v2_1_2
Core Rates Month: 2025_07 Generated: 2025-09-21 11:22:14
Overview​
This analysis examines coverage gaps in CLD data by identifying rows where canonical_rate IS NULL
and investigating raw data sources to check if the gaps are legitimate.
1. Coverage Gap Statistics​
Overall Coverage Statistics​
- Total Records: 1,582,919,753.0
- Records with canonical_rate: 465,331,301.0
- Records without canonical_rate: 1,117,588,452.0
- NULL Rate Percentage: 0.7%
Click to see SQL
SELECT
COUNT(*) as total_records,
COUNT(canonical_rate) as records_with_rate,
COUNT(*) - COUNT(canonical_rate) as records_without_rate,
ROUND(1.000*(COUNT(*) - COUNT(canonical_rate)) / COUNT(*), 2) as null_rate_percentage
FROM tq_dev.internal_dev_csong_cld_v2_1_2.prod_combined_all
Coverage Statistics by Provider Type​
| provider_type | total_records | records_with_rate | records_without_rate | coverage_percentage | null_rate_percentage |
|---|---|---|---|---|---|
| Imaging Center | 35,350,130 | 3,070,924 | 32,279,206 | 9.0% | 91.0% |
| Rehabilitation Hospital | 46,828,215 | 5,889,167 | 40,939,048 | 13.0% | 87.0% |
| Laboratory | 12,851,796 | 2,591,276 | 10,260,520 | 20.0% | 80.0% |
| ASC | 201,028,474 | 42,706,463 | 158,322,011 | 21.0% | 79.0% |
| Childrens Hospital | 30,004,218 | 6,253,647 | 23,750,571 | 21.0% | 79.0% |
| Physician Group | 768,439,112 | 186,629,616 | 581,809,496 | 24.0% | 76.0% |
| Short Term Acute Care Hospital | 384,475,302 | 170,707,322 | 213,767,980 | 44.0% | 56.0% |
| Critical Access Hospital | 103,942,506 | 47,482,886 | 56,459,620 | 46.0% | 54.0% |
Click to see SQL
SELECT
provider_type,
COUNT(*) as total_records,
COUNT(canonical_rate) as records_with_rate,
COUNT(*) - COUNT(canonical_rate) as records_without_rate,
ROUND(1.000*COUNT(canonical_rate) / COUNT(*), 2) as coverage_percentage,
ROUND(1.000*(COUNT(*) - COUNT(canonical_rate)) / COUNT(*), 2) as null_rate_percentage
FROM tq_dev.internal_dev_csong_cld_v2_1_2.prod_combined_all
GROUP BY provider_type
ORDER BY coverage_percentage ASC
2. Sample Analysis of Hospital Coverage Gaps​
Look for ✅ to indicate matches found in the respective tables.
Sample Record 1​
Sample Record Details:
- Payer ID: 624
- Provider ID: 5564
- Billing Code Type: APR-DRG
- Billing Code: 0510-1
- Networks: ['NAVIGATOR GOLD']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '624'
AND provider_id = '5564'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0510-1'
AND product_network_label IN ('NAVIGATOR GOLD')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 624
AND provider_id = '5564'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0510-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 2​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2949
- Billing Code Type: HCPCS
- Billing Code: C9087
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2949'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9087'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2949'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9087'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 3​
Sample Record Details:
- Payer ID: 636
- Provider ID: 5991
- Billing Code Type: HCPCS
- Billing Code: 49423
- Networks: ['VALUE HMO', 'MED HMO - UT', 'MED HMO', 'VALUE HMO - UT', 'CARE HMO - UT', 'SHARE HMO', 'MED HMO - NV', 'VALUE HMO - NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '636'
AND provider_id = '5991'
AND billing_code_type = 'HCPCS'
AND billing_code = '49423'
AND product_network_label IN ('VALUE HMO', 'MED HMO - UT', 'MED HMO', 'VALUE HMO - UT', 'CARE HMO - UT', 'SHARE HMO', 'MED HMO - NV', 'VALUE HMO - NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 636
AND provider_id = '5991'
AND billing_code_type = 'HCPCS'
AND billing_code = '49423'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 4​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5366
- Billing Code Type: HCPCS
- Billing Code: 30450
- Networks: ['TX INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '5366'
AND billing_code_type = 'HCPCS'
AND billing_code = '30450'
AND product_network_label IN ('TX INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '5366'
AND billing_code_type = 'HCPCS'
AND billing_code = '30450'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 5​
Sample Record Details:
- Payer ID: 151
- Provider ID: 1920
- Billing Code Type: HCPCS
- Billing Code: 32999
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '1920'
AND billing_code_type = 'HCPCS'
AND billing_code = '32999'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '1920'
AND billing_code_type = 'HCPCS'
AND billing_code = '32999'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 6​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5789
- Billing Code Type: HCPCS
- Billing Code: 86490
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5789'
AND billing_code_type = 'HCPCS'
AND billing_code = '86490'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5789'
AND billing_code_type = 'HCPCS'
AND billing_code = '86490'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 7​
Sample Record Details:
- Payer ID: 42
- Provider ID: 683
- Billing Code Type: HCPCS
- Billing Code: 64820
- Networks: ['CT CENTURY PREFERRED PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '683'
AND billing_code_type = 'HCPCS'
AND billing_code = '64820'
AND product_network_label IN ('CT CENTURY PREFERRED PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '683'
AND billing_code_type = 'HCPCS'
AND billing_code = '64820'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 8​
Sample Record Details:
- Payer ID: 720
- Provider ID: 677
- Billing Code Type: HCPCS
- Billing Code: 65286
- Networks: ['ELEVATEHEALTH HMO HSA', 'HMO FLEX', 'VIRTUAL CHOICE HMO', 'NH LOCAL CHOICE HMO', 'GROUP INSURANCE COMMISSION HARVARD PILGRIM QUALITY HMO', 'CHOICENET HMO', 'NH LOCAL HMO', 'BEST BUY HMO HSA', 'AMERICAN INDIAN ALASKAN NATIVES HMO', 'MAINES CHOICE PLUS HMO', 'HARVARD PILGRIM HEALTH CARE HOUSE ACCT ELEVATEHEALTH HMO HSA', 'AMERICAN INDIAN NATIVE ALASKAN HMO FLEX', 'FOCUS NETWORK MA HMO', 'HMO LP', 'HMO', 'SIMPLYVIRTUAL HMO', 'ELEVATEHEALTH HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '720'
AND provider_id = '677'
AND billing_code_type = 'HCPCS'
AND billing_code = '65286'
AND product_network_label IN ('ELEVATEHEALTH HMO HSA', 'HMO FLEX', 'VIRTUAL CHOICE HMO', 'NH LOCAL CHOICE HMO', 'GROUP INSURANCE COMMISSION HARVARD PILGRIM QUALITY HMO', 'CHOICENET HMO', 'NH LOCAL HMO', 'BEST BUY HMO HSA', 'AMERICAN INDIAN ALASKAN NATIVES HMO', 'MAINES CHOICE PLUS HMO', 'HARVARD PILGRIM HEALTH CARE HOUSE ACCT ELEVATEHEALTH HMO HSA', 'AMERICAN INDIAN NATIVE ALASKAN HMO FLEX', 'FOCUS NETWORK MA HMO', 'HMO LP', 'HMO', 'SIMPLYVIRTUAL HMO', 'ELEVATEHEALTH HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 720
AND provider_id = '677'
AND billing_code_type = 'HCPCS'
AND billing_code = '65286'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 9​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2735
- Billing Code Type: HCPCS
- Billing Code: 52320
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2735'
AND billing_code_type = 'HCPCS'
AND billing_code = '52320'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2735'
AND billing_code_type = 'HCPCS'
AND billing_code = '52320'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 10​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10197
- Billing Code Type: HCPCS
- Billing Code: 26755
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '10197'
AND billing_code_type = 'HCPCS'
AND billing_code = '26755'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '10197'
AND billing_code_type = 'HCPCS'
AND billing_code = '26755'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 11​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2199
- Billing Code Type: HCPCS
- Billing Code: 62270
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '2199'
AND billing_code_type = 'HCPCS'
AND billing_code = '62270'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '2199'
AND billing_code_type = 'HCPCS'
AND billing_code = '62270'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 12​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5304
- Billing Code Type: HCPCS
- Billing Code: 30915
- Networks: ['SOUTH TEXAS HMO', 'NORTH TEXAS HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '5304'
AND billing_code_type = 'HCPCS'
AND billing_code = '30915'
AND product_network_label IN ('SOUTH TEXAS HMO', 'NORTH TEXAS HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '5304'
AND billing_code_type = 'HCPCS'
AND billing_code = '30915'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 13​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9247
- Billing Code Type: HCPCS
- Billing Code: 44392
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9247'
AND billing_code_type = 'HCPCS'
AND billing_code = '44392'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9247'
AND billing_code_type = 'HCPCS'
AND billing_code = '44392'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 14​
Sample Record Details:
- Payer ID: 52
- Provider ID: 1689
- Billing Code Type: HCPCS
- Billing Code: 43886
- Networks: ['DUKE EMPLOYEE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '52'
AND provider_id = '1689'
AND billing_code_type = 'HCPCS'
AND billing_code = '43886'
AND product_network_label IN ('DUKE EMPLOYEE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 52
AND provider_id = '1689'
AND billing_code_type = 'HCPCS'
AND billing_code = '43886'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 15​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9302
- Billing Code Type: HCPCS
- Billing Code: 52250
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9302'
AND billing_code_type = 'HCPCS'
AND billing_code = '52250'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9302'
AND billing_code_type = 'HCPCS'
AND billing_code = '52250'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 16​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8040
- Billing Code Type: HCPCS
- Billing Code: 28102
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '8040'
AND billing_code_type = 'HCPCS'
AND billing_code = '28102'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '8040'
AND billing_code_type = 'HCPCS'
AND billing_code = '28102'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 17​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2380
- Billing Code Type: APR-DRG
- Billing Code: 0091-4
- Networks: ['KY HMO', 'KY PATHWAY X HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '2380'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0091-4'
AND product_network_label IN ('KY HMO', 'KY PATHWAY X HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '2380'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0091-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 18​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6205
- Billing Code Type: HCPCS
- Billing Code: 88356
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6205'
AND billing_code_type = 'HCPCS'
AND billing_code = '88356'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6205'
AND billing_code_type = 'HCPCS'
AND billing_code = '88356'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 19​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6735
- Billing Code Type: HCPCS
- Billing Code: 52320
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6735'
AND billing_code_type = 'HCPCS'
AND billing_code = '52320'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 1 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 6735 | HCPCS | 52320 | Outpatient | UNITEDHEALTHCARE AARP | MDX HAWAII | 3,993.22 | 8130d98482d34dba9ac4401efb92816f |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6735'
AND billing_code_type = 'HCPCS'
AND billing_code = '52320'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 20​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2767
- Billing Code Type: APR-DRG
- Billing Code: 0169-4
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2767'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-4'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2767'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 21​
Sample Record Details:
- Payer ID: 354
- Provider ID: 794
- Billing Code Type: APR-DRG
- Billing Code: 0694-1
- Networks: ['PREMIUM']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '354'
AND provider_id = '794'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0694-1'
AND product_network_label IN ('PREMIUM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 354
AND provider_id = '794'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0694-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 22​
Sample Record Details:
- Payer ID: 7
- Provider ID: 4240
- Billing Code Type: HCPCS
- Billing Code: J1572
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '4240'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1572'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '4240'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1572'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 23​
Sample Record Details:
- Payer ID: 770
- Provider ID: 686
- Billing Code Type: HCPCS
- Billing Code: 78013
- Networks: ['ALLIES HMO', 'COMMERCIAL HMO', 'VALUE HMO', 'SELECT HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '770'
AND provider_id = '686'
AND billing_code_type = 'HCPCS'
AND billing_code = '78013'
AND product_network_label IN ('ALLIES HMO', 'COMMERCIAL HMO', 'VALUE HMO', 'SELECT HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 770
AND provider_id = '686'
AND billing_code_type = 'HCPCS'
AND billing_code = '78013'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 24​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2033
- Billing Code Type: MS-DRG
- Billing Code: 749
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '2033'
AND billing_code_type = 'MS-DRG'
AND billing_code = '749'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '2033'
AND billing_code_type = 'MS-DRG'
AND billing_code = '749'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 25​
Sample Record Details:
- Payer ID: 456
- Provider ID: 3703
- Billing Code Type: MS-DRG
- Billing Code: 570
- Networks: ['PREFERRED PROVIDER NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '456'
AND provider_id = '3703'
AND billing_code_type = 'MS-DRG'
AND billing_code = '570'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 456
AND provider_id = '3703'
AND billing_code_type = 'MS-DRG'
AND billing_code = '570'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 26​
Sample Record Details:
- Payer ID: 42
- Provider ID: 762
- Billing Code Type: HCPCS
- Billing Code: 46600
- Networks: ['CT HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '762'
AND billing_code_type = 'HCPCS'
AND billing_code = '46600'
AND product_network_label IN ('CT HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '762'
AND billing_code_type = 'HCPCS'
AND billing_code = '46600'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 27​
Sample Record Details:
- Payer ID: 169
- Provider ID: 8772
- Billing Code Type: HCPCS
- Billing Code: 47552
- Networks: ['BLUE ADVANTAGE HMO', 'MYBLUE HEALTH HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '169'
AND provider_id = '8772'
AND billing_code_type = 'HCPCS'
AND billing_code = '47552'
AND product_network_label IN ('BLUE ADVANTAGE HMO', 'MYBLUE HEALTH HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 169
AND provider_id = '8772'
AND billing_code_type = 'HCPCS'
AND billing_code = '47552'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 28​
Sample Record Details:
- Payer ID: 54
- Provider ID: 6813
- Billing Code Type: HCPCS
- Billing Code: 53515
- Networks: ['PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '54'
AND provider_id = '6813'
AND billing_code_type = 'HCPCS'
AND billing_code = '53515'
AND product_network_label IN ('PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 54
AND provider_id = '6813'
AND billing_code_type = 'HCPCS'
AND billing_code = '53515'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 29​
Sample Record Details:
- Payer ID: 354
- Provider ID: 978
- Billing Code Type: HCPCS
- Billing Code: J2404
- Networks: ['PREMIUM']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '354'
AND provider_id = '978'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2404'
AND product_network_label IN ('PREMIUM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 354
AND provider_id = '978'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2404'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 30​
Sample Record Details:
- Payer ID: 174
- Provider ID: 1317
- Billing Code Type: APR-DRG
- Billing Code: 0424-3
- Networks: ['BLUECARD - PREFERRED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '174'
AND provider_id = '1317'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0424-3'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '1317'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0424-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 31​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4439
- Billing Code Type: HCPCS
- Billing Code: J3145
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '4439'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3145'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '4439'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3145'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 32​
Sample Record Details:
- Payer ID: 286
- Provider ID: 876
- Billing Code Type: HCPCS
- Billing Code: 27640
- Networks: ['MVP HMO / POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '286'
AND provider_id = '876'
AND billing_code_type = 'HCPCS'
AND billing_code = '27640'
AND product_network_label IN ('MVP HMO / POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 286
AND provider_id = '876'
AND billing_code_type = 'HCPCS'
AND billing_code = '27640'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 33​
Sample Record Details:
- Payer ID: 174
- Provider ID: 387
- Billing Code Type: HCPCS
- Billing Code: 50553
- Networks: ['BLUECARD - PREFERRED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '174'
AND provider_id = '387'
AND billing_code_type = 'HCPCS'
AND billing_code = '50553'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '387'
AND billing_code_type = 'HCPCS'
AND billing_code = '50553'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 34​
Sample Record Details:
- Payer ID: 774
- Provider ID: 9784
- Billing Code Type: HCPCS
- Billing Code: 52344
- Networks: ['HMO / HEALTHY NY / ESSENTIAL']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '774'
AND provider_id = '9784'
AND billing_code_type = 'HCPCS'
AND billing_code = '52344'
AND product_network_label IN ('HMO / HEALTHY NY / ESSENTIAL')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 774
AND provider_id = '9784'
AND billing_code_type = 'HCPCS'
AND billing_code = '52344'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 35​
Sample Record Details:
- Payer ID: 461
- Provider ID: 3945
- Billing Code Type: APR-DRG
- Billing Code: 0588-2
- Networks: ['WELLMARK HEALTH PLAN IOWA PLAN HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '461'
AND provider_id = '3945'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0588-2'
AND product_network_label IN ('WELLMARK HEALTH PLAN IOWA PLAN HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 461
AND provider_id = '3945'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0588-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 36​
Sample Record Details:
- Payer ID: 52
- Provider ID: 1521
- Billing Code Type: HCPCS
- Billing Code: 63042
- Networks: ['DUKE EMPLOYEE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '52'
AND provider_id = '1521'
AND billing_code_type = 'HCPCS'
AND billing_code = '63042'
AND product_network_label IN ('DUKE EMPLOYEE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 52
AND provider_id = '1521'
AND billing_code_type = 'HCPCS'
AND billing_code = '63042'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 37​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5678
- Billing Code Type: HCPCS
- Billing Code: 11771
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5678'
AND billing_code_type = 'HCPCS'
AND billing_code = '11771'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5678'
AND billing_code_type = 'HCPCS'
AND billing_code = '11771'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 38​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6564
- Billing Code Type: MS-DRG
- Billing Code: 306
- Networks: ['SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '6564'
AND billing_code_type = 'MS-DRG'
AND billing_code = '306'
AND product_network_label IN ('SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6564'
AND billing_code_type = 'MS-DRG'
AND billing_code = '306'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 39​
Sample Record Details:
- Payer ID: 42
- Provider ID: 253
- Billing Code Type: HCPCS
- Billing Code: J9002
- Networks: ['MO BLUE ACCESS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '253'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9002'
AND product_network_label IN ('MO BLUE ACCESS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '253'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9002'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 40​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1020
- Billing Code Type: HCPCS
- Billing Code: 21465
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '1020'
AND billing_code_type = 'HCPCS'
AND billing_code = '21465'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '1020'
AND billing_code_type = 'HCPCS'
AND billing_code = '21465'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 41​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4976
- Billing Code Type: HCPCS
- Billing Code: 49659
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '4976'
AND billing_code_type = 'HCPCS'
AND billing_code = '49659'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '4976'
AND billing_code_type = 'HCPCS'
AND billing_code = '49659'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 42​
Sample Record Details:
- Payer ID: 37
- Provider ID: 4226
- Billing Code Type: HCPCS
- Billing Code: 0809T
- Networks: ['AVERA HEALTH NETWORK ASO NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '37'
AND provider_id = '4226'
AND billing_code_type = 'HCPCS'
AND billing_code = '0809T'
AND product_network_label IN ('AVERA HEALTH NETWORK ASO NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 37
AND provider_id = '4226'
AND billing_code_type = 'HCPCS'
AND billing_code = '0809T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 43​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2741
- Billing Code Type: HCPCS
- Billing Code: J8612
- Networks: ['WI BLUE ACCESS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '2741'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J8612'
AND product_network_label IN ('WI BLUE ACCESS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '2741'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J8612'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 44​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2901
- Billing Code Type: HCPCS
- Billing Code: 41870
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2901'
AND billing_code_type = 'HCPCS'
AND billing_code = '41870'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2901'
AND billing_code_type = 'HCPCS'
AND billing_code = '41870'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 45​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6324
- Billing Code Type: HCPCS
- Billing Code: 0271T
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '6324'
AND billing_code_type = 'HCPCS'
AND billing_code = '0271T'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6324'
AND billing_code_type = 'HCPCS'
AND billing_code = '0271T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 46​
Sample Record Details:
- Payer ID: 643
- Provider ID: 8745
- Billing Code Type: HCPCS
- Billing Code: 57135
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '8745'
AND billing_code_type = 'HCPCS'
AND billing_code = '57135'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '8745'
AND billing_code_type = 'HCPCS'
AND billing_code = '57135'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 47​
Sample Record Details:
- Payer ID: 151
- Provider ID: 8392
- Billing Code Type: HCPCS
- Billing Code: 23440
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '8392'
AND billing_code_type = 'HCPCS'
AND billing_code = '23440'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '8392'
AND billing_code_type = 'HCPCS'
AND billing_code = '23440'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 48​
Sample Record Details:
- Payer ID: 151
- Provider ID: 1847
- Billing Code Type: HCPCS
- Billing Code: Q4163
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '1847'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4163'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '1847'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4163'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 49​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3741
- Billing Code Type: APR-DRG
- Billing Code: 0229-3
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '3741'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0229-3'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '3741'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0229-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 50​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8491
- Billing Code Type: HCPCS
- Billing Code: 67141
- Networks: ['TX INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '8491'
AND billing_code_type = 'HCPCS'
AND billing_code = '67141'
AND product_network_label IN ('TX INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8491'
AND billing_code_type = 'HCPCS'
AND billing_code = '67141'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 51​
Sample Record Details:
- Payer ID: 633
- Provider ID: 5157
- Billing Code Type: HCPCS
- Billing Code: 73202
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '633'
AND provider_id = '5157'
AND billing_code_type = 'HCPCS'
AND billing_code = '73202'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '5157'
AND billing_code_type = 'HCPCS'
AND billing_code = '73202'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 52​
Sample Record Details:
- Payer ID: 169
- Provider ID: 8659
- Billing Code Type: HCPCS
- Billing Code: J9094
- Networks: ['BLUE CHOICE PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '169'
AND provider_id = '8659'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9094'
AND product_network_label IN ('BLUE CHOICE PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 169
AND provider_id = '8659'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9094'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 53​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6333
- Billing Code Type: HCPCS
- Billing Code: D7412
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6333'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7412'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6333'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7412'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 54​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1983
- Billing Code Type: HCPCS
- Billing Code: 64635
- Networks: ['GA INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '1983'
AND billing_code_type = 'HCPCS'
AND billing_code = '64635'
AND product_network_label IN ('GA INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1983'
AND billing_code_type = 'HCPCS'
AND billing_code = '64635'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 55​
Sample Record Details:
- Payer ID: 37
- Provider ID: 4225
- Billing Code Type: HCPCS
- Billing Code: 44402
- Networks: ['AVERA HEALTH NETWORK ASO NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '37'
AND provider_id = '4225'
AND billing_code_type = 'HCPCS'
AND billing_code = '44402'
AND product_network_label IN ('AVERA HEALTH NETWORK ASO NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 37
AND provider_id = '4225'
AND billing_code_type = 'HCPCS'
AND billing_code = '44402'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 56​
Sample Record Details:
- Payer ID: 7
- Provider ID: 2793
- Billing Code Type: HCPCS
- Billing Code: 95861
- Networks: ['IL INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '2793'
AND billing_code_type = 'HCPCS'
AND billing_code = '95861'
AND product_network_label IN ('IL INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '2793'
AND billing_code_type = 'HCPCS'
AND billing_code = '95861'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 57​
Sample Record Details:
- Payer ID: 388
- Provider ID: 2145
- Billing Code Type: HCPCS
- Billing Code: 92541
- Networks: ['SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '388'
AND provider_id = '2145'
AND billing_code_type = 'HCPCS'
AND billing_code = '92541'
AND product_network_label IN ('SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 388
AND provider_id = '2145'
AND billing_code_type = 'HCPCS'
AND billing_code = '92541'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 58​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2770
- Billing Code Type: HCPCS
- Billing Code: 41872
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '2770'
AND billing_code_type = 'HCPCS'
AND billing_code = '41872'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '2770'
AND billing_code_type = 'HCPCS'
AND billing_code = '41872'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 59​
Sample Record Details:
- Payer ID: 56
- Provider ID: 989
- Billing Code Type: MS-DRG
- Billing Code: 244
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '989'
AND billing_code_type = 'MS-DRG'
AND billing_code = '244'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '989'
AND billing_code_type = 'MS-DRG'
AND billing_code = '244'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 60​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2480
- Billing Code Type: HCPCS
- Billing Code: 45330
- Networks: ['KY PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '2480'
AND billing_code_type = 'HCPCS'
AND billing_code = '45330'
AND product_network_label IN ('KY PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '2480'
AND billing_code_type = 'HCPCS'
AND billing_code = '45330'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 61​
Sample Record Details:
- Payer ID: 643
- Provider ID: 7678
- Billing Code Type: MS-DRG
- Billing Code: 671
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '7678'
AND billing_code_type = 'MS-DRG'
AND billing_code = '671'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '7678'
AND billing_code_type = 'MS-DRG'
AND billing_code = '671'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 62​
Sample Record Details:
- Payer ID: 56
- Provider ID: 313
- Billing Code Type: APR-DRG
- Billing Code: 0812-4
- Networks: ['KHPE COMMERCIAL HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '313'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0812-4'
AND product_network_label IN ('KHPE COMMERCIAL HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '313'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0812-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 63​
Sample Record Details:
- Payer ID: 42
- Provider ID: 9444
- Billing Code Type: APR-DRG
- Billing Code: 0589-4
- Networks: ['WI BLUE ACCESS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '9444'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0589-4'
AND product_network_label IN ('WI BLUE ACCESS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '9444'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0589-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 64​
Sample Record Details:
- Payer ID: 174
- Provider ID: 387
- Billing Code Type: HCPCS
- Billing Code: 95812
- Networks: ['BLUECARD - PREFERRED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '174'
AND provider_id = '387'
AND billing_code_type = 'HCPCS'
AND billing_code = '95812'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 4 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 174 | 387 | HCPCS | 95812 | 740 | Outpatient | HIGHMARK | BLUE CROSS BLUE SHIELD | 2311.0% | 798.68 | 80c03a537912454783631bb2e768ef9a | |||
| 174 | 387 | HCPCS | 95812 | 740 | Inpatient | HIGHMARK - SPECIAL CARE | BLUE CROSS BLUE SHIELD | b75509fbefb74e609a268d16972c7f52 | |||||
| 174 | 387 | HCPCS | 95812 | 740 | Inpatient | HIGHMARK | BLUE CROSS BLUE SHIELD | c1ae538ccd1544eaa2d7478a77e14f20 | |||||
| 174 | 387 | HCPCS | 95812 | 740 | Outpatient | HIGHMARK - SPECIAL CARE | BLUE CROSS BLUE SHIELD | 1618.0% | 559.18 | 731f54d12dd54222b849c32aaa53d3a7 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '387'
AND billing_code_type = 'HCPCS'
AND billing_code = '95812'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 65​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2698
- Billing Code Type: HCPCS
- Billing Code: 69717
- Networks: ['IN PATHWAY HMO/POS', 'IN PATHWAY X HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '2698'
AND billing_code_type = 'HCPCS'
AND billing_code = '69717'
AND product_network_label IN ('IN PATHWAY HMO/POS', 'IN PATHWAY X HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '2698'
AND billing_code_type = 'HCPCS'
AND billing_code = '69717'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 66​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2969
- Billing Code Type: HCPCS
- Billing Code: J1939
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2969'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1939'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2969'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1939'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 67​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1608
- Billing Code Type: HCPCS
- Billing Code: J0737
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '1608'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0737'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '1608'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0737'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 68​
Sample Record Details:
- Payer ID: 43
- Provider ID: 7058
- Billing Code Type: HCPCS
- Billing Code: J2322
- Networks: ['INDIVIDUAL AND FAMILY HMO - MARICOPA', 'SMALL GROUP HMO - ALLIANCE', 'SMALL GROUP HMO', 'INDIVIDUAL AND FAMILY HMO - PIMA', 'INDIVIDUAL AND FAMILY HMO', 'INDIVIDUAL AND FAMILY HMO - NEIGHBORHOOD']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '43'
AND provider_id = '7058'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2322'
AND product_network_label IN ('INDIVIDUAL AND FAMILY HMO - MARICOPA', 'SMALL GROUP HMO - ALLIANCE', 'SMALL GROUP HMO', 'INDIVIDUAL AND FAMILY HMO - PIMA', 'INDIVIDUAL AND FAMILY HMO', 'INDIVIDUAL AND FAMILY HMO - NEIGHBORHOOD')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 43
AND provider_id = '7058'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2322'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 69​
Sample Record Details:
- Payer ID: 522
- Provider ID: 6120
- Billing Code Type: HCPCS
- Billing Code: 0517T
- Networks: ['SELF FUNDED NORTHWEST']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '522'
AND provider_id = '6120'
AND billing_code_type = 'HCPCS'
AND billing_code = '0517T'
AND product_network_label IN ('SELF FUNDED NORTHWEST')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 522
AND provider_id = '6120'
AND billing_code_type = 'HCPCS'
AND billing_code = '0517T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 70​
Sample Record Details:
- Payer ID: 42
- Provider ID: 8662
- Billing Code Type: HCPCS
- Billing Code: 96371
- Networks: ['OH PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '8662'
AND billing_code_type = 'HCPCS'
AND billing_code = '96371'
AND product_network_label IN ('OH PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '8662'
AND billing_code_type = 'HCPCS'
AND billing_code = '96371'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 71​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4111
- Billing Code Type: HCPCS
- Billing Code: 0817T
- Networks: ['SOUTHWEST MISSOURI HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '4111'
AND billing_code_type = 'HCPCS'
AND billing_code = '0817T'
AND product_network_label IN ('SOUTHWEST MISSOURI HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '4111'
AND billing_code_type = 'HCPCS'
AND billing_code = '0817T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 72​
Sample Record Details:
- Payer ID: 42
- Provider ID: 6381
- Billing Code Type: MS-DRG
- Billing Code: 352
- Networks: ['CA HMO', 'CA PATHWAY HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '6381'
AND billing_code_type = 'MS-DRG'
AND billing_code = '352'
AND product_network_label IN ('CA HMO', 'CA PATHWAY HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '6381'
AND billing_code_type = 'MS-DRG'
AND billing_code = '352'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 73​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2992
- Billing Code Type: HCPCS
- Billing Code: 50727
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '2992'
AND billing_code_type = 'HCPCS'
AND billing_code = '50727'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '2992'
AND billing_code_type = 'HCPCS'
AND billing_code = '50727'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 74​
Sample Record Details:
- Payer ID: 633
- Provider ID: 4959
- Billing Code Type: HCPCS
- Billing Code: 55120
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '633'
AND provider_id = '4959'
AND billing_code_type = 'HCPCS'
AND billing_code = '55120'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '4959'
AND billing_code_type = 'HCPCS'
AND billing_code = '55120'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 75​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6689
- Billing Code Type: APR-DRG
- Billing Code: 0200-4
- Networks: ['SUTTER HEALTH PLUS LARGE GROUP PLANS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '728'
AND provider_id = '6689'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0200-4'
AND product_network_label IN ('SUTTER HEALTH PLUS LARGE GROUP PLANS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 728
AND provider_id = '6689'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0200-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 76​
Sample Record Details:
- Payer ID: 76
- Provider ID: 3372
- Billing Code Type: MS-DRG
- Billing Code: 621
- Networks: ['GEORGIA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '3372'
AND billing_code_type = 'MS-DRG'
AND billing_code = '621'
AND product_network_label IN ('GEORGIA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 2 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 76 | 3372 | MS-DRG | 621 | Facility | Inpatient | OPEN ACCESS | CIGNA | 15,432.46 | d882049bdd374a3ab497b9dc5a799de4 | ||||
| 76 | 3372 | MS-DRG | 621 | Facility | Inpatient | LOCAL PLUS | CIGNA | 14,353.66 | f355bcd4bfda4e0196f54325456fc3ed |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '3372'
AND billing_code_type = 'MS-DRG'
AND billing_code = '621'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 77​
Sample Record Details:
- Payer ID: 229
- Provider ID: 884
- Billing Code Type: MS-DRG
- Billing Code: 605
- Networks: ['GROUP - PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '229'
AND provider_id = '884'
AND billing_code_type = 'MS-DRG'
AND billing_code = '605'
AND product_network_label IN ('GROUP - PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 229
AND provider_id = '884'
AND billing_code_type = 'MS-DRG'
AND billing_code = '605'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 78​
Sample Record Details:
- Payer ID: 390
- Provider ID: 4049
- Billing Code Type: APR-DRG
- Billing Code: 0251-1
- Networks: ['BLUE CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '390'
AND provider_id = '4049'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0251-1'
AND product_network_label IN ('BLUE CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 390
AND provider_id = '4049'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0251-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 79​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10453
- Billing Code Type: HCPCS
- Billing Code: 93292
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '10453'
AND billing_code_type = 'HCPCS'
AND billing_code = '93292'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '10453'
AND billing_code_type = 'HCPCS'
AND billing_code = '93292'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 80​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2743
- Billing Code Type: HCPCS
- Billing Code: 15819
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '2743'
AND billing_code_type = 'HCPCS'
AND billing_code = '15819'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '2743'
AND billing_code_type = 'HCPCS'
AND billing_code = '15819'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 81​
Sample Record Details:
- Payer ID: 317
- Provider ID: 705
- Billing Code Type: APR-DRG
- Billing Code: 0815-1
- Networks: ['YOUR CHOICE HMO MA', 'SELECT HMO MA', 'HMO MA']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '317'
AND provider_id = '705'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0815-1'
AND product_network_label IN ('YOUR CHOICE HMO MA', 'SELECT HMO MA', 'HMO MA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 317
AND provider_id = '705'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0815-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 82​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1835
- Billing Code Type: HCPCS
- Billing Code: 63064
- Networks: ['NORTH CAROLINA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '1835'
AND billing_code_type = 'HCPCS'
AND billing_code = '63064'
AND product_network_label IN ('NORTH CAROLINA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '1835'
AND billing_code_type = 'HCPCS'
AND billing_code = '63064'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 83​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3056
- Billing Code Type: HCPCS
- Billing Code: 25071
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '3056'
AND billing_code_type = 'HCPCS'
AND billing_code = '25071'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '3056'
AND billing_code_type = 'HCPCS'
AND billing_code = '25071'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 84​
Sample Record Details:
- Payer ID: 151
- Provider ID: 9383
- Billing Code Type: APR-DRG
- Billing Code: 0247-4
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '9383'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0247-4'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '9383'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0247-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 85​
Sample Record Details:
- Payer ID: 151
- Provider ID: 7780
- Billing Code Type: HCPCS
- Billing Code: 26483
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '7780'
AND billing_code_type = 'HCPCS'
AND billing_code = '26483'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '7780'
AND billing_code_type = 'HCPCS'
AND billing_code = '26483'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 86​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5217
- Billing Code Type: APR-DRG
- Billing Code: 0723-1
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5217'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0723-1'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5217'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0723-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 87​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9241
- Billing Code Type: HCPCS
- Billing Code: 24582
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9241'
AND billing_code_type = 'HCPCS'
AND billing_code = '24582'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9241'
AND billing_code_type = 'HCPCS'
AND billing_code = '24582'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 88​
Sample Record Details:
- Payer ID: 229
- Provider ID: 1118
- Billing Code Type: HCPCS
- Billing Code: 27884
- Networks: ['GROUP - PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '229'
AND provider_id = '1118'
AND billing_code_type = 'HCPCS'
AND billing_code = '27884'
AND product_network_label IN ('GROUP - PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 229
AND provider_id = '1118'
AND billing_code_type = 'HCPCS'
AND billing_code = '27884'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 89​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8791
- Billing Code Type: HCPCS
- Billing Code: C9066
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '8791'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9066'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8791'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9066'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 90​
Sample Record Details:
- Payer ID: 229
- Provider ID: 1358
- Billing Code Type: HCPCS
- Billing Code: 36819
- Networks: ['GROUP - PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '229'
AND provider_id = '1358'
AND billing_code_type = 'HCPCS'
AND billing_code = '36819'
AND product_network_label IN ('GROUP - PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 229
AND provider_id = '1358'
AND billing_code_type = 'HCPCS'
AND billing_code = '36819'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 91​
Sample Record Details:
- Payer ID: 151
- Provider ID: 7154
- Billing Code Type: APR-DRG
- Billing Code: 0136-3
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '7154'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0136-3'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '7154'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0136-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 92​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1492
- Billing Code Type: HCPCS
- Billing Code: 77605
- Networks: ['PREFERRED PROVIDER NETWORK (PPO)']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '44'
AND provider_id = '1492'
AND billing_code_type = 'HCPCS'
AND billing_code = '77605'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK (PPO)')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 44
AND provider_id = '1492'
AND billing_code_type = 'HCPCS'
AND billing_code = '77605'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 93​
Sample Record Details:
- Payer ID: 643
- Provider ID: 8296
- Billing Code Type: APR-DRG
- Billing Code: 0052-3
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '8296'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0052-3'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '8296'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0052-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 94​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4491
- Billing Code Type: HCPCS
- Billing Code: 27450
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '4491'
AND billing_code_type = 'HCPCS'
AND billing_code = '27450'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '4491'
AND billing_code_type = 'HCPCS'
AND billing_code = '27450'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 95​
Sample Record Details:
- Payer ID: 643
- Provider ID: 7200
- Billing Code Type: HCPCS
- Billing Code: 58559
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '7200'
AND billing_code_type = 'HCPCS'
AND billing_code = '58559'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '7200'
AND billing_code_type = 'HCPCS'
AND billing_code = '58559'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 96​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8051
- Billing Code Type: HCPCS
- Billing Code: 27722
- Networks: ['FL GROUP HMO', 'FL INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '8051'
AND billing_code_type = 'HCPCS'
AND billing_code = '27722'
AND product_network_label IN ('FL GROUP HMO', 'FL INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8051'
AND billing_code_type = 'HCPCS'
AND billing_code = '27722'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 97​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1557
- Billing Code Type: HCPCS
- Billing Code: 11306
- Networks: ['BLUECHOICE (HMO),']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '44'
AND provider_id = '1557'
AND billing_code_type = 'HCPCS'
AND billing_code = '11306'
AND product_network_label IN ('BLUECHOICE (HMO),')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 44
AND provider_id = '1557'
AND billing_code_type = 'HCPCS'
AND billing_code = '11306'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 98​
Sample Record Details:
- Payer ID: 7
- Provider ID: 6498
- Billing Code Type: HCPCS
- Billing Code: J9042
- Networks: ['CA INDIVIDUAL HMO', 'CA GROUP HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '6498'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9042'
AND product_network_label IN ('CA INDIVIDUAL HMO', 'CA GROUP HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '6498'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9042'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 99​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8349
- Billing Code Type: HCPCS
- Billing Code: A9602
- Networks: ['TX INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '8349'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9602'
AND product_network_label IN ('TX INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8349'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9602'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 100​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8332
- Billing Code Type: HCPCS
- Billing Code: 50436
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '8332'
AND billing_code_type = 'HCPCS'
AND billing_code = '50436'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '8332'
AND billing_code_type = 'HCPCS'
AND billing_code = '50436'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 101​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2311
- Billing Code Type: HCPCS
- Billing Code: 36471
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '2311'
AND billing_code_type = 'HCPCS'
AND billing_code = '36471'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '2311'
AND billing_code_type = 'HCPCS'
AND billing_code = '36471'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 102​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2911
- Billing Code Type: APR-DRG
- Billing Code: 0163-2
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2911'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0163-2'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2911'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0163-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 103​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6010
- Billing Code Type: HCPCS
- Billing Code: C9071
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '6010'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9071'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6010'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9071'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 104​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5343
- Billing Code Type: MS-DRG
- Billing Code: 460
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5343'
AND billing_code_type = 'MS-DRG'
AND billing_code = '460'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5343'
AND billing_code_type = 'MS-DRG'
AND billing_code = '460'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 105​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6347
- Billing Code Type: HCPCS
- Billing Code: J9265
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6347'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9265'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6347'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9265'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 106​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5339
- Billing Code Type: MS-DRG
- Billing Code: 299
- Networks: ['SOUTH TEXAS HMO', 'NORTH TEXAS HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '5339'
AND billing_code_type = 'MS-DRG'
AND billing_code = '299'
AND product_network_label IN ('SOUTH TEXAS HMO', 'NORTH TEXAS HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '5339'
AND billing_code_type = 'MS-DRG'
AND billing_code = '299'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 107​
Sample Record Details:
- Payer ID: 389
- Provider ID: 4031
- Billing Code Type: HCPCS
- Billing Code: J1520
- Networks: ['BLUE PRECISION HMO', 'BLUE ADVANTAGE HMO - NON STANDARD', 'BLUE ADVANTAGE HMO HMO NON STANDARD', 'BLUE PRECISION HMO - NON STANDARD', 'BLUE ADVANTAGE HMO', 'HMO ILLINOIS STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO - STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS', 'BLUE PRECISION HMO - STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS HMO NON STANDARD', 'HMO ILLINOIS - NON STANDARD', 'HMO ILLINOIS - STANDARD AND ADVOCATE HEALTH']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '389'
AND provider_id = '4031'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1520'
AND product_network_label IN ('BLUE PRECISION HMO', 'BLUE ADVANTAGE HMO - NON STANDARD', 'BLUE ADVANTAGE HMO HMO NON STANDARD', 'BLUE PRECISION HMO - NON STANDARD', 'BLUE ADVANTAGE HMO', 'HMO ILLINOIS STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO - STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS', 'BLUE PRECISION HMO - STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS HMO NON STANDARD', 'HMO ILLINOIS - NON STANDARD', 'HMO ILLINOIS - STANDARD AND ADVOCATE HEALTH')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 389
AND provider_id = '4031'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1520'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 108​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9540
- Billing Code Type: HCPCS
- Billing Code: 28112
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9540'
AND billing_code_type = 'HCPCS'
AND billing_code = '28112'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9540'
AND billing_code_type = 'HCPCS'
AND billing_code = '28112'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 109​
Sample Record Details:
- Payer ID: 76
- Provider ID: 595
- Billing Code Type: HCPCS
- Billing Code: 30200
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '595'
AND billing_code_type = 'HCPCS'
AND billing_code = '30200'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '595'
AND billing_code_type = 'HCPCS'
AND billing_code = '30200'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 110​
Sample Record Details:
- Payer ID: 151
- Provider ID: 852
- Billing Code Type: HCPCS
- Billing Code: 43217
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '852'
AND billing_code_type = 'HCPCS'
AND billing_code = '43217'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '852'
AND billing_code_type = 'HCPCS'
AND billing_code = '43217'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 111​
Sample Record Details:
- Payer ID: 770
- Provider ID: 734
- Billing Code Type: MS-DRG
- Billing Code: 199
- Networks: ['COMMERCIAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '770'
AND provider_id = '734'
AND billing_code_type = 'MS-DRG'
AND billing_code = '199'
AND product_network_label IN ('COMMERCIAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 770
AND provider_id = '734'
AND billing_code_type = 'MS-DRG'
AND billing_code = '199'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 112​
Sample Record Details:
- Payer ID: 699
- Provider ID: 941
- Billing Code Type: HCPCS
- Billing Code: 78431
- Networks: ['UNIVERA PPO SIGNATURE DEDUCTIBLE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '699'
AND provider_id = '941'
AND billing_code_type = 'HCPCS'
AND billing_code = '78431'
AND product_network_label IN ('UNIVERA PPO SIGNATURE DEDUCTIBLE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 699
AND provider_id = '941'
AND billing_code_type = 'HCPCS'
AND billing_code = '78431'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 113​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5193
- Billing Code Type: HCPCS
- Billing Code: 64605
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '5193'
AND billing_code_type = 'HCPCS'
AND billing_code = '64605'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '5193'
AND billing_code_type = 'HCPCS'
AND billing_code = '64605'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 114​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6094
- Billing Code Type: HCPCS
- Billing Code: 77299
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '6094'
AND billing_code_type = 'HCPCS'
AND billing_code = '77299'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '6094'
AND billing_code_type = 'HCPCS'
AND billing_code = '77299'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 115​
Sample Record Details:
- Payer ID: 7
- Provider ID: 4711
- Billing Code Type: HCPCS
- Billing Code: 21181
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '4711'
AND billing_code_type = 'HCPCS'
AND billing_code = '21181'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '4711'
AND billing_code_type = 'HCPCS'
AND billing_code = '21181'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 116​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2261
- Billing Code Type: HCPCS
- Billing Code: 54450
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '2261'
AND billing_code_type = 'HCPCS'
AND billing_code = '54450'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '2261'
AND billing_code_type = 'HCPCS'
AND billing_code = '54450'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 117​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5362
- Billing Code Type: HCPCS
- Billing Code: 17274
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5362'
AND billing_code_type = 'HCPCS'
AND billing_code = '17274'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 2 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 5362 | HCPCS | 17274 | Facility | Outpatient | HMO/PPO | UNITED HEALTHCARE | 1,922.95 | 03eeb9d8b4cc4c92a51cb7c61deb298f | ||||
| 643 | 5362 | HCPCS | 17274 | Facility | Outpatient | HMO/PPO | UNITED HEALTHCARE | 1,922.95 | 19d8821596244bc68e92721f6906aeb5 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5362'
AND billing_code_type = 'HCPCS'
AND billing_code = '17274'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 118​
Sample Record Details:
- Payer ID: 111
- Provider ID: 1316
- Billing Code Type: HCPCS
- Billing Code: J0750
- Networks: ['PPO/HMO', 'HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '111'
AND provider_id = '1316'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0750'
AND product_network_label IN ('PPO/HMO', 'HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 111
AND provider_id = '1316'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0750'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 119​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4534
- Billing Code Type: HCPCS
- Billing Code: 92511
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '4534'
AND billing_code_type = 'HCPCS'
AND billing_code = '92511'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '4534'
AND billing_code_type = 'HCPCS'
AND billing_code = '92511'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 120​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1001
- Billing Code Type: HCPCS
- Billing Code: 93600
- Networks: ['NORTH NEW JERSEY HMO', 'SOUTH NEW JERSEY HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = '93600'
AND product_network_label IN ('NORTH NEW JERSEY HMO', 'SOUTH NEW JERSEY HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 1 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 76 | 1001 | HCPCS | 93600 | Outpatient | LOCALPLUS | CIGNA | 3,863.00 | 08de1de58b8b43fd8d9a2f20aa64dcaa |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = '93600'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 121​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1459
- Billing Code Type: HCPCS
- Billing Code: 27256
- Networks: ['PREFERRED PROVIDER NETWORK (PPO)']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '44'
AND provider_id = '1459'
AND billing_code_type = 'HCPCS'
AND billing_code = '27256'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK (PPO)')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 44
AND provider_id = '1459'
AND billing_code_type = 'HCPCS'
AND billing_code = '27256'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 122​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6225
- Billing Code Type: HCPCS
- Billing Code: J9026
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9026'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9026'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 123​
Sample Record Details:
- Payer ID: 53
- Provider ID: 4837
- Billing Code Type: HCPCS
- Billing Code: J9270
- Networks: ['BLUELINCS HMO', 'BLUELINCS HMO GROUP', 'BLUELINCS HMO COMMON']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '53'
AND provider_id = '4837'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9270'
AND product_network_label IN ('BLUELINCS HMO', 'BLUELINCS HMO GROUP', 'BLUELINCS HMO COMMON')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 53
AND provider_id = '4837'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9270'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 124​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5302
- Billing Code Type: APR-DRG
- Billing Code: 0462-2
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5302'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-2'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5302'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 125​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6448
- Billing Code Type: HCPCS
- Billing Code: 96130
- Networks: ['SUTTER HEALTH PLUS LARGE GROUP PLANS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '728'
AND provider_id = '6448'
AND billing_code_type = 'HCPCS'
AND billing_code = '96130'
AND product_network_label IN ('SUTTER HEALTH PLUS LARGE GROUP PLANS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 728
AND provider_id = '6448'
AND billing_code_type = 'HCPCS'
AND billing_code = '96130'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 126​
Sample Record Details:
- Payer ID: 53
- Provider ID: 378
- Billing Code Type: HCPCS
- Billing Code: 26460
- Networks: ['BLUE PREFERRED PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '53'
AND provider_id = '378'
AND billing_code_type = 'HCPCS'
AND billing_code = '26460'
AND product_network_label IN ('BLUE PREFERRED PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 53
AND provider_id = '378'
AND billing_code_type = 'HCPCS'
AND billing_code = '26460'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 127​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2135
- Billing Code Type: APR-DRG
- Billing Code: 0160-4
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2135'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0160-4'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2135'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0160-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 128​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5905
- Billing Code Type: APR-DRG
- Billing Code: 0169-2
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '5905'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-2'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '5905'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 129​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1035
- Billing Code Type: HCPCS
- Billing Code: 87070
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '1035'
AND billing_code_type = 'HCPCS'
AND billing_code = '87070'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '1035'
AND billing_code_type = 'HCPCS'
AND billing_code = '87070'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 130​
Sample Record Details:
- Payer ID: 7
- Provider ID: 545
- Billing Code Type: HCPCS
- Billing Code: 27075
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '545'
AND billing_code_type = 'HCPCS'
AND billing_code = '27075'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '545'
AND billing_code_type = 'HCPCS'
AND billing_code = '27075'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 131​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8819
- Billing Code Type: HCPCS
- Billing Code: 53605
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '8819'
AND billing_code_type = 'HCPCS'
AND billing_code = '53605'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '8819'
AND billing_code_type = 'HCPCS'
AND billing_code = '53605'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 132​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5482
- Billing Code Type: HCPCS
- Billing Code: J3373
- Networks: ['TX INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '5482'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3373'
AND product_network_label IN ('TX INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '5482'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3373'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 133​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3571
- Billing Code Type: HCPCS
- Billing Code: 0540T
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '3571'
AND billing_code_type = 'HCPCS'
AND billing_code = '0540T'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '3571'
AND billing_code_type = 'HCPCS'
AND billing_code = '0540T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 134​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4987
- Billing Code Type: APR-DRG
- Billing Code: 0252-4
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '4987'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0252-4'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '4987'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0252-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 135​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1164
- Billing Code Type: MS-DRG
- Billing Code: 509
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '1164'
AND billing_code_type = 'MS-DRG'
AND billing_code = '509'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '1164'
AND billing_code_type = 'MS-DRG'
AND billing_code = '509'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 136​
Sample Record Details:
- Payer ID: 76
- Provider ID: 575
- Billing Code Type: APR-DRG
- Billing Code: 0482-3
- Networks: ['MAINE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '575'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0482-3'
AND product_network_label IN ('MAINE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '575'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0482-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 137​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1897
- Billing Code Type: HCPCS
- Billing Code: 65286
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '1897'
AND billing_code_type = 'HCPCS'
AND billing_code = '65286'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '1897'
AND billing_code_type = 'HCPCS'
AND billing_code = '65286'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 138​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6862
- Billing Code Type: HCPCS
- Billing Code: J7519
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '6862'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7519'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '6862'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7519'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 139​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3676
- Billing Code Type: HCPCS
- Billing Code: 61623
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '3676'
AND billing_code_type = 'HCPCS'
AND billing_code = '61623'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '3676'
AND billing_code_type = 'HCPCS'
AND billing_code = '61623'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 140​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6225
- Billing Code Type: HCPCS
- Billing Code: 63017
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = '63017'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = '63017'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 141​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9387
- Billing Code Type: HCPCS
- Billing Code: 50694
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9387'
AND billing_code_type = 'HCPCS'
AND billing_code = '50694'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9387'
AND billing_code_type = 'HCPCS'
AND billing_code = '50694'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 142​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6524
- Billing Code Type: HCPCS
- Billing Code: 31570
- Networks: ['SUTTER HEALTH PLUS LARGE GROUP PLANS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '728'
AND provider_id = '6524'
AND billing_code_type = 'HCPCS'
AND billing_code = '31570'
AND product_network_label IN ('SUTTER HEALTH PLUS LARGE GROUP PLANS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 728
AND provider_id = '6524'
AND billing_code_type = 'HCPCS'
AND billing_code = '31570'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 143​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10492
- Billing Code Type: APR-DRG
- Billing Code: 0754-1
- Networks: ['WI BLUE ACCESS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '10492'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0754-1'
AND product_network_label IN ('WI BLUE ACCESS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '10492'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0754-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 144​
Sample Record Details:
- Payer ID: 456
- Provider ID: 9081
- Billing Code Type: HCPCS
- Billing Code: 57230
- Networks: ['PREFERRED PROVIDER NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '456'
AND provider_id = '9081'
AND billing_code_type = 'HCPCS'
AND billing_code = '57230'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 456
AND provider_id = '9081'
AND billing_code_type = 'HCPCS'
AND billing_code = '57230'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 145​
Sample Record Details:
- Payer ID: 56
- Provider ID: 7202
- Billing Code Type: HCPCS
- Billing Code: 77333
- Networks: ['KHPE COMMERCIAL HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '7202'
AND billing_code_type = 'HCPCS'
AND billing_code = '77333'
AND product_network_label IN ('KHPE COMMERCIAL HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '7202'
AND billing_code_type = 'HCPCS'
AND billing_code = '77333'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 146​
Sample Record Details:
- Payer ID: 7
- Provider ID: 9417
- Billing Code Type: HCPCS
- Billing Code: J1490
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '9417'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1490'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '9417'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1490'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 147​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4466
- Billing Code Type: HCPCS
- Billing Code: 96369
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '4466'
AND billing_code_type = 'HCPCS'
AND billing_code = '96369'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '4466'
AND billing_code_type = 'HCPCS'
AND billing_code = '96369'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 148​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6310
- Billing Code Type: HCPCS
- Billing Code: 0971T
- Networks: ['SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '6310'
AND billing_code_type = 'HCPCS'
AND billing_code = '0971T'
AND product_network_label IN ('SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6310'
AND billing_code_type = 'HCPCS'
AND billing_code = '0971T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 149​
Sample Record Details:
- Payer ID: 169
- Provider ID: 10612
- Billing Code Type: HCPCS
- Billing Code: J0179
- Networks: ['BLUE CHOICE PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '169'
AND provider_id = '10612'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0179'
AND product_network_label IN ('BLUE CHOICE PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 169
AND provider_id = '10612'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0179'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 150​
Sample Record Details:
- Payer ID: 397
- Provider ID: 8521
- Billing Code Type: HCPCS
- Billing Code: 24575
- Networks: ['PPO1']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '397'
AND provider_id = '8521'
AND billing_code_type = 'HCPCS'
AND billing_code = '24575'
AND product_network_label IN ('PPO1')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 397
AND provider_id = '8521'
AND billing_code_type = 'HCPCS'
AND billing_code = '24575'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 151​
Sample Record Details:
- Payer ID: 7
- Provider ID: 958
- Billing Code Type: HCPCS
- Billing Code: 98942
- Networks: ['PA GROUP HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '958'
AND billing_code_type = 'HCPCS'
AND billing_code = '98942'
AND product_network_label IN ('PA GROUP HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '958'
AND billing_code_type = 'HCPCS'
AND billing_code = '98942'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 152​
Sample Record Details:
- Payer ID: 151
- Provider ID: 10361
- Billing Code Type: HCPCS
- Billing Code: 24587
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '10361'
AND billing_code_type = 'HCPCS'
AND billing_code = '24587'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '10361'
AND billing_code_type = 'HCPCS'
AND billing_code = '24587'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 153​
Sample Record Details:
- Payer ID: 174
- Provider ID: 911
- Billing Code Type: HCPCS
- Billing Code: 27091
- Networks: ['BLUECARD - PREFERRED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '174'
AND provider_id = '911'
AND billing_code_type = 'HCPCS'
AND billing_code = '27091'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '911'
AND billing_code_type = 'HCPCS'
AND billing_code = '27091'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 154​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1105
- Billing Code Type: HCPCS
- Billing Code: 95924
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '1105'
AND billing_code_type = 'HCPCS'
AND billing_code = '95924'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 6 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB001 PPACA | IBC | 416.84 | 95e22f4dc02f48b78b0843a1b34c35e2 | ||||
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB001 PPO | IBC | 208.84 | db86c5888fcd492db86d4f6080dc97e4 | ||||
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB001 HMO | IBC | 208.84 | 8694ecb6ed0b496c9ac1730d19c86be8 | ||||
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB001 INDEM_TRAD | IBC | 231.68 | 1c1781097955420bb3322e53c77a249a | ||||
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB001 COMMERCIAL | IBC EMPLOYEE BENEFIT | 374.05 | 69f013d190684ebe8d13749899fa8928 | ||||
| 56 | 1105 | HCPCS | 95924 | Facility | Outpatient | JAB0001 COMMERCIAL | IBC MAIN LINE HEALTH | 374.05 | f58a156160e04bacbf602ff9998db4dd |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '1105'
AND billing_code_type = 'HCPCS'
AND billing_code = '95924'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 155​
Sample Record Details:
- Payer ID: 111
- Provider ID: 1153
- Billing Code Type: MS-DRG
- Billing Code: 625
- Networks: ['PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '111'
AND provider_id = '1153'
AND billing_code_type = 'MS-DRG'
AND billing_code = '625'
AND product_network_label IN ('PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 111
AND provider_id = '1153'
AND billing_code_type = 'MS-DRG'
AND billing_code = '625'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 156​
Sample Record Details:
- Payer ID: 76
- Provider ID: 524
- Billing Code Type: APR-DRG
- Billing Code: 0046-2
- Networks: ['SOUTH TEXAS HMO', 'NORTH TEXAS HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '524'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0046-2'
AND product_network_label IN ('SOUTH TEXAS HMO', 'NORTH TEXAS HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '524'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0046-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 157​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10116
- Billing Code Type: HCPCS
- Billing Code: 65235
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '10116'
AND billing_code_type = 'HCPCS'
AND billing_code = '65235'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '10116'
AND billing_code_type = 'HCPCS'
AND billing_code = '65235'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 158​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3652
- Billing Code Type: HCPCS
- Billing Code: 45379
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '3652'
AND billing_code_type = 'HCPCS'
AND billing_code = '45379'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '3652'
AND billing_code_type = 'HCPCS'
AND billing_code = '45379'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 159​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4298
- Billing Code Type: HCPCS
- Billing Code: 36262
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '4298'
AND billing_code_type = 'HCPCS'
AND billing_code = '36262'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '4298'
AND billing_code_type = 'HCPCS'
AND billing_code = '36262'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 160​
Sample Record Details:
- Payer ID: 229
- Provider ID: 1232
- Billing Code Type: HCPCS
- Billing Code: 11043
- Networks: ['GROUP - OMNIA']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '229'
AND provider_id = '1232'
AND billing_code_type = 'HCPCS'
AND billing_code = '11043'
AND product_network_label IN ('GROUP - OMNIA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 229
AND provider_id = '1232'
AND billing_code_type = 'HCPCS'
AND billing_code = '11043'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 161​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1705
- Billing Code Type: HCPCS
- Billing Code: 0213T
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '1705'
AND billing_code_type = 'HCPCS'
AND billing_code = '0213T'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1705'
AND billing_code_type = 'HCPCS'
AND billing_code = '0213T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 162​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9834
- Billing Code Type: HCPCS
- Billing Code: 52284
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '9834'
AND billing_code_type = 'HCPCS'
AND billing_code = '52284'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '9834'
AND billing_code_type = 'HCPCS'
AND billing_code = '52284'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 163​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3239
- Billing Code Type: HCPCS
- Billing Code: 27403
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '3239'
AND billing_code_type = 'HCPCS'
AND billing_code = '27403'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '3239'
AND billing_code_type = 'HCPCS'
AND billing_code = '27403'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 164​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1342
- Billing Code Type: HCPCS
- Billing Code: 12017
- Networks: ['PA GROUP HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '1342'
AND billing_code_type = 'HCPCS'
AND billing_code = '12017'
AND product_network_label IN ('PA GROUP HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1342'
AND billing_code_type = 'HCPCS'
AND billing_code = '12017'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 165​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2035
- Billing Code Type: HCPCS
- Billing Code: J0530
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '2035'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0530'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2035'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0530'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 166​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9260
- Billing Code Type: HCPCS
- Billing Code: 0604T
- Networks: ['SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '9260'
AND billing_code_type = 'HCPCS'
AND billing_code = '0604T'
AND product_network_label IN ('SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '9260'
AND billing_code_type = 'HCPCS'
AND billing_code = '0604T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 167​
Sample Record Details:
- Payer ID: 391
- Provider ID: 4692
- Billing Code Type: HCPCS
- Billing Code: 22865
- Networks: ['BLUECARD - COMMUNITY BLUE HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '391'
AND provider_id = '4692'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
AND product_network_label IN ('BLUECARD - COMMUNITY BLUE HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 391
AND provider_id = '4692'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 168​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6668
- Billing Code Type: HCPCS
- Billing Code: C9091
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6668'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9091'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6668'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9091'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 169​
Sample Record Details:
- Payer ID: 166
- Provider ID: 5861
- Billing Code Type: HCPCS
- Billing Code: J1200
- Networks: ['BLUE ADVANTAGE HMO', 'HEALTH MAINTENANCE ORGANIZATION HMO', 'BLUE COMMUNITY HMO NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '166'
AND provider_id = '5861'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1200'
AND product_network_label IN ('BLUE ADVANTAGE HMO', 'HEALTH MAINTENANCE ORGANIZATION HMO', 'BLUE COMMUNITY HMO NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 166
AND provider_id = '5861'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1200'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 170​
Sample Record Details:
- Payer ID: 56
- Provider ID: 795
- Billing Code Type: HCPCS
- Billing Code: J3000
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '795'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3000'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '795'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3000'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 171​
Sample Record Details:
- Payer ID: 76
- Provider ID: 807
- Billing Code Type: HCPCS
- Billing Code: 27329
- Networks: ['METRO NEW YORK HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '807'
AND billing_code_type = 'HCPCS'
AND billing_code = '27329'
AND product_network_label IN ('METRO NEW YORK HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '807'
AND billing_code_type = 'HCPCS'
AND billing_code = '27329'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 172​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4860
- Billing Code Type: MS-DRG
- Billing Code: 295
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '4860'
AND billing_code_type = 'MS-DRG'
AND billing_code = '295'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '4860'
AND billing_code_type = 'MS-DRG'
AND billing_code = '295'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 173​
Sample Record Details:
- Payer ID: 76
- Provider ID: 3746
- Billing Code Type: MS-DRG
- Billing Code: 945
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '3746'
AND billing_code_type = 'MS-DRG'
AND billing_code = '945'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '3746'
AND billing_code_type = 'MS-DRG'
AND billing_code = '945'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 174​
Sample Record Details:
- Payer ID: 42
- Provider ID: 762
- Billing Code Type: HCPCS
- Billing Code: 45385
- Networks: ['CT HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '42'
AND provider_id = '762'
AND billing_code_type = 'HCPCS'
AND billing_code = '45385'
AND product_network_label IN ('CT HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '762'
AND billing_code_type = 'HCPCS'
AND billing_code = '45385'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 175​
Sample Record Details:
- Payer ID: 7
- Provider ID: 3325
- Billing Code Type: HCPCS
- Billing Code: 58554
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '3325'
AND billing_code_type = 'HCPCS'
AND billing_code = '58554'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '3325'
AND billing_code_type = 'HCPCS'
AND billing_code = '58554'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 176​
Sample Record Details:
- Payer ID: 56
- Provider ID: 803
- Billing Code Type: HCPCS
- Billing Code: 25295
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '803'
AND billing_code_type = 'HCPCS'
AND billing_code = '25295'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '803'
AND billing_code_type = 'HCPCS'
AND billing_code = '25295'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 177​
Sample Record Details:
- Payer ID: 723
- Provider ID: 954
- Billing Code Type: HCPCS
- Billing Code: 88374
- Networks: ['ESSENTIAL PLAN']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '723'
AND provider_id = '954'
AND billing_code_type = 'HCPCS'
AND billing_code = '88374'
AND product_network_label IN ('ESSENTIAL PLAN')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 723
AND provider_id = '954'
AND billing_code_type = 'HCPCS'
AND billing_code = '88374'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 178​
Sample Record Details:
- Payer ID: 354
- Provider ID: 9173
- Billing Code Type: HCPCS
- Billing Code: 96127
- Networks: ['PREMIUM']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '354'
AND provider_id = '9173'
AND billing_code_type = 'HCPCS'
AND billing_code = '96127'
AND product_network_label IN ('PREMIUM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 354
AND provider_id = '9173'
AND billing_code_type = 'HCPCS'
AND billing_code = '96127'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 179​
Sample Record Details:
- Payer ID: 272
- Provider ID: 2425
- Billing Code Type: HCPCS
- Billing Code: J0170
- Networks: ['SUPERMED PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '272'
AND provider_id = '2425'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0170'
AND product_network_label IN ('SUPERMED PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 272
AND provider_id = '2425'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0170'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 180​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9326
- Billing Code Type: HCPCS
- Billing Code: 42725
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '9326'
AND billing_code_type = 'HCPCS'
AND billing_code = '42725'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '9326'
AND billing_code_type = 'HCPCS'
AND billing_code = '42725'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 181​
Sample Record Details:
- Payer ID: 636
- Provider ID: 6013
- Billing Code Type: HCPCS
- Billing Code: 24925
- Networks: ['VALUE/CARE TIERED POS - UT']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '636'
AND provider_id = '6013'
AND billing_code_type = 'HCPCS'
AND billing_code = '24925'
AND product_network_label IN ('VALUE/CARE TIERED POS - UT')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 636
AND provider_id = '6013'
AND billing_code_type = 'HCPCS'
AND billing_code = '24925'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 182​
Sample Record Details:
- Payer ID: 111
- Provider ID: 10339
- Billing Code Type: HCPCS
- Billing Code: 90684
- Networks: ['PPO/HMO', 'HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '111'
AND provider_id = '10339'
AND billing_code_type = 'HCPCS'
AND billing_code = '90684'
AND product_network_label IN ('PPO/HMO', 'HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 111
AND provider_id = '10339'
AND billing_code_type = 'HCPCS'
AND billing_code = '90684'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 183​
Sample Record Details:
- Payer ID: 522
- Provider ID: 1155
- Billing Code Type: HCPCS
- Billing Code: J0223
- Networks: ['KPIC MID ATLANTIC', 'SELF FUNDED MID ATLANTIC']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '522'
AND provider_id = '1155'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0223'
AND product_network_label IN ('KPIC MID ATLANTIC', 'SELF FUNDED MID ATLANTIC')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 522
AND provider_id = '1155'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0223'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 184​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6869
- Billing Code Type: HCPCS
- Billing Code: 73721
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '6869'
AND billing_code_type = 'HCPCS'
AND billing_code = '73721'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '6869'
AND billing_code_type = 'HCPCS'
AND billing_code = '73721'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 185​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6175
- Billing Code Type: HCPCS
- Billing Code: J3401
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '6175'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3401'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6175'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3401'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 186​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1962
- Billing Code Type: MS-DRG
- Billing Code: 418
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '1962'
AND billing_code_type = 'MS-DRG'
AND billing_code = '418'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '1962'
AND billing_code_type = 'MS-DRG'
AND billing_code = '418'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 187​
Sample Record Details:
- Payer ID: 76
- Provider ID: 10047
- Billing Code Type: HCPCS
- Billing Code: 38208
- Networks: ['SOUTH TEXAS HMO', 'NORTH TEXAS HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '10047'
AND billing_code_type = 'HCPCS'
AND billing_code = '38208'
AND product_network_label IN ('SOUTH TEXAS HMO', 'NORTH TEXAS HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '10047'
AND billing_code_type = 'HCPCS'
AND billing_code = '38208'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 188​
Sample Record Details:
- Payer ID: 7
- Provider ID: 6474
- Billing Code Type: HCPCS
- Billing Code: 49580
- Networks: ['OPEN ACCESS MANAGED CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '7'
AND provider_id = '6474'
AND billing_code_type = 'HCPCS'
AND billing_code = '49580'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '6474'
AND billing_code_type = 'HCPCS'
AND billing_code = '49580'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 189​
Sample Record Details:
- Payer ID: 76
- Provider ID: 595
- Billing Code Type: HCPCS
- Billing Code: 20999
- Networks: ['NEW HAMPSHIRE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '595'
AND billing_code_type = 'HCPCS'
AND billing_code = '20999'
AND product_network_label IN ('NEW HAMPSHIRE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '595'
AND billing_code_type = 'HCPCS'
AND billing_code = '20999'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 190​
Sample Record Details:
- Payer ID: 56
- Provider ID: 6821
- Billing Code Type: HCPCS
- Billing Code: 21151
- Networks: ['KHPE COMMERCIAL HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '56'
AND provider_id = '6821'
AND billing_code_type = 'HCPCS'
AND billing_code = '21151'
AND product_network_label IN ('KHPE COMMERCIAL HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '6821'
AND billing_code_type = 'HCPCS'
AND billing_code = '21151'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 191​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4094
- Billing Code Type: HCPCS
- Billing Code: C9041
- Networks: ['SOUTHWEST MISSOURI HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '4094'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9041'
AND product_network_label IN ('SOUTHWEST MISSOURI HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '4094'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9041'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 192​
Sample Record Details:
- Payer ID: 643
- Provider ID: 201
- Billing Code Type: MS-DRG
- Billing Code: 858
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '201'
AND billing_code_type = 'MS-DRG'
AND billing_code = '858'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '201'
AND billing_code_type = 'MS-DRG'
AND billing_code = '858'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 193​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4236
- Billing Code Type: HCPCS
- Billing Code: 62269
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '4236'
AND billing_code_type = 'HCPCS'
AND billing_code = '62269'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '4236'
AND billing_code_type = 'HCPCS'
AND billing_code = '62269'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 194​
Sample Record Details:
- Payer ID: 354
- Provider ID: 1293
- Billing Code Type: HCPCS
- Billing Code: J9093
- Networks: ['PREMIUM']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '354'
AND provider_id = '1293'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9093'
AND product_network_label IN ('PREMIUM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 354
AND provider_id = '1293'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9093'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 195​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5832
- Billing Code Type: HCPCS
- Billing Code: 66505
- Networks: ['NATIONAL OAP', 'NATIONAL PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '76'
AND provider_id = '5832'
AND billing_code_type = 'HCPCS'
AND billing_code = '66505'
AND product_network_label IN ('NATIONAL OAP', 'NATIONAL PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '5832'
AND billing_code_type = 'HCPCS'
AND billing_code = '66505'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 196​
Sample Record Details:
- Payer ID: 151
- Provider ID: 40
- Billing Code Type: HCPCS
- Billing Code: Q4143
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '40'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4143'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '40'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4143'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 197​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10144
- Billing Code Type: HCPCS
- Billing Code: 49613
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '10144'
AND billing_code_type = 'HCPCS'
AND billing_code = '49613'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '10144'
AND billing_code_type = 'HCPCS'
AND billing_code = '49613'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 198​
Sample Record Details:
- Payer ID: 166
- Provider ID: 5832
- Billing Code Type: HCPCS
- Billing Code: 26567
- Networks: ['PREFERRED PROVIDER ORGANIZATION PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '166'
AND provider_id = '5832'
AND billing_code_type = 'HCPCS'
AND billing_code = '26567'
AND product_network_label IN ('PREFERRED PROVIDER ORGANIZATION PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 166
AND provider_id = '5832'
AND billing_code_type = 'HCPCS'
AND billing_code = '26567'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 199​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5177
- Billing Code Type: HCPCS
- Billing Code: 90721
- Networks: ['COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '643'
AND provider_id = '5177'
AND billing_code_type = 'HCPCS'
AND billing_code = '90721'
AND product_network_label IN ('COMPASS HMO', 'SIERRA HEALTH HMO', 'HMO GATED', 'CORE ESSENTIAL HMO', 'HMO NONGATED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5177'
AND billing_code_type = 'HCPCS'
AND billing_code = '90721'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 200​
Sample Record Details:
- Payer ID: 151
- Provider ID: 9353
- Billing Code Type: HCPCS
- Billing Code: 21408
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_07.core_rates
WHERE payer_id = '151'
AND provider_id = '9353'
AND billing_code_type = 'HCPCS'
AND billing_code = '21408'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '9353'
AND billing_code_type = 'HCPCS'
AND billing_code = '21408'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
3. Sample Analysis Summary​
Analyzed 200 sample records:
- Total Core Rates matches: 0 (avg: 0.000)
- Total Hospital Rates matches: 6 (avg: 0.030)
This analysis provides insights into the potential for filling coverage gaps by integrating data from core_rates and hospital_rates tables.