v2_2_0
Core Rates Month: 2025_08 Generated: 2025-10-15 10:33:22
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: 2,696,744,177.0
- Records with canonical_rate: 868,999,344.0
- Records without canonical_rate: 1,827,744,833.0
- NULL Rate Percentage: 68.0%
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_2_0.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 | 47,502,241 | 3,945,017 | 43,557,224 | 8.0% | 92.0% |
| Rehabilitation Hospital | 63,215,642 | 8,845,371 | 54,370,271 | 14.0% | 86.0% |
| Childrens Hospital | 41,453,038 | 7,997,567 | 33,455,471 | 19.0% | 81.0% |
| Laboratory | 12,852,774 | 2,853,190 | 9,999,584 | 22.0% | 78.0% |
| ASC | 191,594,052 | 56,705,411 | 134,888,641 | 30.0% | 70.0% |
| Physician Group | 1,668,473,488 | 508,894,699 | 1,159,578,789 | 31.0% | 69.0% |
| Critical Access Hospital | 147,548,142 | 58,053,352 | 89,494,790 | 39.0% | 61.0% |
| Short Term Acute Care Hospital | 524,104,800 | 221,704,737 | 302,400,063 | 42.0% | 58.0% |
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_2_0.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: 76
- Provider ID: 942
- Billing Code Type: HCPCS
- Billing Code: J2788
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '942'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2788'
AND product_network_label IN ('METRO NEW YORK HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 3 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 | 942 | HCPCS | J2788 | Facility | 636 | Outpatient | ALL COMMERCIAL AND HMO PPO POS PLANS | CIGNA | 6500.0% | 65 | 10e290f7d994450aa9f261415ebe0a06 | ||
| 76 | 942 | HCPCS | J2788 | Facility | 636 | Outpatient | ALL COMMERCIAL AND HMO PPO POS PLANS | CIGNA | 6500.0% | 65 | c9eb6a33192b487ca3b14f907a053edd | ||
| 76 | 942 | HCPCS | J2788 | Facility | 636 | Outpatient | ALL COMMERCIAL AND HMO PPO POS PLANS | CIGNA | 6500.0% | 65 | 19f7f7c1dca14c7d95fb0c5133b40924 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '942'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2788'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 2
Sample Record Details:
- Payer ID: 522
- Provider ID: 1883
- Billing Code Type: HCPCS
- Billing Code: 0680T
- Networks: ['KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '522'
AND provider_id = '1883'
AND billing_code_type = 'HCPCS'
AND billing_code = '0680T'
AND product_network_label IN ('KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1883'
AND billing_code_type = 'HCPCS'
AND billing_code = '0680T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 3
Sample Record Details:
- Payer ID: 42
- Provider ID: 1917
- Billing Code Type: HCPCS
- Billing Code: 43886
- Networks: ['GA BLUE VALUE IND NETWORK 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '1917'
AND billing_code_type = 'HCPCS'
AND billing_code = '43886'
AND product_network_label IN ('GA BLUE VALUE IND NETWORK 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 = '1917'
AND billing_code_type = 'HCPCS'
AND billing_code = '43886'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 4
Sample Record Details:
- Payer ID: 76
- Provider ID: 5922
- Billing Code Type: HCPCS
- Billing Code: 26548
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5922'
AND billing_code_type = 'HCPCS'
AND billing_code = '26548'
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 = '5922'
AND billing_code_type = 'HCPCS'
AND billing_code = '26548'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 5
Sample Record Details:
- Payer ID: 403
- Provider ID: 6333
- Billing Code Type: MS-DRG
- Billing Code: 977
- Networks: ['INDIVIDUAL & FAMILY HMO TRIO', 'GROUP HMO TRIO', 'INDIVIDUAL & FAMILY HMO TRIO AI-AN']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '403'
AND provider_id = '6333'
AND billing_code_type = 'MS-DRG'
AND billing_code = '977'
AND product_network_label IN ('INDIVIDUAL & FAMILY HMO TRIO', 'GROUP HMO TRIO', 'INDIVIDUAL & FAMILY HMO TRIO AI-AN')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 403
AND provider_id = '6333'
AND billing_code_type = 'MS-DRG'
AND billing_code = '977'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 6
Sample Record Details:
- Payer ID: 76
- Provider ID: 9635
- Billing Code Type: HCPCS
- Billing Code: 30460
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '9635'
AND billing_code_type = 'HCPCS'
AND billing_code = '30460'
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 = '9635'
AND billing_code_type = 'HCPCS'
AND billing_code = '30460'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 7
Sample Record Details:
- Payer ID: 76
- Provider ID: 5948
- Billing Code Type: HCPCS
- Billing Code: C9062
- Networks: ['ARIZONA 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5948'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9062'
AND product_network_label IN ('ARIZONA 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 = '5948'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9062'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 8
Sample Record Details:
- Payer ID: 76
- Provider ID: 10162
- Billing Code Type: APR-DRG
- Billing Code: 0052-2
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '10162'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0052-2'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10162'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0052-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 9
Sample Record Details:
- Payer ID: 42
- Provider ID: 627
- Billing Code Type: HCPCS
- Billing Code: 28240
- Networks: ['NH 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '627'
AND billing_code_type = 'HCPCS'
AND billing_code = '28240'
AND product_network_label IN ('NH 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 = '627'
AND billing_code_type = 'HCPCS'
AND billing_code = '28240'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 10
Sample Record Details:
- Payer ID: 403
- Provider ID: 6322
- Billing Code Type: HCPCS
- Billing Code: J1571
- 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_08.core_rates
WHERE payer_id = '403'
AND provider_id = '6322'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1571'
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 = 403
AND provider_id = '6322'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1571'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 11
Sample Record Details:
- Payer ID: 643
- Provider ID: 8600
- Billing Code Type: HCPCS
- Billing Code: 15830
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8600'
AND billing_code_type = 'HCPCS'
AND billing_code = '15830'
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 = '8600'
AND billing_code_type = 'HCPCS'
AND billing_code = '15830'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 12
Sample Record Details:
- Payer ID: 728
- Provider ID: 6583
- Billing Code Type: HCPCS
- Billing Code: 93225
- 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_08.core_rates
WHERE payer_id = '728'
AND provider_id = '6583'
AND billing_code_type = 'HCPCS'
AND billing_code = '93225'
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 = '6583'
AND billing_code_type = 'HCPCS'
AND billing_code = '93225'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 13
Sample Record Details:
- Payer ID: 151
- Provider ID: 2484
- Billing Code Type: HCPCS
- Billing Code: 25420
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2484'
AND billing_code_type = 'HCPCS'
AND billing_code = '25420'
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 = '2484'
AND billing_code_type = 'HCPCS'
AND billing_code = '25420'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 14
Sample Record Details:
- Payer ID: 7
- Provider ID: 9938
- Billing Code Type: HCPCS
- Billing Code: 59072
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '9938'
AND billing_code_type = 'HCPCS'
AND billing_code = '59072'
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 = '9938'
AND billing_code_type = 'HCPCS'
AND billing_code = '59072'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 15
Sample Record Details:
- Payer ID: 76
- Provider ID: 5324
- Billing Code Type: HCPCS
- Billing Code: 28107
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5324'
AND billing_code_type = 'HCPCS'
AND billing_code = '28107'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5324'
AND billing_code_type = 'HCPCS'
AND billing_code = '28107'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 16
Sample Record Details:
- Payer ID: 643
- Provider ID: 2402
- Billing Code Type: HCPCS
- Billing Code: 26494
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2402'
AND billing_code_type = 'HCPCS'
AND billing_code = '26494'
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 = '2402'
AND billing_code_type = 'HCPCS'
AND billing_code = '26494'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 17
Sample Record Details:
- Payer ID: 643
- Provider ID: 592
- Billing Code Type: MS-DRG
- Billing Code: 983
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '592'
AND billing_code_type = 'MS-DRG'
AND billing_code = '983'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '592'
AND billing_code_type = 'MS-DRG'
AND billing_code = '983'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 18
Sample Record Details:
- Payer ID: 76
- Provider ID: 5348
- Billing Code Type: HCPCS
- Billing Code: 0884T
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5348'
AND billing_code_type = 'HCPCS'
AND billing_code = '0884T'
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 = '5348'
AND billing_code_type = 'HCPCS'
AND billing_code = '0884T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 19
Sample Record Details:
- Payer ID: 42
- Provider ID: 9591
- Billing Code Type: HCPCS
- Billing Code: 95982
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '9591'
AND billing_code_type = 'HCPCS'
AND billing_code = '95982'
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 = '9591'
AND billing_code_type = 'HCPCS'
AND billing_code = '95982'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 20
Sample Record Details:
- Payer ID: 643
- Provider ID: 3918
- Billing Code Type: APR-DRG
- Billing Code: 0608-3
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3918'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0608-3'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3918'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0608-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 21
Sample Record Details:
- Payer ID: 151
- Provider ID: 4977
- Billing Code Type: HCPCS
- Billing Code: 27756
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '4977'
AND billing_code_type = 'HCPCS'
AND billing_code = '27756'
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 = '4977'
AND billing_code_type = 'HCPCS'
AND billing_code = '27756'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 22
Sample Record Details:
- Payer ID: 97
- Provider ID: 1078
- Billing Code Type: HCPCS
- Billing Code: J0295
- Networks: ['DC37 MED-TEAM']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '97'
AND provider_id = '1078'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0295'
AND product_network_label IN ('DC37 MED-TEAM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 97
AND provider_id = '1078'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0295'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 23
Sample Record Details:
- Payer ID: 643
- Provider ID: 707
- Billing Code Type: HCPCS
- Billing Code: 21750
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '707'
AND billing_code_type = 'HCPCS'
AND billing_code = '21750'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '707'
AND billing_code_type = 'HCPCS'
AND billing_code = '21750'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 24
Sample Record Details:
- Payer ID: 643
- Provider ID: 1667
- Billing Code Type: HCPCS
- Billing Code: 64738
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1667'
AND billing_code_type = 'HCPCS'
AND billing_code = '64738'
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 = '1667'
AND billing_code_type = 'HCPCS'
AND billing_code = '64738'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 25
Sample Record Details:
- Payer ID: 174
- Provider ID: 7159
- Billing Code Type: HCPCS
- Billing Code: 76856
- 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_08.core_rates
WHERE payer_id = '174'
AND provider_id = '7159'
AND billing_code_type = 'HCPCS'
AND billing_code = '76856'
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 = '7159'
AND billing_code_type = 'HCPCS'
AND billing_code = '76856'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 26
Sample Record Details:
- Payer ID: 958
- Provider ID: 1024
- Billing Code Type: HCPCS
- Billing Code: 67299
- Networks: ['NYC GOLD / GOLDCARE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '958'
AND provider_id = '1024'
AND billing_code_type = 'HCPCS'
AND billing_code = '67299'
AND product_network_label IN ('NYC GOLD / GOLDCARE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 958
AND provider_id = '1024'
AND billing_code_type = 'HCPCS'
AND billing_code = '67299'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 27
Sample Record Details:
- Payer ID: 643
- Provider ID: 6713
- Billing Code Type: APR-DRG
- Billing Code: 0680-1
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6713'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0680-1'
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 = '6713'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0680-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 28
Sample Record Details:
- Payer ID: 643
- Provider ID: 3698
- Billing Code Type: HCPCS
- Billing Code: 27704
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3698'
AND billing_code_type = 'HCPCS'
AND billing_code = '27704'
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 = '3698'
AND billing_code_type = 'HCPCS'
AND billing_code = '27704'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 29
Sample Record Details:
- Payer ID: 643
- Provider ID: 1753
- Billing Code Type: APR-DRG
- Billing Code: 0199-4
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1753'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0199-4'
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 = '1753'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0199-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 30
Sample Record Details:
- Payer ID: 76
- Provider ID: 4339
- Billing Code Type: HCPCS
- Billing Code: 65400
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4339'
AND billing_code_type = 'HCPCS'
AND billing_code = '65400'
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 = '4339'
AND billing_code_type = 'HCPCS'
AND billing_code = '65400'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 31
Sample Record Details:
- Payer ID: 643
- Provider ID: 9157
- Billing Code Type: HCPCS
- Billing Code: J0874
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '9157'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0874'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '9157'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0874'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 32
Sample Record Details:
- Payer ID: 643
- Provider ID: 5901
- Billing Code Type: HCPCS
- Billing Code: 42120
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5901'
AND billing_code_type = 'HCPCS'
AND billing_code = '42120'
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 = '5901'
AND billing_code_type = 'HCPCS'
AND billing_code = '42120'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 33
Sample Record Details:
- Payer ID: 643
- Provider ID: 1654
- Billing Code Type: HCPCS
- Billing Code: 76825
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1654'
AND billing_code_type = 'HCPCS'
AND billing_code = '76825'
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 = '1654'
AND billing_code_type = 'HCPCS'
AND billing_code = '76825'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 34
Sample Record Details:
- Payer ID: 56
- Provider ID: 1247
- Billing Code Type: HCPCS
- Billing Code: 99284
- 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_08.core_rates
WHERE payer_id = '56'
AND provider_id = '1247'
AND billing_code_type = 'HCPCS'
AND billing_code = '99284'
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 = '1247'
AND billing_code_type = 'HCPCS'
AND billing_code = '99284'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 35
Sample Record Details:
- Payer ID: 643
- Provider ID: 4557
- Billing Code Type: HCPCS
- Billing Code: 26492
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4557'
AND billing_code_type = 'HCPCS'
AND billing_code = '26492'
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 = '4557'
AND billing_code_type = 'HCPCS'
AND billing_code = '26492'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 36
Sample Record Details:
- Payer ID: 643
- Provider ID: 7332
- Billing Code Type: HCPCS
- Billing Code: 37243
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '7332'
AND billing_code_type = 'HCPCS'
AND billing_code = '37243'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 16 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 | 7332 | HCPCS | 37243 | Facility | 360 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 71ecbd7e28e54127bf33eafeb1ddac93 | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | fc62057903d34f7b824ea2654649f285 | |||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 30,243.00 | 6944a43b0d714398a4782bd49f417a27 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 10,149.00 | 975f73f63ee04e7dbfc9a63bc228cdb0 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 97f24eb0a6b84b24a59322acb4db9102 | |||||
| 643 | 7332 | HCPCS | 37243 | Facility | 361 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | b96d4ad474b84c08bf744827c43702e1 | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 30,243.00 | 7abd2366e1a64c0da4f93deb6b0647d7 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 361 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 30,243.00 | d961cf1d20f84f44abb0d77a141581bf | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 361 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 14c0f349ba0b46ba950b19c13a65395a | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 10,149.00 | b937069274fc49ef914e56a2cedf2a76 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | b11c785546534878bd6bd14d4ebabee3 | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 151b918d05074ecca95906bdb3922334 | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Inpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 1ea41426e1084728b805d48cc2f9bfdc | ||||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 33,806.69 | 849308d45d4e484c92a7ad24adcb4fc3 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 360 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 33,806.69 | 0d9a5416e2a0473995360033268e2b90 | ||
| 643 | 7332 | HCPCS | 37243 | Facility | 361 | Outpatient | UNITED HMO/PPO [21040201] | UNITED HEALTHCARE [210402] | 31,610.00 | 30,243.00 | 6fd82c794dc04a7781603164302e6535 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '7332'
AND billing_code_type = 'HCPCS'
AND billing_code = '37243'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 37
Sample Record Details:
- Payer ID: 54
- Provider ID: 1342
- Billing Code Type: HCPCS
- Billing Code: 61001
- 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_08.core_rates
WHERE payer_id = '54'
AND provider_id = '1342'
AND billing_code_type = 'HCPCS'
AND billing_code = '61001'
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 = '1342'
AND billing_code_type = 'HCPCS'
AND billing_code = '61001'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 38
Sample Record Details:
- Payer ID: 151
- Provider ID: 6618
- Billing Code Type: HCPCS
- Billing Code: 97155
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '6618'
AND billing_code_type = 'HCPCS'
AND billing_code = '97155'
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 = '6618'
AND billing_code_type = 'HCPCS'
AND billing_code = '97155'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 39
Sample Record Details:
- Payer ID: 151
- Provider ID: 326
- Billing Code Type: HCPCS
- Billing Code: J2865
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2865'
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 = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2865'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 40
Sample Record Details:
- Payer ID: 76
- Provider ID: 8180
- Billing Code Type: HCPCS
- Billing Code: G0414
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '8180'
AND billing_code_type = 'HCPCS'
AND billing_code = 'G0414'
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 = '8180'
AND billing_code_type = 'HCPCS'
AND billing_code = 'G0414'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 41
Sample Record Details:
- Payer ID: 636
- Provider ID: 5980
- Billing Code Type: HCPCS
- Billing Code: 75572
- 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_08.core_rates
WHERE payer_id = '636'
AND provider_id = '5980'
AND billing_code_type = 'HCPCS'
AND billing_code = '75572'
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 = '5980'
AND billing_code_type = 'HCPCS'
AND billing_code = '75572'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 42
Sample Record Details:
- Payer ID: 151
- Provider ID: 4325
- Billing Code Type: HCPCS
- Billing Code: 64644
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '4325'
AND billing_code_type = 'HCPCS'
AND billing_code = '64644'
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 = '4325'
AND billing_code_type = 'HCPCS'
AND billing_code = '64644'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 43
Sample Record Details:
- Payer ID: 76
- Provider ID: 945
- Billing Code Type: APR-DRG
- Billing Code: 0115-1
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '945'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0115-1'
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 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '945'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0115-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 44
Sample Record Details:
- Payer ID: 151
- Provider ID: 2761
- Billing Code Type: HCPCS
- Billing Code: 38745
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2761'
AND billing_code_type = 'HCPCS'
AND billing_code = '38745'
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 = '2761'
AND billing_code_type = 'HCPCS'
AND billing_code = '38745'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 45
Sample Record Details:
- Payer ID: 76
- Provider ID: 557
- Billing Code Type: HCPCS
- Billing Code: J1201
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '557'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1201'
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 = '557'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1201'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 46
Sample Record Details:
- Payer ID: 643
- Provider ID: 10162
- Billing Code Type: HCPCS
- Billing Code: 30906
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '10162'
AND billing_code_type = 'HCPCS'
AND billing_code = '30906'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10162'
AND billing_code_type = 'HCPCS'
AND billing_code = '30906'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 47
Sample Record Details:
- Payer ID: 643
- Provider ID: 10308
- Billing Code Type: MS-DRG
- Billing Code: 469
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '10308'
AND billing_code_type = 'MS-DRG'
AND billing_code = '469'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10308'
AND billing_code_type = 'MS-DRG'
AND billing_code = '469'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 48
Sample Record Details:
- Payer ID: 7
- Provider ID: 5170
- Billing Code Type: APR-DRG
- Billing Code: 0589-2
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '5170'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0589-2'
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 = '5170'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0589-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 49
Sample Record Details:
- Payer ID: 56
- Provider ID: 9382
- Billing Code Type: HCPCS
- Billing Code: J1595
- 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_08.core_rates
WHERE payer_id = '56'
AND provider_id = '9382'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1595'
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 = '9382'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1595'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 50
Sample Record Details:
- Payer ID: 643
- Provider ID: 4632
- Billing Code Type: HCPCS
- Billing Code: J0596
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4632'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0596'
AND product_network_label IN ('NAVIGATE')
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 | 4632 | HCPCS | J0596 | Facility | Outpatient | MM | UNITED HEALTHCARE | 31.59 | c7a4f4d7dd7f47c2879cfcab77cd2adb | ||||
| 643 | 4632 | HCPCS | J0596 | Facility | Outpatient | ALLPAYER | UNITED HEALTHCARE | 33.02 | e41f43a11dd94d2f81be0ce989032e51 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '4632'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0596'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 51
Sample Record Details:
- Payer ID: 42
- Provider ID: 2851
- Billing Code Type: HCPCS
- Billing Code: 27495
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '2851'
AND billing_code_type = 'HCPCS'
AND billing_code = '27495'
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 = '2851'
AND billing_code_type = 'HCPCS'
AND billing_code = '27495'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 52
Sample Record Details:
- Payer ID: 76
- Provider ID: 4169
- Billing Code Type: HCPCS
- Billing Code: 0429T
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4169'
AND billing_code_type = 'HCPCS'
AND billing_code = '0429T'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '4169'
AND billing_code_type = 'HCPCS'
AND billing_code = '0429T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 53
Sample Record Details:
- Payer ID: 643
- Provider ID: 4744
- Billing Code Type: APR-DRG
- Billing Code: 0564-1
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4744'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0564-1'
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 = '4744'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0564-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 54
Sample Record Details:
- Payer ID: 643
- Provider ID: 3997
- Billing Code Type: HCPCS
- Billing Code: 27045
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3997'
AND billing_code_type = 'HCPCS'
AND billing_code = '27045'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3997'
AND billing_code_type = 'HCPCS'
AND billing_code = '27045'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 55
Sample Record Details:
- Payer ID: 643
- Provider ID: 1236
- Billing Code Type: HCPCS
- Billing Code: A9594
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1236'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9594'
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 = '1236'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9594'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 56
Sample Record Details:
- Payer ID: 774
- Provider ID: 871
- Billing Code Type: HCPCS
- Billing Code: 45350
- 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_08.core_rates
WHERE payer_id = '774'
AND provider_id = '871'
AND billing_code_type = 'HCPCS'
AND billing_code = '45350'
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 = '871'
AND billing_code_type = 'HCPCS'
AND billing_code = '45350'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 57
Sample Record Details:
- Payer ID: 42
- Provider ID: 8655
- Billing Code Type: HCPCS
- Billing Code: Q4109
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '8655'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4109'
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 = '8655'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4109'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 58
Sample Record Details:
- Payer ID: 643
- Provider ID: 2525
- Billing Code Type: HCPCS
- Billing Code: J2781
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2525'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2781'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2525'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2781'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 59
Sample Record Details:
- Payer ID: 42
- Provider ID: 7780
- Billing Code Type: APR-DRG
- Billing Code: 0053-3
- Networks: ['NY 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '7780'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0053-3'
AND product_network_label IN ('NY 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 = '7780'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0053-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 60
Sample Record Details:
- Payer ID: 76
- Provider ID: 339
- Billing Code Type: HCPCS
- Billing Code: 25426
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '339'
AND billing_code_type = 'HCPCS'
AND billing_code = '25426'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '339'
AND billing_code_type = 'HCPCS'
AND billing_code = '25426'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 61
Sample Record Details:
- Payer ID: 643
- Provider ID: 842
- Billing Code Type: APR-DRG
- Billing Code: 0532-1
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '842'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0532-1'
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 = '842'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0532-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 62
Sample Record Details:
- Payer ID: 111
- Provider ID: 336
- Billing Code Type: HCPCS
- Billing Code: 76770
- 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_08.core_rates
WHERE payer_id = '111'
AND provider_id = '336'
AND billing_code_type = 'HCPCS'
AND billing_code = '76770'
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 = '336'
AND billing_code_type = 'HCPCS'
AND billing_code = '76770'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 63
Sample Record Details:
- Payer ID: 643
- Provider ID: 9467
- Billing Code Type: HCPCS
- Billing Code: J9010
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '9467'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9010'
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 = '9467'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9010'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 64
Sample Record Details:
- Payer ID: 76
- Provider ID: 9276
- Billing Code Type: HCPCS
- Billing Code: 19328
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '9276'
AND billing_code_type = 'HCPCS'
AND billing_code = '19328'
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 = '9276'
AND billing_code_type = 'HCPCS'
AND billing_code = '19328'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 65
Sample Record Details:
- Payer ID: 272
- Provider ID: 2478
- Billing Code Type: HCPCS
- Billing Code: 57556
- 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_08.core_rates
WHERE payer_id = '272'
AND provider_id = '2478'
AND billing_code_type = 'HCPCS'
AND billing_code = '57556'
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 = '2478'
AND billing_code_type = 'HCPCS'
AND billing_code = '57556'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 66
Sample Record Details:
- Payer ID: 76
- Provider ID: 705
- Billing Code Type: HCPCS
- Billing Code: J7343
- Networks: ['NEW ENGLAND 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '705'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7343'
AND product_network_label IN ('NEW ENGLAND 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 = 76
AND provider_id = '705'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7343'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 67
Sample Record Details:
- Payer ID: 643
- Provider ID: 1781
- Billing Code Type: HCPCS
- Billing Code: 64772
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1781'
AND billing_code_type = 'HCPCS'
AND billing_code = '64772'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1781'
AND billing_code_type = 'HCPCS'
AND billing_code = '64772'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 68
Sample Record Details:
- Payer ID: 76
- Provider ID: 3493
- Billing Code Type: HCPCS
- Billing Code: 36592
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '3493'
AND billing_code_type = 'HCPCS'
AND billing_code = '36592'
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 = '3493'
AND billing_code_type = 'HCPCS'
AND billing_code = '36592'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 69
Sample Record Details:
- Payer ID: 392
- Provider ID: 742
- Billing Code Type: HCPCS
- Billing Code: D7770
- Networks: ['HMO BLUE SELF INSURED THIRD PARTY', 'HMO BLUE FULLY INSURED']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '392'
AND provider_id = '742'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7770'
AND product_network_label IN ('HMO BLUE SELF INSURED THIRD PARTY', 'HMO BLUE FULLY INSURED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 392
AND provider_id = '742'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7770'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 70
Sample Record Details:
- Payer ID: 643
- Provider ID: 4558
- Billing Code Type: HCPCS
- Billing Code: 49084
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4558'
AND billing_code_type = 'HCPCS'
AND billing_code = '49084'
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 = '4558'
AND billing_code_type = 'HCPCS'
AND billing_code = '49084'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 71
Sample Record Details:
- Payer ID: 636
- Provider ID: 6061
- Billing Code Type: HCPCS
- Billing Code: 22856
- 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_08.core_rates
WHERE payer_id = '636'
AND provider_id = '6061'
AND billing_code_type = 'HCPCS'
AND billing_code = '22856'
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 = '6061'
AND billing_code_type = 'HCPCS'
AND billing_code = '22856'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 72
Sample Record Details:
- Payer ID: 47
- Provider ID: 8604
- Billing Code Type: HCPCS
- Billing Code: 58672
- Networks: ['PREFERREDCARE BLUE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '47'
AND provider_id = '8604'
AND billing_code_type = 'HCPCS'
AND billing_code = '58672'
AND product_network_label IN ('PREFERREDCARE BLUE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 47
AND provider_id = '8604'
AND billing_code_type = 'HCPCS'
AND billing_code = '58672'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 73
Sample Record Details:
- Payer ID: 522
- Provider ID: 6133
- Billing Code Type: HCPCS
- Billing Code: Q4248
- 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_08.core_rates
WHERE payer_id = '522'
AND provider_id = '6133'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4248'
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 = '6133'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4248'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 74
Sample Record Details:
- Payer ID: 643
- Provider ID: 5836
- Billing Code Type: HCPCS
- Billing Code: J0476
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5836'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0476'
AND product_network_label IN ('NEXUS ACO OAP')
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 | 5836 | HCPCS | J0476 | UHC COMM | 0.85 | 33ed6b83d5134a3e9cd01c0e73e89cbd |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5836'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0476'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 75
Sample Record Details:
- Payer ID: 7
- Provider ID: 8055
- Billing Code Type: MS-DRG
- Billing Code: 547
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '8055'
AND billing_code_type = 'MS-DRG'
AND billing_code = '547'
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 = '8055'
AND billing_code_type = 'MS-DRG'
AND billing_code = '547'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 76
Sample Record Details:
- Payer ID: 76
- Provider ID: 1547
- Billing Code Type: HCPCS
- Billing Code: 53605
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '1547'
AND billing_code_type = 'HCPCS'
AND billing_code = '53605'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1547'
AND billing_code_type = 'HCPCS'
AND billing_code = '53605'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 77
Sample Record Details:
- Payer ID: 643
- Provider ID: 1236
- Billing Code Type: HCPCS
- Billing Code: Q2051
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1236'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2051'
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 = '1236'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2051'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 78
Sample Record Details:
- Payer ID: 7
- Provider ID: 1847
- Billing Code Type: APR-DRG
- Billing Code: 0773-1
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '1847'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0773-1'
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 = '1847'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0773-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 79
Sample Record Details:
- Payer ID: 97
- Provider ID: 1034
- Billing Code Type: MS-DRG
- Billing Code: 090
- Networks: ['GHI-CBP', 'NY 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_08.core_rates
WHERE payer_id = '97'
AND provider_id = '1034'
AND billing_code_type = 'MS-DRG'
AND billing_code = '090'
AND product_network_label IN ('GHI-CBP', 'NY 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 = 97
AND provider_id = '1034'
AND billing_code_type = 'MS-DRG'
AND billing_code = '090'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 80
Sample Record Details:
- Payer ID: 229
- Provider ID: 838
- Billing Code Type: HCPCS
- Billing Code: 36478
- 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_08.core_rates
WHERE payer_id = '229'
AND provider_id = '838'
AND billing_code_type = 'HCPCS'
AND billing_code = '36478'
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 = '838'
AND billing_code_type = 'HCPCS'
AND billing_code = '36478'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 81
Sample Record Details:
- Payer ID: 151
- Provider ID: 3293
- Billing Code Type: HCPCS
- Billing Code: 21401
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '3293'
AND billing_code_type = 'HCPCS'
AND billing_code = '21401'
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 = '3293'
AND billing_code_type = 'HCPCS'
AND billing_code = '21401'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 82
Sample Record Details:
- Payer ID: 7
- Provider ID: 4103
- Billing Code Type: APR-DRG
- Billing Code: 0314-4
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '4103'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0314-4'
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 = '4103'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0314-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 83
Sample Record Details:
- Payer ID: 720
- Provider ID: 700
- Billing Code Type: HCPCS
- Billing Code: 25332
- 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_08.core_rates
WHERE payer_id = '720'
AND provider_id = '700'
AND billing_code_type = 'HCPCS'
AND billing_code = '25332'
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 = '700'
AND billing_code_type = 'HCPCS'
AND billing_code = '25332'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 84
Sample Record Details:
- Payer ID: 76
- Provider ID: 5789
- Billing Code Type: HCPCS
- Billing Code: 27381
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5789'
AND billing_code_type = 'HCPCS'
AND billing_code = '27381'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5789'
AND billing_code_type = 'HCPCS'
AND billing_code = '27381'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 85
Sample Record Details:
- Payer ID: 774
- Provider ID: 1075
- Billing Code Type: HCPCS
- Billing Code: 15013
- 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_08.core_rates
WHERE payer_id = '774'
AND provider_id = '1075'
AND billing_code_type = 'HCPCS'
AND billing_code = '15013'
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 = '1075'
AND billing_code_type = 'HCPCS'
AND billing_code = '15013'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 86
Sample Record Details:
- Payer ID: 643
- Provider ID: 1321
- Billing Code Type: HCPCS
- Billing Code: 29520
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1321'
AND billing_code_type = 'HCPCS'
AND billing_code = '29520'
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 = '1321'
AND billing_code_type = 'HCPCS'
AND billing_code = '29520'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 87
Sample Record Details:
- Payer ID: 643
- Provider ID: 3028
- Billing Code Type: HCPCS
- Billing Code: 36253
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3028'
AND billing_code_type = 'HCPCS'
AND billing_code = '36253'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3028'
AND billing_code_type = 'HCPCS'
AND billing_code = '36253'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 88
Sample Record Details:
- Payer ID: 643
- Provider ID: 4006
- Billing Code Type: HCPCS
- Billing Code: 21335
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4006'
AND billing_code_type = 'HCPCS'
AND billing_code = '21335'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '4006'
AND billing_code_type = 'HCPCS'
AND billing_code = '21335'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 89
Sample Record Details:
- Payer ID: 643
- Provider ID: 6094
- Billing Code Type: HCPCS
- Billing Code: 80307
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6094'
AND billing_code_type = 'HCPCS'
AND billing_code = '80307'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6094'
AND billing_code_type = 'HCPCS'
AND billing_code = '80307'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 90
Sample Record Details:
- Payer ID: 7
- Provider ID: 9797
- Billing Code Type: APR-DRG
- Billing Code: 0220-3
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '9797'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0220-3'
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 = '9797'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0220-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 91
Sample Record Details:
- Payer ID: 643
- Provider ID: 5859
- Billing Code Type: HCPCS
- Billing Code: 96146
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5859'
AND billing_code_type = 'HCPCS'
AND billing_code = '96146'
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 = '5859'
AND billing_code_type = 'HCPCS'
AND billing_code = '96146'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 92
Sample Record Details:
- Payer ID: 76
- Provider ID: 5781
- Billing Code Type: HCPCS
- Billing Code: 26498
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5781'
AND billing_code_type = 'HCPCS'
AND billing_code = '26498'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5781'
AND billing_code_type = 'HCPCS'
AND billing_code = '26498'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 93
Sample Record Details:
- Payer ID: 7
- Provider ID: 4906
- Billing Code Type: APR-DRG
- Billing Code: 0757-4
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '4906'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0757-4'
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 = '4906'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0757-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 94
Sample Record Details:
- Payer ID: 76
- Provider ID: 6827
- Billing Code Type: HCPCS
- Billing Code: 86970
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '6827'
AND billing_code_type = 'HCPCS'
AND billing_code = '86970'
AND product_network_label IN ('LOCALPLUS')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 76 | 6827 | HCPCS | 86970 | Outpatient | SUREFIT_EPO | CIGNA_HEALTHCARE | 84 | 25.0% | 76 | 72ca836258c4409bbee36a1fc17ec993 | |||
| 76 | 6827 | HCPCS | 86970 | Outpatient | HMO_PPO | CIGNA_HEALTHCARE | 116 | 35.0% | 104 | 565457386be9498b9089f622e3d973b3 | |||
| 76 | 6827 | HCPCS | 86970 | Outpatient | HMO_PPO | CIGNA_HEALTHCARE | 116 | 35.0% | 104 | 460ea1bf24c44b168cbf9c323588f286 | |||
| 76 | 6827 | HCPCS | 86970 | Outpatient | SUREFIT_EPO | CIGNA_HEALTHCARE | 84 | 25.0% | 76 | 0a7353284b78414b9e30b5487cecf650 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6827'
AND billing_code_type = 'HCPCS'
AND billing_code = '86970'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 95
Sample Record Details:
- Payer ID: 42
- Provider ID: 2771
- Billing Code Type: MS-DRG
- Billing Code: 593
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '2771'
AND billing_code_type = 'MS-DRG'
AND billing_code = '593'
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 = '2771'
AND billing_code_type = 'MS-DRG'
AND billing_code = '593'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 96
Sample Record Details:
- Payer ID: 354
- Provider ID: 9231
- Billing Code Type: HCPCS
- Billing Code: 11770
- 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_08.core_rates
WHERE payer_id = '354'
AND provider_id = '9231'
AND billing_code_type = 'HCPCS'
AND billing_code = '11770'
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 = '9231'
AND billing_code_type = 'HCPCS'
AND billing_code = '11770'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 97
Sample Record Details:
- Payer ID: 151
- Provider ID: 3454
- Billing Code Type: HCPCS
- Billing Code: 95199
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '3454'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
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 = '3454'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 98
Sample Record Details:
- Payer ID: 643
- Provider ID: 8701
- Billing Code Type: HCPCS
- Billing Code: J0578
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8701'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0578'
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 = '8701'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0578'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 99
Sample Record Details:
- Payer ID: 643
- Provider ID: 3783
- Billing Code Type: HCPCS
- Billing Code: 36590
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3783'
AND billing_code_type = 'HCPCS'
AND billing_code = '36590'
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 = '3783'
AND billing_code_type = 'HCPCS'
AND billing_code = '36590'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 100
Sample Record Details:
- Payer ID: 643
- Provider ID: 6672
- Billing Code Type: HCPCS
- Billing Code: 76506
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6672'
AND billing_code_type = 'HCPCS'
AND billing_code = '76506'
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 = '6672'
AND billing_code_type = 'HCPCS'
AND billing_code = '76506'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 101
Sample Record Details:
- Payer ID: 643
- Provider ID: 1698
- Billing Code Type: HCPCS
- Billing Code: 67999
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1698'
AND billing_code_type = 'HCPCS'
AND billing_code = '67999'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1698'
AND billing_code_type = 'HCPCS'
AND billing_code = '67999'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 102
Sample Record Details:
- Payer ID: 643
- Provider ID: 4392
- Billing Code Type: HCPCS
- Billing Code: 52346
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4392'
AND billing_code_type = 'HCPCS'
AND billing_code = '52346'
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 = '4392'
AND billing_code_type = 'HCPCS'
AND billing_code = '52346'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 103
Sample Record Details:
- Payer ID: 42
- Provider ID: 3750
- Billing Code Type: HCPCS
- Billing Code: 27137
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '3750'
AND billing_code_type = 'HCPCS'
AND billing_code = '27137'
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 = '3750'
AND billing_code_type = 'HCPCS'
AND billing_code = '27137'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 104
Sample Record Details:
- Payer ID: 643
- Provider ID: 5639
- Billing Code Type: HCPCS
- Billing Code: 75833
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5639'
AND billing_code_type = 'HCPCS'
AND billing_code = '75833'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5639'
AND billing_code_type = 'HCPCS'
AND billing_code = '75833'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 105
Sample Record Details:
- Payer ID: 229
- Provider ID: 7160
- Billing Code Type: HCPCS
- Billing Code: 53000
- 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_08.core_rates
WHERE payer_id = '229'
AND provider_id = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = '53000'
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 = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = '53000'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 106
Sample Record Details:
- Payer ID: 151
- Provider ID: 1054
- Billing Code Type: APR-DRG
- Billing Code: 0340-3
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '1054'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0340-3'
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 = '1054'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0340-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 107
Sample Record Details:
- Payer ID: 643
- Provider ID: 10451
- Billing Code Type: HCPCS
- Billing Code: 33212
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '10451'
AND billing_code_type = 'HCPCS'
AND billing_code = '33212'
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 = '10451'
AND billing_code_type = 'HCPCS'
AND billing_code = '33212'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 108
Sample Record Details:
- Payer ID: 76
- Provider ID: 1917
- Billing Code Type: HCPCS
- Billing Code: 57180
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '1917'
AND billing_code_type = 'HCPCS'
AND billing_code = '57180'
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 | 1917 | HCPCS | 57180 | Inpatient | PPO | CIGNA_HEALTHCARE_OF_GEORGIA | 1,621.00 | 52.0% | 1,459.00 | 14b771631511466fbcedd967dc551ad9 | |||
| 76 | 1917 | HCPCS | 57180 | Outpatient | PPO | CIGNA_HEALTHCARE_OF_GEORGIA | 1,611.00 | 52.0% | 1,450.00 | a1adbdbc39fd4f84841ed14be4672ff4 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1917'
AND billing_code_type = 'HCPCS'
AND billing_code = '57180'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 109
Sample Record Details:
- Payer ID: 42
- Provider ID: 2743
- Billing Code Type: MS-DRG
- Billing Code: 727
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '2743'
AND billing_code_type = 'MS-DRG'
AND billing_code = '727'
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 = '2743'
AND billing_code_type = 'MS-DRG'
AND billing_code = '727'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 110
Sample Record Details:
- Payer ID: 97
- Provider ID: 890
- Billing Code Type: HCPCS
- Billing Code: 21616
- Networks: ['DC37 MED-TEAM']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '97'
AND provider_id = '890'
AND billing_code_type = 'HCPCS'
AND billing_code = '21616'
AND product_network_label IN ('DC37 MED-TEAM')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 97
AND provider_id = '890'
AND billing_code_type = 'HCPCS'
AND billing_code = '21616'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 111
Sample Record Details:
- Payer ID: 643
- Provider ID: 3945
- Billing Code Type: HCPCS
- Billing Code: 53080
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3945'
AND billing_code_type = 'HCPCS'
AND billing_code = '53080'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3945'
AND billing_code_type = 'HCPCS'
AND billing_code = '53080'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 112
Sample Record Details:
- Payer ID: 300
- Provider ID: 6264
- Billing Code Type: HCPCS
- Billing Code: 22010
- Networks: ['PEBB 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_08.core_rates
WHERE payer_id = '300'
AND provider_id = '6264'
AND billing_code_type = 'HCPCS'
AND billing_code = '22010'
AND product_network_label IN ('PEBB 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 = 300
AND provider_id = '6264'
AND billing_code_type = 'HCPCS'
AND billing_code = '22010'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 113
Sample Record Details:
- Payer ID: 151
- Provider ID: 2021
- Billing Code Type: HCPCS
- Billing Code: J2210
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2021'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2210'
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 = '2021'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2210'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 114
Sample Record Details:
- Payer ID: 643
- Provider ID: 8740
- Billing Code Type: APR-DRG
- Billing Code: 0343-2
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8740'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0343-2'
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 = '8740'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0343-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 115
Sample Record Details:
- Payer ID: 643
- Provider ID: 333
- Billing Code Type: HCPCS
- Billing Code: 27445
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '333'
AND billing_code_type = 'HCPCS'
AND billing_code = '27445'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '333'
AND billing_code_type = 'HCPCS'
AND billing_code = '27445'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 116
Sample Record Details:
- Payer ID: 169
- Provider ID: 5398
- Billing Code Type: HCPCS
- Billing Code: J3487
- 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_08.core_rates
WHERE payer_id = '169'
AND provider_id = '5398'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3487'
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 = '5398'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3487'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 117
Sample Record Details:
- Payer ID: 796
- Provider ID: 996
- Billing Code Type: HCPCS
- Billing Code: J0696
- Networks: ['EXCHANGE MARKETPLACE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '796'
AND provider_id = '996'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0696'
AND product_network_label IN ('EXCHANGE MARKETPLACE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 796
AND provider_id = '996'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0696'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 118
Sample Record Details:
- Payer ID: 76
- Provider ID: 6226
- Billing Code Type: HCPCS
- Billing Code: J0970
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '6226'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0970'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6226'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0970'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 119
Sample Record Details:
- Payer ID: 643
- Provider ID: 9225
- Billing Code Type: HCPCS
- Billing Code: 0636T
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '9225'
AND billing_code_type = 'HCPCS'
AND billing_code = '0636T'
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 = '9225'
AND billing_code_type = 'HCPCS'
AND billing_code = '0636T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 120
Sample Record Details:
- Payer ID: 76
- Provider ID: 6291
- Billing Code Type: HCPCS
- Billing Code: 0102T
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '6291'
AND billing_code_type = 'HCPCS'
AND billing_code = '0102T'
AND product_network_label IN ('LOCALPLUS')
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 | 6291 | HCPCS | 0102T | Facility | Outpatient | HMO/PPO | CIGNA | 2,995.00 | 0d90ef23d7254ae684c9fac10cdcc290 | ||||
| 76 | 6291 | HCPCS | 0102T | Facility | Outpatient | HMO/PPO | CIGNA | 2,995.00 | 7e0170ea9db0420ba3ec5c84e2c11645 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6291'
AND billing_code_type = 'HCPCS'
AND billing_code = '0102T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 121
Sample Record Details:
- Payer ID: 643
- Provider ID: 6161
- Billing Code Type: HCPCS
- Billing Code: 15572
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6161'
AND billing_code_type = 'HCPCS'
AND billing_code = '15572'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6161'
AND billing_code_type = 'HCPCS'
AND billing_code = '15572'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 122
Sample Record Details:
- Payer ID: 151
- Provider ID: 2671
- Billing Code Type: HCPCS
- Billing Code: 27138
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2671'
AND billing_code_type = 'HCPCS'
AND billing_code = '27138'
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 = '2671'
AND billing_code_type = 'HCPCS'
AND billing_code = '27138'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 123
Sample Record Details:
- Payer ID: 643
- Provider ID: 6430
- Billing Code Type: HCPCS
- Billing Code: C9174
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6430'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9174'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6430'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9174'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 124
Sample Record Details:
- Payer ID: 796
- Provider ID: 942
- Billing Code Type: HCPCS
- Billing Code: 42180
- Networks: ['EXCHANGE MARKETPLACE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '796'
AND provider_id = '942'
AND billing_code_type = 'HCPCS'
AND billing_code = '42180'
AND product_network_label IN ('EXCHANGE MARKETPLACE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 796
AND provider_id = '942'
AND billing_code_type = 'HCPCS'
AND billing_code = '42180'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 125
Sample Record Details:
- Payer ID: 97
- Provider ID: 333
- Billing Code Type: HCPCS
- Billing Code: 30140
- Networks: ['GHI-CBP', 'NY 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_08.core_rates
WHERE payer_id = '97'
AND provider_id = '333'
AND billing_code_type = 'HCPCS'
AND billing_code = '30140'
AND product_network_label IN ('GHI-CBP', 'NY 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 = 97
AND provider_id = '333'
AND billing_code_type = 'HCPCS'
AND billing_code = '30140'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 126
Sample Record Details:
- Payer ID: 7
- Provider ID: 2844
- Billing Code Type: HCPCS
- Billing Code: 86921
- 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '2844'
AND billing_code_type = 'HCPCS'
AND billing_code = '86921'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7 | 2844 | HCPCS | 86921 | 300 | Aetna - POS | 15.13 | fb0b8344a2864a7b8fc11d82e465f063 | ||||||
| 7 | 2844 | HCPCS | 86921 | 300 | Aetna - PPO | 15.13 | 5e3b335fcd954e1c880e8c9db13977c4 | ||||||
| 7 | 2844 | HCPCS | 86921 | 300 | Aetna - HMO | 15.13 | 1c29359662ed4e0a9419d810cbbe33aa | ||||||
| 7 | 2844 | HCPCS | 86921 | 300 | Aetna First Health | 19.48 | 4f9c88f7ccc04c57bc614882e722e87b |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2844'
AND billing_code_type = 'HCPCS'
AND billing_code = '86921'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 127
Sample Record Details:
- Payer ID: 391
- Provider ID: 10171
- Billing Code Type: HCPCS
- Billing Code: 49555
- Networks: ['PPO - PREFERRED CARE 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_08.core_rates
WHERE payer_id = '391'
AND provider_id = '10171'
AND billing_code_type = 'HCPCS'
AND billing_code = '49555'
AND product_network_label IN ('PPO - PREFERRED CARE 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 = 391
AND provider_id = '10171'
AND billing_code_type = 'HCPCS'
AND billing_code = '49555'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 128
Sample Record Details:
- Payer ID: 76
- Provider ID: 442
- Billing Code Type: HCPCS
- Billing Code: C9168
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '442'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9168'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '442'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9168'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 129
Sample Record Details:
- Payer ID: 76
- Provider ID: 1947
- Billing Code Type: MS-DRG
- Billing Code: 059
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '1947'
AND billing_code_type = 'MS-DRG'
AND billing_code = '059'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1947'
AND billing_code_type = 'MS-DRG'
AND billing_code = '059'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 130
Sample Record Details:
- Payer ID: 643
- Provider ID: 2148
- Billing Code Type: HCPCS
- Billing Code: 83880
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2148'
AND billing_code_type = 'HCPCS'
AND billing_code = '83880'
AND product_network_label IN ('NAVIGATE')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 2148 | HCPCS | 83880 | Facility | 301 | Outpatient | UNITED HEALTHCARE COMMERCIAL GROUP 1 | UNITED HEALTHCARE | 117.78 | cac167acde914062a1f514df6c45e9c4 | |||
| 643 | 2148 | HCPCS | 83880 | Facility | 301 | Outpatient | UNITED HEALTHCARE (NHP) | UNITED HEALTHCARE | 78.52 | 96261a781a174355a1da5300f83e3f80 | |||
| 643 | 2148 | HCPCS | 83880 | Facility | 301 | Outpatient | UNITED HEALTHCARE COMMERCIAL GROUP 2 | UNITED HEALTHCARE | 117.78 | 3da27d88dba7499f9a37ebf442ffed65 | |||
| 643 | 2148 | HCPCS | 83880 | Facility | 301 | Outpatient | UNITED HEALTHCARE FLORIDA HEALTHY KIDS | UNITED HEALTHCARE | 40.85 | 14f88c188ef446fe8bd5875c0a0d3dd9 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2148'
AND billing_code_type = 'HCPCS'
AND billing_code = '83880'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 131
Sample Record Details:
- Payer ID: 461
- Provider ID: 4242
- Billing Code Type: HCPCS
- Billing Code: 46030
- 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_08.core_rates
WHERE payer_id = '461'
AND provider_id = '4242'
AND billing_code_type = 'HCPCS'
AND billing_code = '46030'
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 = '4242'
AND billing_code_type = 'HCPCS'
AND billing_code = '46030'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 132
Sample Record Details:
- Payer ID: 286
- Provider ID: 951
- Billing Code Type: HCPCS
- Billing Code: 21337
- 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_08.core_rates
WHERE payer_id = '286'
AND provider_id = '951'
AND billing_code_type = 'HCPCS'
AND billing_code = '21337'
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 = '951'
AND billing_code_type = 'HCPCS'
AND billing_code = '21337'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 133
Sample Record Details:
- Payer ID: 643
- Provider ID: 1216
- Billing Code Type: HCPCS
- Billing Code: 88319
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '1216'
AND billing_code_type = 'HCPCS'
AND billing_code = '88319'
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 = '1216'
AND billing_code_type = 'HCPCS'
AND billing_code = '88319'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 134
Sample Record Details:
- Payer ID: 643
- Provider ID: 5236
- Billing Code Type: HCPCS
- Billing Code: 74485
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5236'
AND billing_code_type = 'HCPCS'
AND billing_code = '74485'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5236'
AND billing_code_type = 'HCPCS'
AND billing_code = '74485'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 135
Sample Record Details:
- Payer ID: 628
- Provider ID: 6101
- Billing Code Type: APR-DRG
- Billing Code: 0792-4
- Networks: ['SHERWOOD 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_08.core_rates
WHERE payer_id = '628'
AND provider_id = '6101'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0792-4'
AND product_network_label IN ('SHERWOOD 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 = 628
AND provider_id = '6101'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0792-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 136
Sample Record Details:
- Payer ID: 56
- Provider ID: 2515
- Billing Code Type: HCPCS
- Billing Code: 66175
- 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_08.core_rates
WHERE payer_id = '56'
AND provider_id = '2515'
AND billing_code_type = 'HCPCS'
AND billing_code = '66175'
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 = '2515'
AND billing_code_type = 'HCPCS'
AND billing_code = '66175'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 137
Sample Record Details:
- Payer ID: 643
- Provider ID: 10612
- Billing Code Type: HCPCS
- Billing Code: 51720
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '10612'
AND billing_code_type = 'HCPCS'
AND billing_code = '51720'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10612'
AND billing_code_type = 'HCPCS'
AND billing_code = '51720'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 138
Sample Record Details:
- Payer ID: 643
- Provider ID: 284
- Billing Code Type: HCPCS
- Billing Code: 64624
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '284'
AND billing_code_type = 'HCPCS'
AND billing_code = '64624'
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 = '284'
AND billing_code_type = 'HCPCS'
AND billing_code = '64624'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 139
Sample Record Details:
- Payer ID: 229
- Provider ID: 1175
- Billing Code Type: APR-DRG
- Billing Code: 0608-4
- 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_08.core_rates
WHERE payer_id = '229'
AND provider_id = '1175'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0608-4'
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 = '1175'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0608-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 140
Sample Record Details:
- Payer ID: 76
- Provider ID: 9879
- Billing Code Type: HCPCS
- Billing Code: 87636
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '9879'
AND billing_code_type = 'HCPCS'
AND billing_code = '87636'
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 = '9879'
AND billing_code_type = 'HCPCS'
AND billing_code = '87636'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 141
Sample Record Details:
- Payer ID: 286
- Provider ID: 973
- Billing Code Type: HCPCS
- Billing Code: 77085
- 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_08.core_rates
WHERE payer_id = '286'
AND provider_id = '973'
AND billing_code_type = 'HCPCS'
AND billing_code = '77085'
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 = '973'
AND billing_code_type = 'HCPCS'
AND billing_code = '77085'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 142
Sample Record Details:
- Payer ID: 643
- Provider ID: 8843
- Billing Code Type: HCPCS
- Billing Code: 27228
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8843'
AND billing_code_type = 'HCPCS'
AND billing_code = '27228'
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 = '8843'
AND billing_code_type = 'HCPCS'
AND billing_code = '27228'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 143
Sample Record Details:
- Payer ID: 42
- Provider ID: 3904
- Billing Code Type: MS-DRG
- Billing Code: 091
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '3904'
AND billing_code_type = 'MS-DRG'
AND billing_code = '091'
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 = '3904'
AND billing_code_type = 'MS-DRG'
AND billing_code = '091'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 144
Sample Record Details:
- Payer ID: 76
- Provider ID: 5424
- Billing Code Type: APR-DRG
- Billing Code: 0145-1
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '5424'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0145-1'
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 = '5424'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0145-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 145
Sample Record Details:
- Payer ID: 151
- Provider ID: 4108
- Billing Code Type: HCPCS
- Billing Code: 38999
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '4108'
AND billing_code_type = 'HCPCS'
AND billing_code = '38999'
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 = '4108'
AND billing_code_type = 'HCPCS'
AND billing_code = '38999'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 146
Sample Record Details:
- Payer ID: 643
- Provider ID: 6332
- Billing Code Type: APR-DRG
- Billing Code: 0462-3
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6332'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-3'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6332'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 147
Sample Record Details:
- Payer ID: 643
- Provider ID: 8508
- Billing Code Type: HCPCS
- Billing Code: 74470
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8508'
AND billing_code_type = 'HCPCS'
AND billing_code = '74470'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '8508'
AND billing_code_type = 'HCPCS'
AND billing_code = '74470'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 148
Sample Record Details:
- Payer ID: 76
- Provider ID: 4283
- Billing Code Type: HCPCS
- Billing Code: J1290
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4283'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1290'
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 = '4283'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1290'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 149
Sample Record Details:
- Payer ID: 628
- Provider ID: 6237
- Billing Code Type: HCPCS
- Billing Code: 76885
- Networks: ['PBC PPO (HERITAGE) 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_08.core_rates
WHERE payer_id = '628'
AND provider_id = '6237'
AND billing_code_type = 'HCPCS'
AND billing_code = '76885'
AND product_network_label IN ('PBC PPO (HERITAGE) 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 = 628
AND provider_id = '6237'
AND billing_code_type = 'HCPCS'
AND billing_code = '76885'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 150
Sample Record Details:
- Payer ID: 628
- Provider ID: 6120
- Billing Code Type: HCPCS
- Billing Code: Q4235
- Networks: ['ALASKA HERITAGE 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_08.core_rates
WHERE payer_id = '628'
AND provider_id = '6120'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4235'
AND product_network_label IN ('ALASKA HERITAGE 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 = 628
AND provider_id = '6120'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4235'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 151
Sample Record Details:
- Payer ID: 76
- Provider ID: 873
- Billing Code Type: HCPCS
- Billing Code: 58770
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '873'
AND billing_code_type = 'HCPCS'
AND billing_code = '58770'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '873'
AND billing_code_type = 'HCPCS'
AND billing_code = '58770'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 152
Sample Record Details:
- Payer ID: 151
- Provider ID: 6251
- Billing Code Type: HCPCS
- Billing Code: 47553
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '6251'
AND billing_code_type = 'HCPCS'
AND billing_code = '47553'
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 = '6251'
AND billing_code_type = 'HCPCS'
AND billing_code = '47553'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 153
Sample Record Details:
- Payer ID: 7
- Provider ID: 10534
- Billing Code Type: HCPCS
- Billing Code: 58600
- Networks: ['NC 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '10534'
AND billing_code_type = 'HCPCS'
AND billing_code = '58600'
AND product_network_label IN ('NC 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 = '10534'
AND billing_code_type = 'HCPCS'
AND billing_code = '58600'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 154
Sample Record Details:
- Payer ID: 42
- Provider ID: 7160
- Billing Code Type: HCPCS
- Billing Code: Q4113
- Networks: ['NY 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4113'
AND product_network_label IN ('NY 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 = 42
AND provider_id = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4113'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 155
Sample Record Details:
- Payer ID: 42
- Provider ID: 4451
- Billing Code Type: HCPCS
- Billing Code: Q2038
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '4451'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2038'
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 = '4451'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2038'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 156
Sample Record Details:
- Payer ID: 7
- Provider ID: 10586
- Billing Code Type: HCPCS
- Billing Code: 21125
- Networks: ['NY GROUP 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '10586'
AND billing_code_type = 'HCPCS'
AND billing_code = '21125'
AND product_network_label IN ('NY GROUP 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 = 7
AND provider_id = '10586'
AND billing_code_type = 'HCPCS'
AND billing_code = '21125'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 157
Sample Record Details:
- Payer ID: 643
- Provider ID: 6564
- Billing Code Type: HCPCS
- Billing Code: 22325
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6564'
AND billing_code_type = 'HCPCS'
AND billing_code = '22325'
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 = '6564'
AND billing_code_type = 'HCPCS'
AND billing_code = '22325'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 158
Sample Record Details:
- Payer ID: 229
- Provider ID: 1359
- Billing Code Type: HCPCS
- Billing Code: 78483
- 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_08.core_rates
WHERE payer_id = '229'
AND provider_id = '1359'
AND billing_code_type = 'HCPCS'
AND billing_code = '78483'
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 = '1359'
AND billing_code_type = 'HCPCS'
AND billing_code = '78483'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 159
Sample Record Details:
- Payer ID: 76
- Provider ID: 587
- Billing Code Type: APR-DRG
- Billing Code: 0519-4
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '587'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0519-4'
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 = '587'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0519-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 160
Sample Record Details:
- Payer ID: 76
- Provider ID: 4658
- Billing Code Type: HCPCS
- Billing Code: J2782
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4658'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2782'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '4658'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2782'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 161
Sample Record Details:
- Payer ID: 643
- Provider ID: 2966
- Billing Code Type: HCPCS
- Billing Code: D7413
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2966'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7413'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2966'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7413'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 162
Sample Record Details:
- Payer ID: 522
- Provider ID: 10632
- Billing Code Type: HCPCS
- Billing Code: 65756
- Networks: ['KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '522'
AND provider_id = '10632'
AND billing_code_type = 'HCPCS'
AND billing_code = '65756'
AND product_network_label IN ('KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10632'
AND billing_code_type = 'HCPCS'
AND billing_code = '65756'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 163
Sample Record Details:
- Payer ID: 643
- Provider ID: 9651
- Billing Code Type: HCPCS
- Billing Code: 28715
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '9651'
AND billing_code_type = 'HCPCS'
AND billing_code = '28715'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '9651'
AND billing_code_type = 'HCPCS'
AND billing_code = '28715'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 164
Sample Record Details:
- Payer ID: 76
- Provider ID: 10466
- Billing Code Type: HCPCS
- Billing Code: 17276
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '10466'
AND billing_code_type = 'HCPCS'
AND billing_code = '17276'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10466'
AND billing_code_type = 'HCPCS'
AND billing_code = '17276'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 165
Sample Record Details:
- Payer ID: 643
- Provider ID: 441
- Billing Code Type: APR-DRG
- Billing Code: 0614-1
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '441'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0614-1'
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 = '441'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0614-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 166
Sample Record Details:
- Payer ID: 168
- Provider ID: 1842
- Billing Code Type: HCPCS
- Billing Code: 29835
- Networks: ['PPO - PREFERRED BLUE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '168'
AND provider_id = '1842'
AND billing_code_type = 'HCPCS'
AND billing_code = '29835'
AND product_network_label IN ('PPO - PREFERRED BLUE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 168
AND provider_id = '1842'
AND billing_code_type = 'HCPCS'
AND billing_code = '29835'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 167
Sample Record Details:
- Payer ID: 728
- Provider ID: 6572
- Billing Code Type: HCPCS
- Billing Code: J9061
- 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_08.core_rates
WHERE payer_id = '728'
AND provider_id = '6572'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9061'
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 = '6572'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9061'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 168
Sample Record Details:
- Payer ID: 76
- Provider ID: 3089
- Billing Code Type: HCPCS
- Billing Code: 96999
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '3089'
AND billing_code_type = 'HCPCS'
AND billing_code = '96999'
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 = '3089'
AND billing_code_type = 'HCPCS'
AND billing_code = '96999'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 169
Sample Record Details:
- Payer ID: 774
- Provider ID: 795
- Billing Code Type: MS-DRG
- Billing Code: 315
- 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_08.core_rates
WHERE payer_id = '774'
AND provider_id = '795'
AND billing_code_type = 'MS-DRG'
AND billing_code = '315'
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 = '795'
AND billing_code_type = 'MS-DRG'
AND billing_code = '315'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 170
Sample Record Details:
- Payer ID: 643
- Provider ID: 8882
- Billing Code Type: HCPCS
- Billing Code: 11403
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8882'
AND billing_code_type = 'HCPCS'
AND billing_code = '11403'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '8882'
AND billing_code_type = 'HCPCS'
AND billing_code = '11403'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 171
Sample Record Details:
- Payer ID: 42
- Provider ID: 2825
- Billing Code Type: APR-DRG
- Billing Code: 0363-3
- 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '2825'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0363-3'
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 = '2825'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0363-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 172
Sample Record Details:
- Payer ID: 643
- Provider ID: 5796
- Billing Code Type: APR-DRG
- Billing Code: 0518-3
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5796'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0518-3'
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 = '5796'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0518-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 173
Sample Record Details:
- Payer ID: 111
- Provider ID: 1156
- Billing Code Type: HCPCS
- Billing Code: J0285
- 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_08.core_rates
WHERE payer_id = '111'
AND provider_id = '1156'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0285'
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 = '1156'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0285'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 174
Sample Record Details:
- Payer ID: 643
- Provider ID: 2908
- Billing Code Type: HCPCS
- Billing Code: A9588
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2908'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9588'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2908'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9588'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 175
Sample Record Details:
- Payer ID: 76
- Provider ID: 2672
- Billing Code Type: HCPCS
- Billing Code: 11762
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '2672'
AND billing_code_type = 'HCPCS'
AND billing_code = '11762'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2672'
AND billing_code_type = 'HCPCS'
AND billing_code = '11762'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 176
Sample Record Details:
- Payer ID: 76
- Provider ID: 4759
- Billing Code Type: MS-DRG
- Billing Code: 093
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4759'
AND billing_code_type = 'MS-DRG'
AND billing_code = '093'
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 = '4759'
AND billing_code_type = 'MS-DRG'
AND billing_code = '093'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 177
Sample Record Details:
- Payer ID: 42
- Provider ID: 1065
- Billing Code Type: MS-DRG
- Billing Code: 398
- Networks: ['NY 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '1065'
AND billing_code_type = 'MS-DRG'
AND billing_code = '398'
AND product_network_label IN ('NY 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 = 42
AND provider_id = '1065'
AND billing_code_type = 'MS-DRG'
AND billing_code = '398'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 178
Sample Record Details:
- Payer ID: 76
- Provider ID: 9488
- Billing Code Type: HCPCS
- Billing Code: 86038
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '9488'
AND billing_code_type = 'HCPCS'
AND billing_code = '86038'
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 = '9488'
AND billing_code_type = 'HCPCS'
AND billing_code = '86038'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 179
Sample Record Details:
- Payer ID: 76
- Provider ID: 4179
- Billing Code Type: HCPCS
- Billing Code: P9041
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '4179'
AND billing_code_type = 'HCPCS'
AND billing_code = 'P9041'
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 = '4179'
AND billing_code_type = 'HCPCS'
AND billing_code = 'P9041'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 180
Sample Record Details:
- Payer ID: 101
- Provider ID: 951
- Billing Code Type: HCPCS
- Billing Code: J0699
- Networks: ['EXCELLUS BLUECROSS BLUESHIELD']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '101'
AND provider_id = '951'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0699'
AND product_network_label IN ('EXCELLUS BLUECROSS BLUESHIELD')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 101
AND provider_id = '951'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0699'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 181
Sample Record Details:
- Payer ID: 774
- Provider ID: 853
- Billing Code Type: HCPCS
- Billing Code: 27040
- Networks: ['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_08.core_rates
WHERE payer_id = '774'
AND provider_id = '853'
AND billing_code_type = 'HCPCS'
AND billing_code = '27040'
AND product_network_label IN ('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 = 774
AND provider_id = '853'
AND billing_code_type = 'HCPCS'
AND billing_code = '27040'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 182
Sample Record Details:
- Payer ID: 61
- Provider ID: 5623
- Billing Code Type: HCPCS
- Billing Code: 95199
- Networks: ['PREFERRED IDAHO PCP/SPEC (SZ)', 'PREFERRED IDAHO (GRANDFATHERED GROUPS ONLY)']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '61'
AND provider_id = '5623'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
AND product_network_label IN ('PREFERRED IDAHO PCP/SPEC (SZ)', 'PREFERRED IDAHO (GRANDFATHERED GROUPS ONLY)')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 61
AND provider_id = '5623'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 183
Sample Record Details:
- Payer ID: 7
- Provider ID: 1079
- Billing Code Type: HCPCS
- Billing Code: 92640
- Networks: ['NY GROUP 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_08.core_rates
WHERE payer_id = '7'
AND provider_id = '1079'
AND billing_code_type = 'HCPCS'
AND billing_code = '92640'
AND product_network_label IN ('NY GROUP 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 = 7
AND provider_id = '1079'
AND billing_code_type = 'HCPCS'
AND billing_code = '92640'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 184
Sample Record Details:
- Payer ID: 643
- Provider ID: 5457
- Billing Code Type: HCPCS
- Billing Code: 94621
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5457'
AND billing_code_type = 'HCPCS'
AND billing_code = '94621'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5457'
AND billing_code_type = 'HCPCS'
AND billing_code = '94621'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 185
Sample Record Details:
- Payer ID: 813
- Provider ID: 2943
- Billing Code Type: MS-DRG
- Billing Code: 858
- Networks: ['HMO - HAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '813'
AND provider_id = '2943'
AND billing_code_type = 'MS-DRG'
AND billing_code = '858'
AND product_network_label IN ('HMO - HAP')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 813 | 2943 | MS-DRG | 858 | Facility | Inpatient | PPO | HAP | 47,250.45 | 8000.0% | 47,250.45 | 642f1d05f4e34c4d8ee9e5ad5222174c |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 813
AND provider_id = '2943'
AND billing_code_type = 'MS-DRG'
AND billing_code = '858'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 186
Sample Record Details:
- Payer ID: 76
- Provider ID: 9548
- Billing Code Type: HCPCS
- Billing Code: 36450
- 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_08.core_rates
WHERE payer_id = '76'
AND provider_id = '9548'
AND billing_code_type = 'HCPCS'
AND billing_code = '36450'
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 = '9548'
AND billing_code_type = 'HCPCS'
AND billing_code = '36450'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 187
Sample Record Details:
- Payer ID: 49
- Provider ID: 2996
- Billing Code Type: APR-DRG
- Billing Code: 0753-1
- Networks: ['HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - 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_08.core_rates
WHERE payer_id = '49'
AND provider_id = '2996'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0753-1'
AND product_network_label IN ('HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - 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 = 49
AND provider_id = '2996'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0753-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 188
Sample Record Details:
- Payer ID: 958
- Provider ID: 868
- Billing Code Type: MS-DRG
- Billing Code: 388
- Networks: ['METROPLUS FFS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '958'
AND provider_id = '868'
AND billing_code_type = 'MS-DRG'
AND billing_code = '388'
AND product_network_label IN ('METROPLUS FFS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 958
AND provider_id = '868'
AND billing_code_type = 'MS-DRG'
AND billing_code = '388'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 189
Sample Record Details:
- Payer ID: 779
- Provider ID: 3720
- Billing Code Type: HCPCS
- Billing Code: 29902
- Networks: ['PREFERREDONE 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_08.core_rates
WHERE payer_id = '779'
AND provider_id = '3720'
AND billing_code_type = 'HCPCS'
AND billing_code = '29902'
AND product_network_label IN ('PREFERREDONE 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 = 779
AND provider_id = '3720'
AND billing_code_type = 'HCPCS'
AND billing_code = '29902'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 190
Sample Record Details:
- Payer ID: 151
- Provider ID: 2616
- Billing Code Type: HCPCS
- Billing Code: C9146
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2616'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9146'
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 = '2616'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9146'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 191
Sample Record Details:
- Payer ID: 643
- Provider ID: 8381
- Billing Code Type: HCPCS
- Billing Code: 84100
- Networks: ['NAVIGATE']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '8381'
AND billing_code_type = 'HCPCS'
AND billing_code = '84100'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '8381'
AND billing_code_type = 'HCPCS'
AND billing_code = '84100'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 192
Sample Record Details:
- Payer ID: 643
- Provider ID: 3560
- Billing Code Type: APR-DRG
- Billing Code: 0500-1
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3560'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0500-1'
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 = '3560'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0500-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 193
Sample Record Details:
- Payer ID: 42
- Provider ID: 10389
- Billing Code Type: HCPCS
- Billing Code: J0896
- Networks: ['GA BLUE VALUE IND NETWORK 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '10389'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0896'
AND product_network_label IN ('GA BLUE VALUE IND NETWORK 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 = '10389'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0896'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 194
Sample Record Details:
- Payer ID: 44
- Provider ID: 1110
- Billing Code Type: HCPCS
- Billing Code: D7411
- 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_08.core_rates
WHERE payer_id = '44'
AND provider_id = '1110'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7411'
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 = '1110'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7411'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 195
Sample Record Details:
- Payer ID: 151
- Provider ID: 2684
- Billing Code Type: APR-DRG
- Billing Code: 0115-4
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2684'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0115-4'
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 = '2684'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0115-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 196
Sample Record Details:
- Payer ID: 643
- Provider ID: 3002
- Billing Code Type: HCPCS
- Billing Code: J1990
- Networks: ['NEXUS ACO OAP']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '3002'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1990'
AND product_network_label IN ('NEXUS ACO OAP')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3002'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1990'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 197
Sample Record Details:
- Payer ID: 151
- Provider ID: 2116
- Billing Code Type: HCPCS
- Billing Code: 27178
- 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_08.core_rates
WHERE payer_id = '151'
AND provider_id = '2116'
AND billing_code_type = 'HCPCS'
AND billing_code = '27178'
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 = '2116'
AND billing_code_type = 'HCPCS'
AND billing_code = '27178'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 198
Sample Record Details:
- Payer ID: 76
- Provider ID: 3863
- Billing Code Type: HCPCS
- Billing Code: J1413
- Networks: ['LOCALPLUS']
Core Rates Lookup Results
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '3863'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1413'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3863'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1413'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 199
Sample Record Details:
- Payer ID: 42
- Provider ID: 10622
- Billing Code Type: HCPCS
- Billing Code: J7332
- Networks: ['CA BLUE CROSS 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_08.core_rates
WHERE payer_id = '42'
AND provider_id = '10622'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7332'
AND product_network_label IN ('CA BLUE CROSS 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 = '10622'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7332'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 200
Sample Record Details:
- Payer ID: 643
- Provider ID: 2014
- Billing Code Type: HCPCS
- Billing Code: 90630
- 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_08.core_rates
WHERE payer_id = '643'
AND provider_id = '2014'
AND billing_code_type = 'HCPCS'
AND billing_code = '90630'
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 = '2014'
AND billing_code_type = 'HCPCS'
AND billing_code = '90630'
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: 10 (avg: 0.050)
This analysis provides insights into the potential for filling coverage gaps by integrating data from core_rates and hospital_rates tables.