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.