hospital_name last_updated_on version hospital_location hospital_address license_number|MI "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." Chicago BH Hospital 5/31/2024 2.0.0 "Chicago, Illnois" 4720 Clarendon Ave. license_0006296 | IL TRUE description code |1 code|1|type billing_class setting drug_unit_of_measurement drug_type_of_measurement modifiers standard_charge | gross standard_charge|discounted_cash standard_charge|min standard_charge | max standard_charge|[payer_AETNA]|[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 BETTER HEALTH]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_AETNA BETTER HEALTH]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_AETNA BETTER HEALTH]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_AETNA BETTER HEALTH]|[plan_MANAGED MEDICAID] standard_charge|[payer_AETNA BETTER HEALTH]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_AETNA BETTER HEALTH]|[Plan_MANAGED MEDICAID] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE]|negotiated_dollar standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_percentage standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |negotiated_algorithm estimated_amount|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] standard_charge|[payer_AETNA MEDICARE]|[plan_MANAGED MEDICARE] |methodology additional_payer_notes |[payer_AETNA MEDICARE]|[Plan_MANAGED MEDICARE] standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_ALL SAVERS]|[plan_HMO/PPO] standard_charge|[payer_ALL SAVERS]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_ALL SAVERS]|[Plan_HMO/PPO] standard_charge|[payer_BCBS HMO]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS HMO]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS HMO]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS HMO]|[plan_BLUE CROSS] standard_charge|[payer_BCBS HMO]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS HMO]|[Plan_BLUE CROSS] standard_charge|[payer_BCBS IL]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS IL]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS IL]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS IL]|[plan_BLUE CROSS] standard_charge|[payer_BCBS IL]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS IL]|[Plan_BLUE CROSS] standard_charge|[payer_BCBS OUT OF AREA]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BCBS OUT OF AREA]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BCBS OUT OF AREA]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BCBS OUT OF AREA]|[plan_BLUE CROSS] standard_charge|[payer_BCBS OUT OF AREA]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BCBS OUT OF AREA]|[Plan_BLUE CROSS] standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_BEACON HEALTH]|[plan_HMO/PPO] standard_charge|[payer_BEACON HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_BEACON HEALTH]|[Plan_HMO/PPO] standard_charge|[payer_BLUE CHOICE]|[plan_BLUE CROSS]|negotiated_dollar standard_charge|[payer_BLUE CHOICE]|[plan_BLUE CROSS] |negotiated_percentage standard_charge|[payer_BLUE CHOICE]|[plan_BLUE CROSS] |negotiated_algorithm estimated_amount|[payer_BLUE CHOICE]|[plan_BLUE CROSS] standard_charge|[payer_BLUE CHOICE]|[plan_BLUE CROSS] |methodology additional_payer_notes |[payer_BLUE CHOICE]|[Plan_BLUE CROSS] standard_charge|[payer_BLUE CROSS COMMUNITY]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_BLUE CROSS COMMUNITY]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_BLUE CROSS COMMUNITY]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_BLUE CROSS COMMUNITY]|[plan_MANAGED MEDICAID] standard_charge|[payer_BLUE CROSS COMMUNITY]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_BLUE CROSS COMMUNITY]|[Plan_MANAGED MEDICAID] standard_charge|[payer_CHAMPVA]|[plan_VETERANS ADMIN]|negotiated_dollar standard_charge|[payer_CHAMPVA]|[plan_VETERANS ADMIN] |negotiated_percentage standard_charge|[payer_CHAMPVA]|[plan_VETERANS ADMIN] |negotiated_algorithm estimated_amount|[payer_CHAMPVA]|[plan_VETERANS ADMIN] standard_charge|[payer_CHAMPVA]|[plan_VETERANS ADMIN] |methodology additional_payer_notes |[payer_CHAMPVA]|[Plan_VETERANS ADMIN] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] standard_charge|[payer_CIGNA BEHAVIORAL HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_CIGNA BEHAVIORAL HEALTH]|[Plan_HMO/PPO] standard_charge|[payer_COMPSYCH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_COMPSYCH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_COMPSYCH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_COMPSYCH]|[plan_HMO/PPO] standard_charge|[payer_COMPSYCH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_COMPSYCH]|[Plan_HMO/PPO] standard_charge|[payer_COUNTYCARE]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_COUNTYCARE]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_COUNTYCARE]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_COUNTYCARE]|[plan_MANAGED MEDICAID] standard_charge|[payer_COUNTYCARE]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_COUNTYCARE]|[Plan_MANAGED MEDICAID] standard_charge|[payer_DCFS]|[plan_LOCAL GOVT]|negotiated_dollar standard_charge|[payer_DCFS]|[plan_LOCAL GOVT] |negotiated_percentage standard_charge|[payer_DCFS]|[plan_LOCAL GOVT] |negotiated_algorithm estimated_amount|[payer_DCFS]|[plan_LOCAL GOVT] standard_charge|[payer_DCFS]|[plan_LOCAL GOVT] |methodology additional_payer_notes |[payer_DCFS]|[Plan_LOCAL GOVT] standard_charge|[payer_GOLDEN RULE]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_GOLDEN RULE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_GOLDEN RULE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_GOLDEN RULE]|[plan_HMO/PPO] standard_charge|[payer_GOLDEN RULE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_GOLDEN RULE]|[Plan_HMO/PPO] standard_charge|[payer_HEALTH ALLIANCE]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HEALTH ALLIANCE]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HEALTH ALLIANCE]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HEALTH ALLIANCE]|[plan_HMO/PPO] standard_charge|[payer_HEALTH ALLIANCE]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HEALTH ALLIANCE]|[Plan_HMO/PPO] standard_charge|[payer_HEALTH LINK]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HEALTH LINK]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HEALTH LINK]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HEALTH LINK]|[plan_HMO/PPO] standard_charge|[payer_HEALTH LINK]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HEALTH LINK]|[Plan_HMO/PPO] standard_charge|[payer_HUMANA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_HUMANA]|[plan_HMO/PPO] standard_charge|[payer_HUMANA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_HUMANA]|[Plan_HMO/PPO] standard_charge|[payer_ILLINOIS MEDICAID]|[plan_MEDICAID ]|negotiated_dollar standard_charge|[payer_ILLINOIS MEDICAID]|[plan_MEDICAID ] |negotiated_percentage standard_charge|[payer_ILLINOIS MEDICAID]|[plan_MEDICAID ] |negotiated_algorithm estimated_amount|[payer_ILLINOIS MEDICAID]|[plan_MEDICAID ] standard_charge|[payer_ILLINOIS MEDICAID]|[plan_MEDICAID ] |methodology additional_payer_notes |[payer_ILLINOIS MEDICAID]|[Plan_MEDICAID ] standard_charge|[payer_ILLINOIS MEDICAID]|[plan_PENDING MEDICAID]|negotiated_dollar standard_charge|[payer_ILLINOIS MEDICAID]|[plan_PENDING MEDICAID] |negotiated_percentage standard_charge|[payer_ILLINOIS MEDICAID]|[plan_PENDING MEDICAID] |negotiated_algorithm estimated_amount|[payer_ILLINOIS MEDICAID]|[plan_PENDING MEDICAID] standard_charge|[payer_ILLINOIS MEDICAID]|[plan_PENDING MEDICAID] |methodology additional_payer_notes |[payer_ILLINOIS MEDICAID]|[Plan_PENDING MEDICAID] standard_charge|[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] standard_charge|[payer_MAGELLAN HEALTH SERVICES]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MAGELLAN HEALTH SERVICES]|[Plan_HMO/PPO] standard_charge|[payer_MEDICA]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MEDICA]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MEDICA]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MEDICA]|[plan_HMO/PPO] standard_charge|[payer_MEDICA]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MEDICA]|[Plan_HMO/PPO] standard_charge|[payer_MERIDIAN MEDICAID]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_MERIDIAN MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_MERIDIAN MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_MERIDIAN MEDICAID]|[plan_MANAGED MEDICAID] standard_charge|[payer_MERIDIAN MEDICAID]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_MERIDIAN MEDICAID]|[Plan_MANAGED MEDICAID] standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] standard_charge|[payer_MERITAIN HEALTH]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MERITAIN HEALTH]|[Plan_HMO/PPO] standard_charge|[payer_MHN]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MHN]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MHN]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MHN]|[plan_HMO/PPO] standard_charge|[payer_MHN]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MHN]|[Plan_HMO/PPO] standard_charge|[payer_MISC COMMERCIAL]|[plan_COMMERCIAL]|negotiated_dollar standard_charge|[payer_MISC COMMERCIAL]|[plan_COMMERCIAL] |negotiated_percentage standard_charge|[payer_MISC COMMERCIAL]|[plan_COMMERCIAL] |negotiated_algorithm estimated_amount|[payer_MISC COMMERCIAL]|[plan_COMMERCIAL] standard_charge|[payer_MISC COMMERCIAL]|[plan_COMMERCIAL] |methodology additional_payer_notes |[payer_MISC COMMERCIAL]|[Plan_COMMERCIAL] standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_MISC HMO/PPO]|[plan_HMO/PPO] standard_charge|[payer_MISC HMO/PPO]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_MISC HMO/PPO]|[Plan_HMO/PPO] standard_charge|[payer_MISC OUT OF STATE MCAID]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_MISC OUT OF STATE MCAID]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_MISC OUT OF STATE MCAID]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_MISC OUT OF STATE MCAID]|[plan_MANAGED MEDICAID] standard_charge|[payer_MISC OUT OF STATE MCAID]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_MISC OUT OF STATE MCAID]|[Plan_MANAGED MEDICAID] standard_charge|[payer_MN UCARE]|[plan_MEDICAID: OUT OF STATE]|negotiated_dollar standard_charge|[payer_MN UCARE]|[plan_MEDICAID: OUT OF STATE] |negotiated_percentage standard_charge|[payer_MN UCARE]|[plan_MEDICAID: OUT OF STATE] |negotiated_algorithm estimated_amount|[payer_MN UCARE]|[plan_MEDICAID: OUT OF STATE] standard_charge|[payer_MN UCARE]|[plan_MEDICAID: OUT OF STATE] |methodology additional_payer_notes |[payer_MN UCARE]|[Plan_MEDICAID: OUT OF STATE] standard_charge|[payer_MOLINA MEDICAID]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_MOLINA MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_MOLINA MEDICAID]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_MOLINA MEDICAID]|[plan_MANAGED MEDICAID] standard_charge|[payer_MOLINA MEDICAID]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_MOLINA MEDICAID]|[Plan_MANAGED MEDICAID] standard_charge|[payer_SUREST]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_SUREST]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_SUREST]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_SUREST]|[plan_HMO/PPO] standard_charge|[payer_SUREST]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_SUREST]|[Plan_HMO/PPO] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE EAST]|[plan_TRICARE] standard_charge|[payer_TRICARE EAST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE EAST]|[Plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE]|negotiated_dollar standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_percentage standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |negotiated_algorithm estimated_amount|[payer_TRICARE WEST]|[plan_TRICARE] standard_charge|[payer_TRICARE WEST]|[plan_TRICARE] |methodology additional_payer_notes |[payer_TRICARE WEST]|[Plan_TRICARE] standard_charge|[payer_UBH OPTUM]|[plan_HMO/PPO]|negotiated_dollar standard_charge|[payer_UBH OPTUM]|[plan_HMO/PPO] |negotiated_percentage standard_charge|[payer_UBH OPTUM]|[plan_HMO/PPO] |negotiated_algorithm estimated_amount|[payer_UBH OPTUM]|[plan_HMO/PPO] standard_charge|[payer_UBH OPTUM]|[plan_HMO/PPO] |methodology additional_payer_notes |[payer_UBH OPTUM]|[Plan_HMO/PPO] standard_charge|[payer_YOUTHCARE]|[plan_MANAGED MEDICAID]|negotiated_dollar standard_charge|[payer_YOUTHCARE]|[plan_MANAGED MEDICAID] |negotiated_percentage standard_charge|[payer_YOUTHCARE]|[plan_MANAGED MEDICAID] |negotiated_algorithm estimated_amount|[payer_YOUTHCARE]|[plan_MANAGED MEDICAID] standard_charge|[payer_YOUTHCARE]|[plan_MANAGED MEDICAID] |methodology additional_payer_notes |[payer_YOUTHCARE]|[Plan_MANAGED MEDICAID] additional_generic_notes ROOM AND BOARD ADOLESCENT BOYS 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem ROOM AND BOARD ADOLESCENT GIRLS 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem ROOM AND BOARD CHILDREN 124 RC facility inpatient 3000 850 900 3000 900 per diem 1468.74 per diem 986 per diem 1000 per diem 1100 per diem 1100 per diem 925 per diem 1012 per diem 1468.74 per diem 3000 per diem 1005 per diem 1400 per diem 1468.74 per diem 3000 per diem 986 per diem 3000 per diem 3000 per diem 1050 per diem 1468.74 per diem 1468.74 per diem 965 per diem 3000 per diem 1468.74 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 3000 per diem 1468.74 per diem 986 per diem 3000 per diem 3000 per diem 986 per diem 1468.74 per diem OTHER ROOM AND BOARD ADMIN BOY 169 RC facility inpatient 3000 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem OTHER ROOM AND BOARD ADMIN CHIL 169 RC facility inpatient 3000 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem OTHER ROOM AND BOARD ADMIN GIRL 169 RC facility inpatient 3000 289.48 3000 289.48 per diem 289.48 per diem 289.48 per diem 3000 per diem 1468.74 per diem 289.48 per diem 289.48 per diem 400 per diem INTENSIVE OUTPATIENT PROGRAM PSYCH 905 RC facility outpatient 600 300 161.08 300 215 per diem 161.08 per diem 215 per diem 284 per diem 270 per diem 300 per diem 300 per diem 225 per diem 280 per diem 161.08 per diem 300 per diem 161.08 per diem 300 per diem 161.08 per diem 240 per diem 161.08 per diem 161.08 per diem 284 per diem 284 per diem 161.08 per diem PARTIAL HOSPITAL PROGRAM PSYCH 912 RC facility outpatient 900 400 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem INTENSIVE OUTPATIENT PROGRAM GRP THERAPY 1 915 RC facility outpatient 200 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem PARTIAL HOSPITAL PROGRAM PSYCHOTHRPY GRP1 915 RC facility outpatient 300 161.08 600 375 per diem 161.08 per diem 375 per diem 371 per diem 410 per diem 450 per diem 450 per diem 425 per diem 425 per diem 161.08 per diem 600 per diem 161.08 per diem 560 per diem 161.08 per diem 405 per diem 161.08 per diem 161.08 per diem 371 per diem 371 per diem 161.08 per diem