health,Commercial,328,328,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,United Behavioral Health,Commercial,328,328,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,United Behavioral Health,Commercial,328,328,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,United Behavioral Health,Medicare Advantage,328,328,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,United Behavioral Health,Medicare Advantage,328,328,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,United Behavioral Health,Medicare Advantage,328,328,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,WellCare,Medicare Advantage,325,325,175.122,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,WellCare,Medicare Advantage,325,325,219.066,895,per diem,"per diem rate, code may be bundled with other services"
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,WellCare,Medicare Advantage,325,325,219.066,895,per diem,"per diem rate, code may be bundled with other services"
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Citizen Potawatomi Nation,Commercial,175.122,175.122,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Compsych,Commercial,218.9025,218.9025,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,First Health,Commercial,186.7968,186.7968,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,198.4716,198.4716,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Muscogee Nation,Commercial (Payor of Last Resort),291.87,291.87,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Provider Networks of America,Commercial,248.0895,248.0895,175.122,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Velocity National Provider Network,Group Health-Commercial,248.0895,248.0895,175.122,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Citizen Potawatomi Nation,Commercial,219.066,219.066,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Compsych,Commercial,273.8325,273.8325,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,First Health,Commercial,233.6704,233.6704,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,248.2748,248.2748,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Muscogee Nation,Commercial (Payor of Last Resort),365.11,365.11,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Provider Networks of America,Commercial,310.3435,310.3435,219.066,895,percent of total billed charges,
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Velocity National Provider Network,Group Health-Commercial,310.3435,310.3435,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Citizen Potawatomi Nation,Commercial,219.066,219.066,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Compsych,Commercial,273.8325,273.8325,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,First Health,Commercial,233.6704,233.6704,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,248.2748,248.2748,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Muscogee Nation,Commercial (Payor of Last Resort),365.11,365.11,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Provider Networks of America,Commercial,310.3435,310.3435,219.066,895,percent of total billed charges,
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Velocity National Provider Network,Group Health-Commercial,310.3435,310.3435,219.066,895,percent of total billed charges,
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Bright Health,Medicare Advantage,388.62,388.62,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Humana Behavioral Health,Medicare Advantage,388.62,388.62,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Kempton Group,Commercial,544.068,544.068,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,VA CCN,VA (Administered by Optum),388.62,388.62,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Velocity National Provider Network,Medicare Advantage,408.051,408.051,175.122,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Bright Health,Medicare Advantage,388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Humana Behavioral Health,Medicare Advantage,388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Kempton Group,Commercial,544.068,544.068,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,VA CCN,VA (Administered by Optum),388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Velocity National Provider Network,Medicare Advantage,408.051,408.051,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Bright Health,Medicare Advantage,388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Humana Behavioral Health,Medicare Advantage,388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Kempton Group,Commercial,544.068,544.068,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,VA CCN,VA (Administered by Optum),388.62,388.62,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Velocity National Provider Network,Medicare Advantage,408.051,408.051,219.066,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Aetna Better Health,Managed Medicaid,291.87,291.87,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Humana Behavioral Health,Managed Medicaid,291.87,291.87,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,Oklahoma Complete Health,Managed Medicaid,291.87,291.87,175.122,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Aetna Better Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Humana Behavioral Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,Oklahoma Complete Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Aetna Better Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Humana Behavioral Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,Oklahoma Complete Health,Managed Medicaid,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,TriCare East,TriCare products,277.2765,277.2765,175.122,895,case rate,base rate * weight * contract terms
Half Day PHP Indiv Tx 16-30 min,8926,CDM,914,RC,90832,CPT,outpatient,291.87,350,TriCare West,TriCare products,291.87,291.87,175.122,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,TriCare East,TriCare products,346.8545,346.8545,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 16-30 min,8222,CDM,914,RC,90832,CPT,outpatient,365.11,350,TriCare West,TriCare products,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,TriCare East,TriCare products,346.8545,346.8545,219.066,895,case rate,base rate * weight * contract terms
PHP Indiv Therapy 31-45 min,8232,CDM,914,RC,90834,CPT,outpatient,365.11,350,TriCare West,TriCare products,365.11,365.11,219.066,895,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,6Degrees Health,Commercial,710,710,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Alliance Coal Health Plan,Commercial,350,350,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,American Behavioral,Commercial,375,375,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,Blue Advantage PPO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BlueLincs HMO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BluePreferred Network,150,150,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,"Blue Choice PPO, Federal Employees (FEP)",175,175,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BlueTraditional,205,205,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Beacon,Commercial,240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Beacon,"Commercial, Medicare Advantage",240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Behavioral Health System,Commercial,332,332,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Bright Health,Commercial,330,330,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Community Care,"Commercial PPO, HMO",173.74,173.74,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Evernorth/Cigna,Commercial,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Friday Health Plan,Commercial,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Friday Health Plan,Medicare Advantage,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,HealthChoice,Commercial,472,472,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,6Degrees Health,Commercial,710,710,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Alliance Coal Health Plan,Commercial,350,350,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,American Behavioral,Commercial,375,375,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,Blue Advantage PPO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BlueLincs HMO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BluePreferred Network,150,150,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,"Blue Choice PPO, Federal Employees (FEP)",175,175,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,BCBS,BlueTraditional,205,205,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Beacon,Commercial,240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Beacon,"Commercial, Medicare Advantage",240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Behavioral Health System,Commercial,332,332,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Bright Health,Commercial,330,330,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Community Care,"Commercial PPO, HMO",173.74,173.74,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Evernorth/Cigna,Commercial,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Friday Health Plan,Commercial,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Friday Health Plan,Medicare Advantage,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,HealthChoice,Commercial,472,472,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,6Degrees Health,Commercial,710,710,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Aetna,"Commercial HMO, PPO, QPOS, Elect Choice, Managed Choice POS, Aetna Choice POS II, Aetna Select, National Advantage, Open Choice PPO
",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Aetna,"Medicare Advantage HMO, PPO, POS
(Does not include Dual Eligible)",207,207,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Alliance Coal Health Plan,Commercial,350,350,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,American Behavioral,Commercial,375,375,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,BCBS,Blue Advantage PPO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,BCBS,BlueLincs HMO,140,140,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,BCBS,BluePreferred Network,150,150,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,BCBS,"Blue Choice PPO, Federal Employees (FEP)",175,175,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,BCBS,BlueTraditional,205,205,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Beacon,Commercial,240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Beacon,"Commercial, Medicare Advantage",240,240,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Behavioral Health System,Commercial,332,332,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Bright Health,Commercial,330,330,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Community Care,"Commercial PPO, HMO",173.74,173.74,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Evernorth/Cigna,Commercial,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Friday Health Plan,Commercial,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Friday Health Plan,Medicare Advantage,325,325,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,HealthChoice,Commercial,472,472,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Healthspring,Medicare Advantage,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Healthspring,Medicare Advantage,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Healthspring,Medicare Advantage,247,247,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Commercial,290,290,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Commercial,290,290,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Humana Behavioral Health,Commercial,290,290,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Magellan,"Commercial, Summit, Pinnacle",354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Magellan,"Commercial, Summit, Pinnacle",354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Magellan,"Commercial, Summit, Pinnacle",354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Magellan,Navigator (Medicare Advantage),354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Magellan,Navigator (Medicare Advantage),354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Magellan,Navigator (Medicare Advantage),354,354,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Mercy Managed Health Network,Direct Employer Network,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Mercy Managed Health Network,Direct Employer Network,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Mercy Managed Health Network,Direct Employer Network,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,MHN,Commercial,312,312,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,MHN,Commercial,312,312,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,MHN,Commercial,312,312,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Mines & Associates,Commercial,345,345,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Mines & Associates,Commercial,345,345,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Mines & Associates,Commercial,345,345,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Oklahoma Health Network,Commercial,295,295,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Oklahoma Health Network,Commercial,295,295,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Oklahoma Health Network,Commercial,295,295,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Rivus,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Rivus,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Rivus,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Stillwater Collaborative Care,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Stillwater Collaborative Care,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Stillwater Collaborative Care,Commercial,315,315,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,United Behavioral Health,Commercial,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,United Behavioral Health,Commercial,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,United Behavioral Health,Commercial,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,United Behavioral Health,Medicare Advantage,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,United Behavioral Health,Medicare Advantage,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,United Behavioral Health,Medicare Advantage,180,180,140,710,per diem,"per diem rate, code may be bundled with other services"
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Citizen Potawatomi Nation,Commercial,175.122,175.122,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Compsych,Commercial,218.9025,218.9025,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,First Health,Commercial,186.7968,186.7968,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,198.4716,198.4716,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Muscogee Nation,Commercial (Payor of Last Resort),291.87,291.87,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Provider Networks of America,Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Velocity National Provider Network,Group Health-Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Citizen Potawatomi Nation,Commercial,175.122,175.122,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Compsych,Commercial,218.9025,218.9025,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,First Health,Commercial,186.7968,186.7968,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,198.4716,198.4716,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Muscogee Nation,Commercial (Payor of Last Resort),291.87,291.87,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Provider Networks of America,Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Velocity National Provider Network,Group Health-Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Citizen Potawatomi Nation,Commercial,175.122,175.122,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Compsych,Commercial,218.9025,218.9025,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,First Health,Commercial,186.7968,186.7968,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,MULTIPLAN/PHCS/BEECH STREET,Commercial PPO,198.4716,198.4716,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Muscogee Nation,Commercial (Payor of Last Resort),291.87,291.87,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Provider Networks of America,Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Velocity National Provider Network,Group Health-Commercial,248.0895,248.0895,140,710,percent of total billed charges,
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Bright Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Kempton Group,Commercial,369.544,369.544,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,VA CCN,VA (Administered by Optum),263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Velocity National Provider Network,Medicare Advantage,277.158,277.158,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Bright Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Kempton Group,Commercial,369.544,369.544,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,VA CCN,VA (Administered by Optum),263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Velocity National Provider Network,Medicare Advantage,277.158,277.158,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Bright Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Humana Behavioral Health,Medicare Advantage,263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Kempton Group,Commercial,369.544,369.544,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,VA CCN,VA (Administered by Optum),263.96,263.96,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Velocity National Provider Network,Medicare Advantage,277.158,277.158,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna Better Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,Oklahoma Complete Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Aetna Better Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Humana Behavioral Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,Oklahoma Complete Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Aetna Better Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Humana Behavioral Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,Oklahoma Complete Health,Managed Medicaid,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,TriCare East,TriCare products,277.2765,277.2765,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,924,CDM,914,RC,90832,CPT,outpatient,291.87,200,TriCare West,TriCare products,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,TriCare East,TriCare products,277.2765,277.2765,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 16-30 min,9242,CDM,914,RC,90832,CPT,outpatient,291.87,200,TriCare West,TriCare products,291.87,291.87,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,TriCare East,TriCare products,277.2765,277.2765,140,710,case rate,base rate * weight * contract terms
IOP Indiv Therapy 31-45 min,927,CDM,914,RC,90834,CPT,outpatient,291.87,200,TriCare West,TriCare products,291.87,291.87,140,710,case rate,base rate * weight * contract terms
"Removal of 1 or more breast growth, open procedure",19120,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Shaving of shoulder bone using an endoscope,29826,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of one knee cartilage using an endoscope,29881,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of tonsils and adenoid glands patient younger than age 12,42820,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Diagnostic examination of esophagus, stomach, and/or upper small bowel using an endoscope",43235,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope",43239,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Diagnostic examination of large bowel using an endoscope,45378,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Biopsy of large bowel using an endoscope,45380,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of polyps or growths of large bowel using an endoscope,45385,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Ultrasound examination of lower large bowel using an endoscope,45391,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of gallbladder using an endoscope,47562,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Repair of groin hernia patient age 5 years or older,49505,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Biopsy of prostate gland,55700,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Surgical removal of prostate and surrounding lymph nodes using an endoscope,55866,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Routine obstetric care for vaginal delivery, including pre-and post-delivery care",59400,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Routine obstetric care for cesarean delivery, including pre-and post-delivery care",59510,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care,59610,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Injection of substance into spinal canal of lower back or sacrum using imaging guidance,62322,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Injection of substance into spinal canal of lower back or sacrum using imaging guidance,62323,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance,64483,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of recurring cataract in lens capsule using laser,66821,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Removal of cataract with insertion of lens,66984,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"CT scan, head or brain, without contrast",70450,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
MRI scan of brain before and after contrast,70553,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"X-Ray, lower back, minimum four views",72110,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
MRI scan of lower spinal canal,72148,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"CT scan, pelvis, with contrast",72193,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
MRI scan of leg joint,73721,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
CT scan of abdomen and pelvis with contrast,74177,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Ultrasound of abdomen,76700,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus,76805,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Ultrasound pelvis through vagina,76830,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Mammography of one breast,77065,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Mammography of both breasts,77066,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Mammography, screening, bilateral",77067,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Basic metabolic panel,80048,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Blood test, comprehensive group of blood chemicals",80053,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Obstetric blood test panel,80055,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Blood test, lipids (cholesterol and triglycerides)",80061,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Kidney function panel test,80069,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Liver function blood test panel,80076,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Manual urinalysis test with examination using microscope,81000,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Manual urinalysis test with examination using microscope,81001,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Automated urinalysis test,81002,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Automated urinalysis test,81003,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
PSA (prostate specific antigen),84153,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
PSA (prostate specific antigen),84154,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Blood test, thyroid stimulating hormone (TSH)",84443,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Complete blood cell count, with differential white blood cells, automated",85025,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Complete blood count, automated",85027,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Blood test, clotting time",85610,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Coagulation assessment blood test,85730,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Psychotherapy, 60 min",90837,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Family psychotherapy, not including patient, 50 min",90846,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Family psychotherapy, including patient, 50 min",90847,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Group psychotherapy,90853,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Electrocardiogram, routine, with interpretation and report",93000,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Insertion of catheter into left heart for diagnosis,93452,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Sleep study,95810,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Physical therapy, therapeutic exercise",97110,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"New patient office or other outpatient visit, typically 30 min",99203,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"New patient office of other outpatient visit, typically 45 min",99204,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"New patient office of other outpatient visit, typically 60 min",99205,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Patient office consultation, typically 40 min",99243,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
"Patient office consultation, typically 60 min",99244,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Initial new patient preventive medicine evaluation (18-39 years),99385,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Initial new patient preventive medicine evaluation (40-64 years),99386,CPT,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities,216,DRG,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Cervical spinal fusion without comorbid conditions (CC) or major comorbid conditions or complications (MCC),473,DRG,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications (MCC),470,DRG,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Spinal fusion except cervical without major comorbid conditions or complications (MCC),460,DRG,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.
Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC),743,DRG,,,,,,N/A,,,,,,,,,Not available as a Shoppable Service at this facility.