v2_2_1
Core Rates Month: 2025_08 Generated: 2025-11-03 22:14:28
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: 2,697,227,119.0
- Records with canonical_rate: 875,175,373.0
- Records without canonical_rate: 1,822,051,746.0
- 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_1.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 | 47,511,372 | 3,946,074 | 43,565,298 | 8.0% | 92.0% |
| Laboratory | 12,850,006 | 2,858,563 | 9,991,443 | 22.0% | 78.0% |
| ASC | 191,636,067 | 56,733,353 | 134,902,714 | 30.0% | 70.0% |
| Physician Group | 1,668,956,240 | 509,303,847 | 1,159,652,393 | 31.0% | 69.0% |
| Hospital | 776,273,434 | 302,333,536 | 473,939,898 | 39.0% | 61.0% |
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_1.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: 111
- Provider ID: 1112
- Billing Code Type: HCPCS
- Billing Code: 47371
- 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 = '1112'
AND billing_code_type = 'HCPCS'
AND billing_code = '47371'
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 = '1112'
AND billing_code_type = 'HCPCS'
AND billing_code = '47371'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 2​
Sample Record Details:
- Payer ID: 354
- Provider ID: 872
- Billing Code Type: HCPCS
- Billing Code: J9050
- 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 = '872'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9050'
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 = '872'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9050'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 3​
Sample Record Details:
- Payer ID: 42
- Provider ID: 3232
- Billing Code Type: HCPCS
- Billing Code: 15953
- Networks: ['KY HMO', 'KY PATHWAY X HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '42'
AND provider_id = '3232'
AND billing_code_type = 'HCPCS'
AND billing_code = '15953'
AND product_network_label IN ('KY HMO', 'KY PATHWAY X HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '3232'
AND billing_code_type = 'HCPCS'
AND billing_code = '15953'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 4​
Sample Record Details:
- Payer ID: 403
- Provider ID: 6447
- Billing Code Type: HCPCS
- Billing Code: A9800
- 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 = '6447'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9800'
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 = '6447'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9800'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 5​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1504
- Billing Code Type: HCPCS
- Billing Code: 92274
- 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 = '1504'
AND billing_code_type = 'HCPCS'
AND billing_code = '92274'
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 = '1504'
AND billing_code_type = 'HCPCS'
AND billing_code = '92274'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 6​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9033
- Billing Code Type: HCPCS
- Billing Code: 94011
- 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 = '9033'
AND billing_code_type = 'HCPCS'
AND billing_code = '94011'
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 = '9033'
AND billing_code_type = 'HCPCS'
AND billing_code = '94011'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 7​
Sample Record Details:
- Payer ID: 799
- Provider ID: 2784
- Billing Code Type: MS-DRG
- Billing Code: 271
- Networks: ['QUARTZ TIERED CHOICE PLUS (QHBPC WI): QUARTZ']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '799'
AND provider_id = '2784'
AND billing_code_type = 'MS-DRG'
AND billing_code = '271'
AND product_network_label IN ('QUARTZ TIERED CHOICE PLUS (QHBPC WI): QUARTZ')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 799
AND provider_id = '2784'
AND billing_code_type = 'MS-DRG'
AND billing_code = '271'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 8​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2375
- Billing Code Type: HCPCS
- Billing Code: 52301
- 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 = '2375'
AND billing_code_type = 'HCPCS'
AND billing_code = '52301'
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 = '2375'
AND billing_code_type = 'HCPCS'
AND billing_code = '52301'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 9​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1587
- Billing Code Type: HCPCS
- Billing Code: 46615
- 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 = '1587'
AND billing_code_type = 'HCPCS'
AND billing_code = '46615'
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 = '1587'
AND billing_code_type = 'HCPCS'
AND billing_code = '46615'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 10​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2654
- Billing Code Type: MS-DRG
- Billing Code: 513
- 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 = '2654'
AND billing_code_type = 'MS-DRG'
AND billing_code = '513'
AND product_network_label IN ('NAVIGATE')
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 | 2654 | MS-DRG | 513 | Facility | Inpatient | UHC COMM - ALL OTHER PLANS | UHC COMM - ALL OTHER PLANS | 16,758.72 | 7600.0% | 16,758.72 | 41945656aeb84e9abc877a6d8e210020 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2654'
AND billing_code_type = 'MS-DRG'
AND billing_code = '513'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 11​
Sample Record Details:
- Payer ID: 774
- Provider ID: 7159
- Billing Code Type: HCPCS
- Billing Code: 19330
- 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 = '7159'
AND billing_code_type = 'HCPCS'
AND billing_code = '19330'
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 = '7159'
AND billing_code_type = 'HCPCS'
AND billing_code = '19330'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 12​
Sample Record Details:
- Payer ID: 151
- Provider ID: 7156
- Billing Code Type: HCPCS
- Billing Code: 27437
- 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 = '7156'
AND billing_code_type = 'HCPCS'
AND billing_code = '27437'
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 = '7156'
AND billing_code_type = 'HCPCS'
AND billing_code = '27437'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 13​
Sample Record Details:
- Payer ID: 388
- Provider ID: 2182
- Billing Code Type: HCPCS
- Billing Code: 26992
- Networks: ['BLUECHOICE 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 = '388'
AND provider_id = '2182'
AND billing_code_type = 'HCPCS'
AND billing_code = '26992'
AND product_network_label IN ('BLUECHOICE 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 = 388
AND provider_id = '2182'
AND billing_code_type = 'HCPCS'
AND billing_code = '26992'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 14​
Sample Record Details:
- Payer ID: 633
- Provider ID: 5330
- Billing Code Type: HCPCS
- Billing Code: 92653
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '633'
AND provider_id = '5330'
AND billing_code_type = 'HCPCS'
AND billing_code = '92653'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '5330'
AND billing_code_type = 'HCPCS'
AND billing_code = '92653'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 15​
Sample Record Details:
- Payer ID: 76
- Provider ID: 532
- Billing Code Type: HCPCS
- Billing Code: 25650
- 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 = '532'
AND billing_code_type = 'HCPCS'
AND billing_code = '25650'
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 = '532'
AND billing_code_type = 'HCPCS'
AND billing_code = '25650'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 16​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8040
- Billing Code Type: APR-DRG
- Billing Code: 0049-2
- Networks: ['IL INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '7'
AND provider_id = '8040'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0049-2'
AND product_network_label IN ('IL INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8040'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0049-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 17​
Sample Record Details:
- Payer ID: 151
- Provider ID: 8911
- Billing Code Type: APR-DRG
- Billing Code: 0470-1
- 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 = '8911'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0470-1'
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 = '8911'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0470-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 18​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5433
- Billing Code Type: HCPCS
- Billing Code: Q5116
- 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 = '5433'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5116'
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 = '5433'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5116'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 19​
Sample Record Details:
- Payer ID: 456
- Provider ID: 3666
- Billing Code Type: APR-DRG
- Billing Code: 0862-4
- Networks: ['PREFERRED PROVIDER NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '456'
AND provider_id = '3666'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0862-4'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 456
AND provider_id = '3666'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0862-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 20​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5412
- Billing Code Type: APR-DRG
- Billing Code: 0206-4
- 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 = '5412'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0206-4'
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 = '5412'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0206-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 21​
Sample Record Details:
- Payer ID: 522
- Provider ID: 9150
- Billing Code Type: HCPCS
- Billing Code: 23921
- Networks: ['KFHP NORTHERN CALIFORNIA', 'KFHP SOUTHERN CALIFORNIA', 'KPIC NORTHERN CALIFORNIA', 'KPIC SOUTHERN CALIFORNIA']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '9150'
AND billing_code_type = 'HCPCS'
AND billing_code = '23921'
AND product_network_label IN ('KFHP NORTHERN CALIFORNIA', 'KFHP SOUTHERN CALIFORNIA', 'KPIC NORTHERN CALIFORNIA', 'KPIC SOUTHERN CALIFORNIA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '9150'
AND billing_code_type = 'HCPCS'
AND billing_code = '23921'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 22​
Sample Record Details:
- Payer ID: 42
- Provider ID: 1052
- Billing Code Type: HCPCS
- Billing Code: 10121
- 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 = '42'
AND provider_id = '1052'
AND billing_code_type = 'HCPCS'
AND billing_code = '10121'
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 = 42
AND provider_id = '1052'
AND billing_code_type = 'HCPCS'
AND billing_code = '10121'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 23​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2746
- Billing Code Type: HCPCS
- Billing Code: J9160
- 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 = '2746'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9160'
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 = '2746'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9160'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 24​
Sample Record Details:
- Payer ID: 728
- Provider ID: 9574
- Billing Code Type: HCPCS
- Billing Code: 70330
- 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 = '9574'
AND billing_code_type = 'HCPCS'
AND billing_code = '70330'
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 = '9574'
AND billing_code_type = 'HCPCS'
AND billing_code = '70330'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 25​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6225
- Billing Code Type: HCPCS
- Billing Code: 91321
- 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 = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = '91321'
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 = '6225'
AND billing_code_type = 'HCPCS'
AND billing_code = '91321'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 26​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2164
- Billing Code Type: HCPCS
- Billing Code: 55980
- Networks: ['SOUTH FLORIDA HMO', 'FLORIDA 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 = '2164'
AND billing_code_type = 'HCPCS'
AND billing_code = '55980'
AND product_network_label IN ('SOUTH FLORIDA HMO', 'FLORIDA 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 = '2164'
AND billing_code_type = 'HCPCS'
AND billing_code = '55980'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 27​
Sample Record Details:
- Payer ID: 229
- Provider ID: 10651
- Billing Code Type: APR-DRG
- Billing Code: 0183-3
- 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 = '10651'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0183-3'
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 = '10651'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0183-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 28​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1303
- Billing Code Type: HCPCS
- Billing Code: 28153
- 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 = '1303'
AND billing_code_type = 'HCPCS'
AND billing_code = '28153'
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 = '1303'
AND billing_code_type = 'HCPCS'
AND billing_code = '28153'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 29​
Sample Record Details:
- Payer ID: 398
- Provider ID: 3464
- Billing Code Type: HCPCS
- Billing Code: J9280
- 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 = '398'
AND provider_id = '3464'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9280'
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 = 398
AND provider_id = '3464'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9280'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 30​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2825
- Billing Code Type: HCPCS
- Billing Code: J7070
- 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 = 'HCPCS'
AND billing_code = 'J7070'
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 = 'HCPCS'
AND billing_code = 'J7070'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 31​
Sample Record Details:
- Payer ID: 774
- Provider ID: 862
- Billing Code Type: HCPCS
- Billing Code: 64632
- 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 = '862'
AND billing_code_type = 'HCPCS'
AND billing_code = '64632'
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 = '862'
AND billing_code_type = 'HCPCS'
AND billing_code = '64632'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 32​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4614
- Billing Code Type: HCPCS
- Billing Code: 92136
- 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 = '4614'
AND billing_code_type = 'HCPCS'
AND billing_code = '92136'
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 = '4614'
AND billing_code_type = 'HCPCS'
AND billing_code = '92136'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 33​
Sample Record Details:
- Payer ID: 7
- Provider ID: 742
- Billing Code Type: HCPCS
- Billing Code: 27514
- 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 = '742'
AND billing_code_type = 'HCPCS'
AND billing_code = '27514'
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 = '742'
AND billing_code_type = 'HCPCS'
AND billing_code = '27514'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 34​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1744
- Billing Code Type: HCPCS
- Billing Code: Q2028
- 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 = '1744'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2028'
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 = '1744'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2028'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 35​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1660
- Billing Code Type: APR-DRG
- Billing Code: 0626-4
- Networks: ['NORTH CAROLINA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '1660'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0626-4'
AND product_network_label IN ('NORTH CAROLINA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '1660'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0626-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 36​
Sample Record Details:
- Payer ID: 389
- Provider ID: 2805
- Billing Code Type: HCPCS
- Billing Code: 29730
- Networks: ['PPO PARTICIPATING PROVIDER OPTIONS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '389'
AND provider_id = '2805'
AND billing_code_type = 'HCPCS'
AND billing_code = '29730'
AND product_network_label IN ('PPO PARTICIPATING PROVIDER OPTIONS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 389
AND provider_id = '2805'
AND billing_code_type = 'HCPCS'
AND billing_code = '29730'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 37​
Sample Record Details:
- Payer ID: 97
- Provider ID: 897
- Billing Code Type: HCPCS
- Billing Code: 67318
- Networks: ['HIP 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 = '97'
AND provider_id = '897'
AND billing_code_type = 'HCPCS'
AND billing_code = '67318'
AND product_network_label IN ('HIP 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 = 97
AND provider_id = '897'
AND billing_code_type = 'HCPCS'
AND billing_code = '67318'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 38​
Sample Record Details:
- Payer ID: 774
- Provider ID: 860
- Billing Code Type: HCPCS
- Billing Code: J9380
- 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 = '860'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9380'
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 = '860'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9380'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 39​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2526
- Billing Code Type: HCPCS
- Billing Code: 0239U
- 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 = '2526'
AND billing_code_type = 'HCPCS'
AND billing_code = '0239U'
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 = '2526'
AND billing_code_type = 'HCPCS'
AND billing_code = '0239U'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 40​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5586
- Billing Code Type: HCPCS
- Billing Code: 57240
- 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 = '5586'
AND billing_code_type = 'HCPCS'
AND billing_code = '57240'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 20 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 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCARE | UNITED_HEALTHCARE | 9500.0% | 3,024.80 | d2fc032e6dcf495199973a7ca7784a1b | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UHCOXFORD | UHC_OXFORD | 9500.0% | 3,024.80 | 8456dd9a969646d6a8cdd5bcada6be74 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | APWUBILLTOUHC | APWU_BILL_TO_UHC | 9500.0% | 3,024.80 | 96ff4cb6b57849528c023db7ad5504af | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | HPHCUNITEDHEALTH | HPHC_UNITED_HEALTH | 9500.0% | 3,024.80 | 22ab72e6e7c94b3bb5a13cd85214203a | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | NTCABENEFITSUHC | NTCA_BENEFITS_UHC | 9500.0% | 3,024.80 | efe2506d2cf942dfb21e049c96e910f2 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | GEHABILLTOUNITEDHEALTHINTGRD | GEHA_BILL_TO_UNITEDHEALTH_INTGRD | 9500.0% | 3,024.80 | b6c3a2c7ed24435388a8698fc99bf098 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDBEHAVIORALHEALTH | UNITED_BEHAVIORAL_HEALTH | 9500.0% | 3,024.80 | ef380bd7ff164ed1bc978527c364bdec | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDBEHAVIORALHEALTH | UNITED_BEHAVIORAL_HEALTH | 9500.0% | 3,024.80 | 8a52b62a07c045798a64a19d196a93f2 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCAREAARP | UNITED_HEALTHCARE_AARP | 9500.0% | 3,024.80 | 1fc8981be5284b9dbae704052b03482a | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UHCINTERNATIONAL | UHC_INTERNATIONAL | 9500.0% | 3,024.80 | aa4214c41d684e3eae210436e3c15c50 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCARE2NDPOLICY | UNITED_HEALTHCARE_2ND_POLICY | 9500.0% | 3,024.80 | 20ad04ec793b4ba3bda7b7fc256178af | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | HPHCUNITEDHEALTH | HPHC_UNITED_HEALTH | 9500.0% | 3,024.80 | 5a6dbe88de7147cb99e2dae3ccdf7309 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UHCOXFORD | UHC_OXFORD | 9500.0% | 3,024.80 | 6cfdb0827a034425a8508c11b8490497 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCARE2NDPOLICY | UNITED_HEALTHCARE_2ND_POLICY | 9500.0% | 3,024.80 | 1b634ce7faa94f1388610b9f3a20cfe0 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCAREAARP | UNITED_HEALTHCARE_AARP | 9500.0% | 3,024.80 | e80fdee8e1c34c0a8f4844b6968478a5 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | APWUBILLTOUHC | APWU_BILL_TO_UHC | 9500.0% | 3,024.80 | 9990183ce8284e20a3dd65917a411b07 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | NTCABENEFITSUHC | NTCA_BENEFITS_UHC | 9500.0% | 3,024.80 | 0905d4ac99b04ce180826c02d4cb210d | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UHCINTERNATIONAL | UHC_INTERNATIONAL | 9500.0% | 3,024.80 | e76db49613f14aefb2fff3910f691743 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | GEHABILLTOUNITEDHEALTHINTGRD | GEHA_BILL_TO_UNITEDHEALTH_INTGRD | 9500.0% | 3,024.80 | 935b5c41b02e477c8e854e4c3e515992 | ||||
| 643 | 5586 | HCPCS | 57240 | Inpatient & Outpatient | UNITEDHEALTHCARE | UNITED_HEALTHCARE | 9500.0% | 3,024.80 | f4107245ef3043bbb76eb506e5e08647 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5586'
AND billing_code_type = 'HCPCS'
AND billing_code = '57240'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 41​
Sample Record Details:
- Payer ID: 42
- Provider ID: 6277
- Billing Code Type: APR-DRG
- Billing Code: 0775-2
- 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 = '6277'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0775-2'
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 = '6277'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0775-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 42​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4462
- Billing Code Type: HCPCS
- Billing Code: 17004
- 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 = '4462'
AND billing_code_type = 'HCPCS'
AND billing_code = '17004'
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 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 151 | 4462 | HCPCS | 17004 | Inpatient | 587_AMBETTER SUNFLOWER INPATIENT 20241001 | AMBETTER | 17000.0% | bbaa807afa7041e8a3c5c92cc2742d86 | |||||
| 151 | 4462 | HCPCS | 17004 | Outpatient | 539_AMBETTER SUNFLOWER OUTPATIENT 20230101 | AMBETTER | 17000.0% | e081ee3ac9634c4d98d5ac685d9c7132 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '4462'
AND billing_code_type = 'HCPCS'
AND billing_code = '17004'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 43​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4059
- Billing Code Type: HCPCS
- Billing Code: 58323
- 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 = '4059'
AND billing_code_type = 'HCPCS'
AND billing_code = '58323'
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 = '4059'
AND billing_code_type = 'HCPCS'
AND billing_code = '58323'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 44​
Sample Record Details:
- Payer ID: 356
- Provider ID: 2765
- Billing Code Type: HCPCS
- Billing Code: 28002
- Networks: ['ALLIANCE WPS STATEWIDE FIRST HEALTH WPS HEALTH INSURANCE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '356'
AND provider_id = '2765'
AND billing_code_type = 'HCPCS'
AND billing_code = '28002'
AND product_network_label IN ('ALLIANCE WPS STATEWIDE FIRST HEALTH WPS HEALTH INSURANCE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 356
AND provider_id = '2765'
AND billing_code_type = 'HCPCS'
AND billing_code = '28002'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 45​
Sample Record Details:
- Payer ID: 391
- Provider ID: 4700
- Billing Code Type: HCPCS
- Billing Code: C9083
- 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 = '4700'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9083'
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 = '4700'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9083'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 46​
Sample Record Details:
- Payer ID: 391
- Provider ID: 4695
- Billing Code Type: HCPCS
- Billing Code: J9059
- 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 = '4695'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9059'
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 = '4695'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9059'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 47​
Sample Record Details:
- Payer ID: 791
- Provider ID: 5987
- Billing Code Type: HCPCS
- Billing Code: J1203
- Networks: ['MOTIVNET']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '791'
AND provider_id = '5987'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1203'
AND product_network_label IN ('MOTIVNET')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 791
AND provider_id = '5987'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1203'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 48​
Sample Record Details:
- Payer ID: 305
- Provider ID: 3834
- Billing Code Type: HCPCS
- Billing Code: 21812
- Networks: ['BROAD 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 = '305'
AND provider_id = '3834'
AND billing_code_type = 'HCPCS'
AND billing_code = '21812'
AND product_network_label IN ('BROAD 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 = 305
AND provider_id = '3834'
AND billing_code_type = 'HCPCS'
AND billing_code = '21812'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 49​
Sample Record Details:
- Payer ID: 403
- Provider ID: 6495
- Billing Code Type: APR-DRG
- Billing Code: 0247-4
- 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 = '403'
AND provider_id = '6495'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0247-4'
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 = 403
AND provider_id = '6495'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0247-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 50​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3324
- Billing Code Type: HCPCS
- Billing Code: 77085
- 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 = '3324'
AND billing_code_type = 'HCPCS'
AND billing_code = '77085'
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 = '3324'
AND billing_code_type = 'HCPCS'
AND billing_code = '77085'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 51​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5235
- Billing Code Type: HCPCS
- Billing Code: 64595
- 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 = '5235'
AND billing_code_type = 'HCPCS'
AND billing_code = '64595'
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 = '5235'
AND billing_code_type = 'HCPCS'
AND billing_code = '64595'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 52​
Sample Record Details:
- Payer ID: 643
- Provider ID: 8321
- Billing Code Type: HCPCS
- Billing Code: D7321
- 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 = '8321'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7321'
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 = '8321'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7321'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 53​
Sample Record Details:
- Payer ID: 169
- Provider ID: 8536
- Billing Code Type: MS-DRG
- Billing Code: 250
- Networks: ['BLUE ADVANTAGE HMO', 'MYBLUE HEALTH HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '169'
AND provider_id = '8536'
AND billing_code_type = 'MS-DRG'
AND billing_code = '250'
AND product_network_label IN ('BLUE ADVANTAGE HMO', 'MYBLUE HEALTH HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 169
AND provider_id = '8536'
AND billing_code_type = 'MS-DRG'
AND billing_code = '250'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 54​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9299
- Billing Code Type: HCPCS
- Billing Code: 22899
- 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 = '9299'
AND billing_code_type = 'HCPCS'
AND billing_code = '22899'
AND product_network_label IN ('NEXUS ACO OAP')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 9299 | HCPCS | 22899 | Facility | 360 | Outpatient | HMO/PPO/POS/INDEMNITY | UHC | 3,298.00 | 8c81ff1c93204df0b4c14d35ddb9941a | |||
| 643 | 9299 | HCPCS | 22899 | Facility | 360 | Outpatient | HMO/PPO/POS/INDEMNITY | UHC | 3,298.00 | b8505672b9674e46bcd8bd98a2f90e76 | |||
| 643 | 9299 | HCPCS | 22899 | Facility | 360 | Outpatient | HMO/PPO/POS/INDEMNITY | UHC | 3,298.00 | 3486b7f933574428be2a3b7a90a3fa95 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '9299'
AND billing_code_type = 'HCPCS'
AND billing_code = '22899'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 55​
Sample Record Details:
- Payer ID: 76
- Provider ID: 973
- Billing Code Type: HCPCS
- Billing Code: 0275T
- 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 = '973'
AND billing_code_type = 'HCPCS'
AND billing_code = '0275T'
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 = '973'
AND billing_code_type = 'HCPCS'
AND billing_code = '0275T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 56​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6728
- Billing Code Type: HCPCS
- Billing Code: 29822
- 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 = '6728'
AND billing_code_type = 'HCPCS'
AND billing_code = '29822'
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 | 6728 | HCPCS | 29822 | Outpatient | MCDHMO | UHC | 521.33 | 43cc69c7f5a84366912bdf7d334226c6 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6728'
AND billing_code_type = 'HCPCS'
AND billing_code = '29822'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 57​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3289
- Billing Code Type: HCPCS
- Billing Code: J0589
- 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 = '3289'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0589'
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 = '3289'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0589'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 58​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4592
- Billing Code Type: APR-DRG
- Billing Code: 0205-1
- 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 = '4592'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0205-1'
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 = '4592'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0205-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 59​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3162
- Billing Code Type: HCPCS
- Billing Code: 78597
- 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 = '3162'
AND billing_code_type = 'HCPCS'
AND billing_code = '78597'
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 = '3162'
AND billing_code_type = 'HCPCS'
AND billing_code = '78597'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 60​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9233
- Billing Code Type: HCPCS
- Billing Code: 28050
- 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 = '9233'
AND billing_code_type = 'HCPCS'
AND billing_code = '28050'
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 = '9233'
AND billing_code_type = 'HCPCS'
AND billing_code = '28050'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 61​
Sample Record Details:
- Payer ID: 522
- Provider ID: 5787
- Billing Code Type: APR-DRG
- Billing Code: 0193-3
- Networks: ['KFHP COLORADO', 'KPIC COLORADO', 'SELF FUNDED COLORADO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '5787'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0193-3'
AND product_network_label IN ('KFHP COLORADO', 'KPIC COLORADO', 'SELF FUNDED COLORADO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5787'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0193-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 62​
Sample Record Details:
- Payer ID: 643
- Provider ID: 828
- Billing Code Type: APR-DRG
- Billing Code: 0114-2
- 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 = '828'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0114-2'
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 = '828'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0114-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 63​
Sample Record Details:
- Payer ID: 76
- Provider ID: 3133
- Billing Code Type: HCPCS
- Billing Code: 35231
- 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 = '3133'
AND billing_code_type = 'HCPCS'
AND billing_code = '35231'
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 = '3133'
AND billing_code_type = 'HCPCS'
AND billing_code = '35231'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 64​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2245
- Billing Code Type: HCPCS
- Billing Code: 20697
- 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 = '2245'
AND billing_code_type = 'HCPCS'
AND billing_code = '20697'
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 = '2245'
AND billing_code_type = 'HCPCS'
AND billing_code = '20697'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 65​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5963
- Billing Code Type: HCPCS
- Billing Code: 0339T
- 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 = '5963'
AND billing_code_type = 'HCPCS'
AND billing_code = '0339T'
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 = '5963'
AND billing_code_type = 'HCPCS'
AND billing_code = '0339T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 66​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9650
- Billing Code Type: HCPCS
- Billing Code: 63685
- 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 = '9650'
AND billing_code_type = 'HCPCS'
AND billing_code = '63685'
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 = '9650'
AND billing_code_type = 'HCPCS'
AND billing_code = '63685'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 67​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5829
- Billing Code Type: MS-DRG
- Billing Code: 282
- 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 = '5829'
AND billing_code_type = 'MS-DRG'
AND billing_code = '282'
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 = '5829'
AND billing_code_type = 'MS-DRG'
AND billing_code = '282'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 68​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1001
- Billing Code Type: HCPCS
- Billing Code: J9265
- 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 = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9265'
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 = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9265'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 69​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3926
- Billing Code Type: HCPCS
- Billing Code: 74425
- 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 = '3926'
AND billing_code_type = 'HCPCS'
AND billing_code = '74425'
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 = '3926'
AND billing_code_type = 'HCPCS'
AND billing_code = '74425'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 70​
Sample Record Details:
- Payer ID: 42
- Provider ID: 1488
- Billing Code Type: HCPCS
- Billing Code: 88125
- Networks: ['VA KEYCARE 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 = '1488'
AND billing_code_type = 'HCPCS'
AND billing_code = '88125'
AND product_network_label IN ('VA KEYCARE 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 = '1488'
AND billing_code_type = 'HCPCS'
AND billing_code = '88125'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 71​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6681
- Billing Code Type: HCPCS
- Billing Code: 0799T
- Networks: ['SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '6681'
AND billing_code_type = 'HCPCS'
AND billing_code = '0799T'
AND product_network_label IN ('SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6681'
AND billing_code_type = 'HCPCS'
AND billing_code = '0799T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 72​
Sample Record Details:
- Payer ID: 7
- Provider ID: 3134
- Billing Code Type: HCPCS
- Billing Code: 93799
- 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 = '3134'
AND billing_code_type = 'HCPCS'
AND billing_code = '93799'
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 = '3134'
AND billing_code_type = 'HCPCS'
AND billing_code = '93799'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 73​
Sample Record Details:
- Payer ID: 774
- Provider ID: 1033
- Billing Code Type: HCPCS
- Billing Code: Q4138
- 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 = '1033'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4138'
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 = '1033'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4138'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 74​
Sample Record Details:
- Payer ID: 168
- Provider ID: 1688
- Billing Code Type: APR-DRG
- Billing Code: 0051-4
- Networks: ['HMO - PRIMARY 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 = '168'
AND provider_id = '1688'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0051-4'
AND product_network_label IN ('HMO - PRIMARY 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 = 168
AND provider_id = '1688'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0051-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 75​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5227
- Billing Code Type: HCPCS
- Billing Code: J2185
- 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 = '5227'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2185'
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 = '5227'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2185'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 76​
Sample Record Details:
- Payer ID: 76
- Provider ID: 3520
- Billing Code Type: HCPCS
- Billing Code: 0780T
- 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 = '3520'
AND billing_code_type = 'HCPCS'
AND billing_code = '0780T'
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 = '3520'
AND billing_code_type = 'HCPCS'
AND billing_code = '0780T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 77​
Sample Record Details:
- Payer ID: 42
- Provider ID: 608
- Billing Code Type: HCPCS
- Billing Code: 92546
- Networks: ['NH HMO', 'BLUECARD - BLUE CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '42'
AND provider_id = '608'
AND billing_code_type = 'HCPCS'
AND billing_code = '92546'
AND product_network_label IN ('NH HMO', 'BLUECARD - BLUE CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '608'
AND billing_code_type = 'HCPCS'
AND billing_code = '92546'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 78​
Sample Record Details:
- Payer ID: 389
- Provider ID: 253
- Billing Code Type: HCPCS
- Billing Code: 11646
- Networks: ['PPO PARTICIPATING PROVIDER OPTIONS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '389'
AND provider_id = '253'
AND billing_code_type = 'HCPCS'
AND billing_code = '11646'
AND product_network_label IN ('PPO PARTICIPATING PROVIDER OPTIONS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 389
AND provider_id = '253'
AND billing_code_type = 'HCPCS'
AND billing_code = '11646'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 79​
Sample Record Details:
- Payer ID: 461
- Provider ID: 3885
- Billing Code Type: HCPCS
- Billing Code: 70310
- 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 = '3885'
AND billing_code_type = 'HCPCS'
AND billing_code = '70310'
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 = '3885'
AND billing_code_type = 'HCPCS'
AND billing_code = '70310'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 80​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9954
- Billing Code Type: HCPCS
- Billing Code: Q5123
- 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 = '9954'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5123'
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 = '9954'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5123'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 81​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4584
- Billing Code Type: HCPCS
- Billing Code: A9593
- 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 = '4584'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9593'
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 = '4584'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9593'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 82​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1732
- Billing Code Type: HCPCS
- Billing Code: 69666
- 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 = '1732'
AND billing_code_type = 'HCPCS'
AND billing_code = '69666'
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 = '1732'
AND billing_code_type = 'HCPCS'
AND billing_code = '69666'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 83​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5638
- Billing Code Type: HCPCS
- Billing Code: 89258
- 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 = '5638'
AND billing_code_type = 'HCPCS'
AND billing_code = '89258'
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 = '5638'
AND billing_code_type = 'HCPCS'
AND billing_code = '89258'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 84​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6018
- Billing Code Type: HCPCS
- Billing Code: 19371
- 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 = '6018'
AND billing_code_type = 'HCPCS'
AND billing_code = '19371'
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 = '6018'
AND billing_code_type = 'HCPCS'
AND billing_code = '19371'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 85​
Sample Record Details:
- Payer ID: 774
- Provider ID: 833
- Billing Code Type: HCPCS
- Billing Code: 42650
- 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 = '833'
AND billing_code_type = 'HCPCS'
AND billing_code = '42650'
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 = '833'
AND billing_code_type = 'HCPCS'
AND billing_code = '42650'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 86​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10554
- Billing Code Type: HCPCS
- Billing Code: 28103
- Networks: ['NV 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 = '42'
AND provider_id = '10554'
AND billing_code_type = 'HCPCS'
AND billing_code = '28103'
AND product_network_label IN ('NV 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 = 42
AND provider_id = '10554'
AND billing_code_type = 'HCPCS'
AND billing_code = '28103'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 87​
Sample Record Details:
- Payer ID: 7
- Provider ID: 9033
- Billing Code Type: HCPCS
- Billing Code: 73219
- 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 = '9033'
AND billing_code_type = 'HCPCS'
AND billing_code = '73219'
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 = '9033'
AND billing_code_type = 'HCPCS'
AND billing_code = '73219'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 88​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6635
- Billing Code Type: MS-DRG
- Billing Code: 516
- 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 = '6635'
AND billing_code_type = 'MS-DRG'
AND billing_code = '516'
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 = '6635'
AND billing_code_type = 'MS-DRG'
AND billing_code = '516'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 89​
Sample Record Details:
- Payer ID: 7
- Provider ID: 4019
- Billing Code Type: HCPCS
- Billing Code: 22865
- 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 = '4019'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
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 = '4019'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 90​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1271
- Billing Code Type: HCPCS
- Billing Code: 93888
- 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 = '1271'
AND billing_code_type = 'HCPCS'
AND billing_code = '93888'
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 = '1271'
AND billing_code_type = 'HCPCS'
AND billing_code = '93888'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 91​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1603
- Billing Code Type: HCPCS
- Billing Code: 31500
- 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 = '1603'
AND billing_code_type = 'HCPCS'
AND billing_code = '31500'
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 = '1603'
AND billing_code_type = 'HCPCS'
AND billing_code = '31500'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 92​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2968
- Billing Code Type: HCPCS
- Billing Code: 29823
- 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 = '2968'
AND billing_code_type = 'HCPCS'
AND billing_code = '29823'
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 | 2968 | HCPCS | 29823 | Facility | Outpatient | UHC | UNITED HEALTHCARE | 9250.0% | 11,009.13 | 3226ff84a33a4141b8ac65417e9cff84 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2968'
AND billing_code_type = 'HCPCS'
AND billing_code = '29823'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 93​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4948
- Billing Code Type: HCPCS
- Billing Code: 73201
- 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 = '4948'
AND billing_code_type = 'HCPCS'
AND billing_code = '73201'
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 = '4948'
AND billing_code_type = 'HCPCS'
AND billing_code = '73201'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 94​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1516
- Billing Code Type: HCPCS
- Billing Code: 50434
- Networks: ['VA INDIVIDUAL HMO', 'DC GROUP HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '7'
AND provider_id = '1516'
AND billing_code_type = 'HCPCS'
AND billing_code = '50434'
AND product_network_label IN ('VA INDIVIDUAL HMO', 'DC GROUP HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1516'
AND billing_code_type = 'HCPCS'
AND billing_code = '50434'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 95​
Sample Record Details:
- Payer ID: 54
- Provider ID: 1316
- Billing Code Type: HCPCS
- Billing Code: 36835
- 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 = '1316'
AND billing_code_type = 'HCPCS'
AND billing_code = '36835'
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 = '1316'
AND billing_code_type = 'HCPCS'
AND billing_code = '36835'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 96​
Sample Record Details:
- Payer ID: 7
- Provider ID: 3895
- Billing Code Type: HCPCS
- Billing Code: J3373
- 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 = '3895'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3373'
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 = '3895'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3373'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 97​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8921
- Billing Code Type: HCPCS
- Billing Code: 10030
- 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 = '8921'
AND billing_code_type = 'HCPCS'
AND billing_code = '10030'
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 = '8921'
AND billing_code_type = 'HCPCS'
AND billing_code = '10030'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 98​
Sample Record Details:
- Payer ID: 389
- Provider ID: 2720
- Billing Code Type: HCPCS
- Billing Code: 64620
- Networks: ['PPO PARTICIPATING PROVIDER OPTIONS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '389'
AND provider_id = '2720'
AND billing_code_type = 'HCPCS'
AND billing_code = '64620'
AND product_network_label IN ('PPO PARTICIPATING PROVIDER OPTIONS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 389
AND provider_id = '2720'
AND billing_code_type = 'HCPCS'
AND billing_code = '64620'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 99​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1782
- Billing Code Type: APR-DRG
- Billing Code: 0073-1
- 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 = '1782'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0073-1'
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 = '1782'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0073-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 100​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2761
- Billing Code Type: HCPCS
- Billing Code: 0923T
- 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 = '2761'
AND billing_code_type = 'HCPCS'
AND billing_code = '0923T'
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 = '2761'
AND billing_code_type = 'HCPCS'
AND billing_code = '0923T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 101​
Sample Record Details:
- Payer ID: 42
- Provider ID: 629
- Billing Code Type: HCPCS
- Billing Code: J9342
- 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 = '629'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9342'
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 = '629'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9342'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 102​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1331
- Billing Code Type: HCPCS
- Billing Code: 43264
- 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 = '1331'
AND billing_code_type = 'HCPCS'
AND billing_code = '43264'
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 = '1331'
AND billing_code_type = 'HCPCS'
AND billing_code = '43264'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 103​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2749
- Billing Code Type: HCPCS
- Billing Code: 70360
- Networks: ['IN 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 = '2749'
AND billing_code_type = 'HCPCS'
AND billing_code = '70360'
AND product_network_label IN ('IN 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 = '2749'
AND billing_code_type = 'HCPCS'
AND billing_code = '70360'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 104​
Sample Record Details:
- Payer ID: 633
- Provider ID: 425
- Billing Code Type: HCPCS
- Billing Code: 57109
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '633'
AND provider_id = '425'
AND billing_code_type = 'HCPCS'
AND billing_code = '57109'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '425'
AND billing_code_type = 'HCPCS'
AND billing_code = '57109'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 105​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6366
- Billing Code Type: HCPCS
- Billing Code: 77789
- 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 = '6366'
AND billing_code_type = 'HCPCS'
AND billing_code = '77789'
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 = '6366'
AND billing_code_type = 'HCPCS'
AND billing_code = '77789'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 106​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5082
- Billing Code Type: HCPCS
- Billing Code: 65820
- 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 = '5082'
AND billing_code_type = 'HCPCS'
AND billing_code = '65820'
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 = '5082'
AND billing_code_type = 'HCPCS'
AND billing_code = '65820'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 107​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3711
- Billing Code Type: HCPCS
- Billing Code: C9054
- 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 = '3711'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9054'
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 = '3711'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9054'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 108​
Sample Record Details:
- Payer ID: 42
- Provider ID: 753
- Billing Code Type: HCPCS
- Billing Code: 24685
- Networks: ['CT HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '42'
AND provider_id = '753'
AND billing_code_type = 'HCPCS'
AND billing_code = '24685'
AND product_network_label IN ('CT HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '753'
AND billing_code_type = 'HCPCS'
AND billing_code = '24685'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 109​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6467
- Billing Code Type: HCPCS
- Billing Code: 25425
- 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 = '6467'
AND billing_code_type = 'HCPCS'
AND billing_code = '25425'
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 = '6467'
AND billing_code_type = 'HCPCS'
AND billing_code = '25425'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 110​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8395
- Billing Code Type: HCPCS
- Billing Code: 27050
- Networks: ['VA INDIVIDUAL HMO', 'DC GROUP HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '7'
AND provider_id = '8395'
AND billing_code_type = 'HCPCS'
AND billing_code = '27050'
AND product_network_label IN ('VA INDIVIDUAL HMO', 'DC GROUP HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '8395'
AND billing_code_type = 'HCPCS'
AND billing_code = '27050'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 111​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1331
- Billing Code Type: MS-DRG
- Billing Code: 560
- 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 = '1331'
AND billing_code_type = 'MS-DRG'
AND billing_code = '560'
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 = '1331'
AND billing_code_type = 'MS-DRG'
AND billing_code = '560'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 112​
Sample Record Details:
- Payer ID: 42
- Provider ID: 3266
- Billing Code Type: MS-DRG
- Billing Code: 907
- 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 = '3266'
AND billing_code_type = 'MS-DRG'
AND billing_code = '907'
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 6 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM PATH HMO | ANTHEM PATH HMO | 60,660.94 | 9d79bd7e07824173a52aac1d6cf10374 | ||||
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM BLUE PREF HMO/HIC | ANTHEM BLUE PREF HMO/HIC | 60,660.94 | f65f284404834377b3b90f84e86af93a | ||||
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM BLUE ACCESS PPO | ANTHEM BLUE ACCESS PPO | 60,660.94 | a29b4c4b2c4c40baa45931fc33e6c253 | ||||
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM BLUE TRAD - ALL OTHER PLANS | ANTHEM BLUE TRAD - ALL OTHER PLANS | 74,002.51 | 0860d1f635b9446f9a52e08e8698abee | ||||
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM BHS1 | ANTHEM BHS1 | 28,385.17 | 2463.0% | 9,473.44 | 8d1548d9966b476cb032013b56b06765 | ||
| 42 | 3266 | MS-DRG | 907 | Facility | Inpatient | ANTHEM PATH HPN | ANTHEM PATH HPN | 54,594.85 | 0ee9f7b8cc4d4288aab065a3e2162f05 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3266'
AND billing_code_type = 'MS-DRG'
AND billing_code = '907'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 113​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5553
- Billing Code Type: MS-DRG
- Billing Code: 804
- 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 = '5553'
AND billing_code_type = 'MS-DRG'
AND billing_code = '804'
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 = '5553'
AND billing_code_type = 'MS-DRG'
AND billing_code = '804'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 114​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5441
- Billing Code Type: HCPCS
- Billing Code: J0290
- 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 = '5441'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0290'
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 = '5441'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0290'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 115​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6662
- Billing Code Type: APR-DRG
- Billing Code: 0862-3
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '6662'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0862-3'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '6662'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0862-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 116​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6127
- Billing Code Type: HCPCS
- Billing Code: 77799
- 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 = '6127'
AND billing_code_type = 'HCPCS'
AND billing_code = '77799'
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 = '6127'
AND billing_code_type = 'HCPCS'
AND billing_code = '77799'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 117​
Sample Record Details:
- Payer ID: 7
- Provider ID: 10138
- Billing Code Type: HCPCS
- Billing Code: 30410
- 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 = '10138'
AND billing_code_type = 'HCPCS'
AND billing_code = '30410'
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 = '10138'
AND billing_code_type = 'HCPCS'
AND billing_code = '30410'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 118​
Sample Record Details:
- Payer ID: 272
- Provider ID: 2358
- Billing Code Type: HCPCS
- Billing Code: 28072
- 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 = '2358'
AND billing_code_type = 'HCPCS'
AND billing_code = '28072'
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 = '2358'
AND billing_code_type = 'HCPCS'
AND billing_code = '28072'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 119​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4227
- Billing Code Type: APR-DRG
- Billing Code: 0169-3
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '4227'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-3'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '4227'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 120​
Sample Record Details:
- Payer ID: 958
- Provider ID: 997
- Billing Code Type: HCPCS
- Billing Code: 31573
- 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 = '997'
AND billing_code_type = 'HCPCS'
AND billing_code = '31573'
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 = '997'
AND billing_code_type = 'HCPCS'
AND billing_code = '31573'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 121​
Sample Record Details:
- Payer ID: 111
- Provider ID: 7160
- Billing Code Type: HCPCS
- Billing Code: C9093
- 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 = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9093'
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 = '7160'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9093'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 122​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6599
- Billing Code Type: HCPCS
- Billing Code: 92517
- Networks: ['SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '76'
AND provider_id = '6599'
AND billing_code_type = 'HCPCS'
AND billing_code = '92517'
AND product_network_label IN ('SAN FRANCISCO SACRAMENTO HMO', 'SOUTHERN CA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '6599'
AND billing_code_type = 'HCPCS'
AND billing_code = '92517'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 123​
Sample Record Details:
- Payer ID: 97
- Provider ID: 326
- Billing Code Type: HCPCS
- Billing Code: 25390
- Networks: ['GHI 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 = '97'
AND provider_id = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = '25390'
AND product_network_label IN ('GHI 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 = 97
AND provider_id = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = '25390'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 124​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10472
- Billing Code Type: HCPCS
- Billing Code: 0524T
- 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 = '10472'
AND billing_code_type = 'HCPCS'
AND billing_code = '0524T'
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 = '10472'
AND billing_code_type = 'HCPCS'
AND billing_code = '0524T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 125​
Sample Record Details:
- Payer ID: 643
- Provider ID: 864
- Billing Code Type: HCPCS
- Billing Code: 54560
- 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 = '864'
AND billing_code_type = 'HCPCS'
AND billing_code = '54560'
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 = '864'
AND billing_code_type = 'HCPCS'
AND billing_code = '54560'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 126​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6244
- Billing Code Type: HCPCS
- Billing Code: 25350
- 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 = '6244'
AND billing_code_type = 'HCPCS'
AND billing_code = '25350'
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 = '6244'
AND billing_code_type = 'HCPCS'
AND billing_code = '25350'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 127​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3277
- Billing Code Type: HCPCS
- Billing Code: 86077
- 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 = '3277'
AND billing_code_type = 'HCPCS'
AND billing_code = '86077'
AND product_network_label IN ('NAVIGATE')
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 | 3277 | HCPCS | 86077 | Facility | Outpatient | HMO | UNITEDHEALTHCARE | 89.16 | bc8bbc9e274b40e7a5978fe1b1e7a938 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3277'
AND billing_code_type = 'HCPCS'
AND billing_code = '86077'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 128​
Sample Record Details:
- Payer ID: 356
- Provider ID: 3097
- Billing Code Type: HCPCS
- Billing Code: J9029
- Networks: ['ALLIANCE WPS STATEWIDE FIRST HEALTH WPS HEALTH INSURANCE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '356'
AND provider_id = '3097'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9029'
AND product_network_label IN ('ALLIANCE WPS STATEWIDE FIRST HEALTH WPS HEALTH INSURANCE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 356
AND provider_id = '3097'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9029'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 129​
Sample Record Details:
- Payer ID: 101
- Provider ID: 1005
- Billing Code Type: HCPCS
- Billing Code: 71101
- 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 = '1005'
AND billing_code_type = 'HCPCS'
AND billing_code = '71101'
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 = '1005'
AND billing_code_type = 'HCPCS'
AND billing_code = '71101'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 130​
Sample Record Details:
- Payer ID: 633
- Provider ID: 445
- Billing Code Type: HCPCS
- Billing Code: 64862
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '633'
AND provider_id = '445'
AND billing_code_type = 'HCPCS'
AND billing_code = '64862'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '445'
AND billing_code_type = 'HCPCS'
AND billing_code = '64862'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 131​
Sample Record Details:
- Payer ID: 643
- Provider ID: 8540
- Billing Code Type: HCPCS
- Billing Code: J2353
- 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 = '8540'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2353'
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 = '8540'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2353'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 132​
Sample Record Details:
- Payer ID: 286
- Provider ID: 1063
- Billing Code Type: HCPCS
- Billing Code: 0453T
- 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 = '1063'
AND billing_code_type = 'HCPCS'
AND billing_code = '0453T'
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 = '1063'
AND billing_code_type = 'HCPCS'
AND billing_code = '0453T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 133​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3932
- Billing Code Type: HCPCS
- Billing Code: 21016
- 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 = '3932'
AND billing_code_type = 'HCPCS'
AND billing_code = '21016'
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 = '3932'
AND billing_code_type = 'HCPCS'
AND billing_code = '21016'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 134​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2402
- Billing Code Type: HCPCS
- Billing Code: 59409
- 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 = '2402'
AND billing_code_type = 'HCPCS'
AND billing_code = '59409'
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 = '2402'
AND billing_code_type = 'HCPCS'
AND billing_code = '59409'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 135​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6045
- Billing Code Type: HCPCS
- Billing Code: J7214
- 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 = '6045'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7214'
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 = '6045'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7214'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 136​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5417
- Billing Code Type: HCPCS
- Billing Code: J0580
- 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 = '5417'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0580'
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 = '5417'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0580'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 137​
Sample Record Details:
- Payer ID: 56
- Provider ID: 832
- Billing Code Type: APR-DRG
- Billing Code: 0205-2
- 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 = '832'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0205-2'
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 = '832'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0205-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 138​
Sample Record Details:
- Payer ID: 76
- Provider ID: 3957
- Billing Code Type: HCPCS
- Billing Code: 31580
- 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 = '3957'
AND billing_code_type = 'HCPCS'
AND billing_code = '31580'
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 = '3957'
AND billing_code_type = 'HCPCS'
AND billing_code = '31580'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 139​
Sample Record Details:
- Payer ID: 624
- Provider ID: 6237
- Billing Code Type: HCPCS
- Billing Code: 0572T
- Networks: ['NAVIGATOR GOLD']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '624'
AND provider_id = '6237'
AND billing_code_type = 'HCPCS'
AND billing_code = '0572T'
AND product_network_label IN ('NAVIGATOR GOLD')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 624
AND provider_id = '6237'
AND billing_code_type = 'HCPCS'
AND billing_code = '0572T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 140​
Sample Record Details:
- Payer ID: 229
- Provider ID: 1006
- Billing Code Type: HCPCS
- Billing Code: D7410
- 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 = '1006'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7410'
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 = '1006'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D7410'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 141​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10367
- Billing Code Type: HCPCS
- Billing Code: J1410
- 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 = '10367'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1410'
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 = '10367'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1410'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 142​
Sample Record Details:
- Payer ID: 7
- Provider ID: 4462
- Billing Code Type: HCPCS
- Billing Code: J1072
- 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 = '4462'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1072'
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 = '4462'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1072'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 143​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5663
- Billing Code Type: HCPCS
- Billing Code: 91010
- 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 = '5663'
AND billing_code_type = 'HCPCS'
AND billing_code = '91010'
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 = '5663'
AND billing_code_type = 'HCPCS'
AND billing_code = '91010'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 144​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5454
- Billing Code Type: HCPCS
- Billing Code: 86890
- 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 = '5454'
AND billing_code_type = 'HCPCS'
AND billing_code = '86890'
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 = '5454'
AND billing_code_type = 'HCPCS'
AND billing_code = '86890'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 145​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10516
- Billing Code Type: APR-DRG
- Billing Code: 0169-2
- Networks: ['KY PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '42'
AND provider_id = '10516'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-2'
AND product_network_label IN ('KY PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '10516'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0169-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 146​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5996
- Billing Code Type: APR-DRG
- Billing Code: 0580-2
- 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 = '5996'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0580-2'
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 = '5996'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0580-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 147​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3412
- Billing Code Type: HCPCS
- Billing Code: 20200
- 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 = '3412'
AND billing_code_type = 'HCPCS'
AND billing_code = '20200'
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 = '3412'
AND billing_code_type = 'HCPCS'
AND billing_code = '20200'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 148​
Sample Record Details:
- Payer ID: 151
- Provider ID: 4563
- Billing Code Type: HCPCS
- Billing Code: 44394
- 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 = '4563'
AND billing_code_type = 'HCPCS'
AND billing_code = '44394'
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 = '4563'
AND billing_code_type = 'HCPCS'
AND billing_code = '44394'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 149​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6705
- Billing Code Type: HCPCS
- Billing Code: J0500
- 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 = '6705'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0500'
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 | 6705 | HCPCS | J0500 | Facility | Outpatient | UNITED HEALTHCARE – PH EMPLOYEES | UNITED HEALTHCARE – PH EMPLOYEES | 5600.0% | 177.17 | 8e9548c0558e43b1a86053041fbba659 | |||
| 643 | 6705 | HCPCS | J0500 | Facility | Outpatient | ALL PAYER APPENDIX | UNITED HEALTHCARE | 10000.0% | 100.51 | b824e0375f934d94bd41f9afcecc29c0 | |||
| 643 | 6705 | HCPCS | J0500 | Facility | Outpatient | DOCTORS PLAN | UNITED HEALTHCARE | 10000.0% | 316.37 | 19d24b2ae8fe414e8de10f21d8bd1947 | |||
| 643 | 6705 | HCPCS | J0500 | Facility | Outpatient | NEXUSACO | UNITED HEALTHCARE | 10000.0% | 316.37 | a1d463062ecf4fb5a197e9172736143e |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6705'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0500'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 150​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5388
- Billing Code Type: APR-DRG
- Billing Code: 0501-2
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '643'
AND provider_id = '5388'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0501-2'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '5388'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0501-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 151​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6523
- Billing Code Type: HCPCS
- Billing Code: 65870
- 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 = '6523'
AND billing_code_type = 'HCPCS'
AND billing_code = '65870'
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 = '6523'
AND billing_code_type = 'HCPCS'
AND billing_code = '65870'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 152​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2399
- Billing Code Type: HCPCS
- Billing Code: 0655T
- 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 = '2399'
AND billing_code_type = 'HCPCS'
AND billing_code = '0655T'
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 = '2399'
AND billing_code_type = 'HCPCS'
AND billing_code = '0655T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 153​
Sample Record Details:
- Payer ID: 54
- Provider ID: 1071
- Billing Code Type: HCPCS
- Billing Code: 93597
- 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 = '1071'
AND billing_code_type = 'HCPCS'
AND billing_code = '93597'
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 = '1071'
AND billing_code_type = 'HCPCS'
AND billing_code = '93597'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 154​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6398
- Billing Code Type: HCPCS
- Billing Code: 23650
- 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 = '6398'
AND billing_code_type = 'HCPCS'
AND billing_code = '23650'
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 = '6398'
AND billing_code_type = 'HCPCS'
AND billing_code = '23650'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 155​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3875
- Billing Code Type: HCPCS
- Billing Code: 0412T
- 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 = '3875'
AND billing_code_type = 'HCPCS'
AND billing_code = '0412T'
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 = '3875'
AND billing_code_type = 'HCPCS'
AND billing_code = '0412T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 156​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3653
- Billing Code Type: HCPCS
- Billing Code: J2372
- 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 = '3653'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2372'
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 = '3653'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2372'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 157​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9198
- Billing Code Type: HCPCS
- Billing Code: 90717
- 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 = '9198'
AND billing_code_type = 'HCPCS'
AND billing_code = '90717'
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 = '9198'
AND billing_code_type = 'HCPCS'
AND billing_code = '90717'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 158​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5801
- Billing Code Type: HCPCS
- Billing Code: J1412
- 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 = '5801'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1412'
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 = '5801'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1412'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 159​
Sample Record Details:
- Payer ID: 768
- Provider ID: 3094
- Billing Code Type: HCPCS
- Billing Code: 27680
- Networks: ['ALL PRODUCTS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '768'
AND provider_id = '3094'
AND billing_code_type = 'HCPCS'
AND billing_code = '27680'
AND product_network_label IN ('ALL PRODUCTS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 768
AND provider_id = '3094'
AND billing_code_type = 'HCPCS'
AND billing_code = '27680'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 160​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4192
- Billing Code Type: MS-DRG
- Billing Code: 708
- 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 = '4192'
AND billing_code_type = 'MS-DRG'
AND billing_code = '708'
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 = '4192'
AND billing_code_type = 'MS-DRG'
AND billing_code = '708'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 161​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3267
- Billing Code Type: HCPCS
- Billing Code: 23155
- 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 = '3267'
AND billing_code_type = 'HCPCS'
AND billing_code = '23155'
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 = '3267'
AND billing_code_type = 'HCPCS'
AND billing_code = '23155'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 162​
Sample Record Details:
- Payer ID: 111
- Provider ID: 1041
- Billing Code Type: HCPCS
- Billing Code: 25365
- 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 = '1041'
AND billing_code_type = 'HCPCS'
AND billing_code = '25365'
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 = '1041'
AND billing_code_type = 'HCPCS'
AND billing_code = '25365'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 163​
Sample Record Details:
- Payer ID: 7
- Provider ID: 8591
- Billing Code Type: APR-DRG
- Billing Code: 0530-3
- 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 = '8591'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0530-3'
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 = '8591'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0530-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 164​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1482
- Billing Code Type: HCPCS
- Billing Code: 42510
- 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 = '1482'
AND billing_code_type = 'HCPCS'
AND billing_code = '42510'
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 = '1482'
AND billing_code_type = 'HCPCS'
AND billing_code = '42510'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 165​
Sample Record Details:
- Payer ID: 42
- Provider ID: 896
- Billing Code Type: APR-DRG
- Billing Code: 0317-3
- 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 = '42'
AND provider_id = '896'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0317-3'
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 = 42
AND provider_id = '896'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0317-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 166​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1914
- Billing Code Type: HCPCS
- Billing Code: Q4316
- Networks: ['GA INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '7'
AND provider_id = '1914'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4316'
AND product_network_label IN ('GA INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1914'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4316'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 167​
Sample Record Details:
- Payer ID: 151
- Provider ID: 1061
- Billing Code Type: HCPCS
- Billing Code: 68360
- 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 = '1061'
AND billing_code_type = 'HCPCS'
AND billing_code = '68360'
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 = '1061'
AND billing_code_type = 'HCPCS'
AND billing_code = '68360'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 168​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5220
- Billing Code Type: APR-DRG
- Billing Code: 0138-3
- 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 = '5220'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0138-3'
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 = '5220'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0138-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 169​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1483
- Billing Code Type: HCPCS
- Billing Code: A9575
- 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 = '1483'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9575'
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 = '1483'
AND billing_code_type = 'HCPCS'
AND billing_code = 'A9575'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 170​
Sample Record Details:
- Payer ID: 101
- Provider ID: 1034
- Billing Code Type: HCPCS
- Billing Code: 37192
- 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 = '1034'
AND billing_code_type = 'HCPCS'
AND billing_code = '37192'
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 = '1034'
AND billing_code_type = 'HCPCS'
AND billing_code = '37192'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 171​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1691
- Billing Code Type: HCPCS
- Billing Code: 36478
- 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 = '1691'
AND billing_code_type = 'HCPCS'
AND billing_code = '36478'
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 = '1691'
AND billing_code_type = 'HCPCS'
AND billing_code = '36478'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 172​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3829
- Billing Code Type: HCPCS
- Billing Code: C9148
- 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 = '3829'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9148'
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 = '3829'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9148'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 173​
Sample Record Details:
- Payer ID: 151
- Provider ID: 1817
- Billing Code Type: HCPCS
- Billing Code: 24685
- 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 = '1817'
AND billing_code_type = 'HCPCS'
AND billing_code = '24685'
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 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 151 | 1817 | HCPCS | 24685 | Outpatient | COMMERCIAL | AMBETTER | 11,036.32 | f0ab89848b4045968971bf2d16a4e9bc |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1817'
AND billing_code_type = 'HCPCS'
AND billing_code = '24685'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 174​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1705
- Billing Code Type: HCPCS
- Billing Code: 40816
- 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 = '1705'
AND billing_code_type = 'HCPCS'
AND billing_code = '40816'
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 = '1705'
AND billing_code_type = 'HCPCS'
AND billing_code = '40816'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 175​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6423
- Billing Code Type: HCPCS
- Billing Code: 11200
- 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 = '6423'
AND billing_code_type = 'HCPCS'
AND billing_code = '11200'
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 = '6423'
AND billing_code_type = 'HCPCS'
AND billing_code = '11200'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 176​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6368
- Billing Code Type: APR-DRG
- Billing Code: 0660-2
- 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 = '6368'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0660-2'
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 = '6368'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0660-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 177​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1005
- Billing Code Type: HCPCS
- Billing Code: D4210
- 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 = '1005'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D4210'
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 = '1005'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D4210'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 178​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2506
- Billing Code Type: HCPCS
- Billing Code: J0580
- 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 = '2506'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0580'
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 = '2506'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0580'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 179​
Sample Record Details:
- Payer ID: 168
- Provider ID: 10061
- Billing Code Type: APR-DRG
- Billing Code: 0462-1
- Networks: ['HMO - PRIMARY 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 = '168'
AND provider_id = '10061'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-1'
AND product_network_label IN ('HMO - PRIMARY 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 = 168
AND provider_id = '10061'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0462-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 180​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5304
- Billing Code Type: HCPCS
- Billing Code: J1572
- 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 = '5304'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1572'
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 = '5304'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1572'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 181​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5465
- Billing Code Type: HCPCS
- Billing Code: 0326U
- 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 = '5465'
AND billing_code_type = 'HCPCS'
AND billing_code = '0326U'
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 = '5465'
AND billing_code_type = 'HCPCS'
AND billing_code = '0326U'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 182​
Sample Record Details:
- Payer ID: 42
- Provider ID: 842
- Billing Code Type: HCPCS
- Billing Code: 90791
- 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 = '42'
AND provider_id = '842'
AND billing_code_type = 'HCPCS'
AND billing_code = '90791'
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 = 42
AND provider_id = '842'
AND billing_code_type = 'HCPCS'
AND billing_code = '90791'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 183​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2445
- Billing Code Type: MS-DRG
- Billing Code: 288
- 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 = '2445'
AND billing_code_type = 'MS-DRG'
AND billing_code = '288'
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 = '2445'
AND billing_code_type = 'MS-DRG'
AND billing_code = '288'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 184​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6641
- Billing Code Type: APR-DRG
- Billing Code: 0241-4
- 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 = '6641'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0241-4'
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 = '6641'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0241-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 185​
Sample Record Details:
- Payer ID: 51
- Provider ID: 4255
- Billing Code Type: HCPCS
- Billing Code: D4240
- Networks: ['NETWORKBLUE PPO INDIVIDUAL', 'NETWORK 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 = '51'
AND provider_id = '4255'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D4240'
AND product_network_label IN ('NETWORKBLUE PPO INDIVIDUAL', 'NETWORK 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 = 51
AND provider_id = '4255'
AND billing_code_type = 'HCPCS'
AND billing_code = 'D4240'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 186​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10048
- Billing Code Type: HCPCS
- Billing Code: 81438
- 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 = '10048'
AND billing_code_type = 'HCPCS'
AND billing_code = '81438'
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 = '10048'
AND billing_code_type = 'HCPCS'
AND billing_code = '81438'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 187​
Sample Record Details:
- Payer ID: 305
- Provider ID: 4197
- Billing Code Type: APR-DRG
- Billing Code: 0046-4
- Networks: ['BROAD 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 = '305'
AND provider_id = '4197'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0046-4'
AND product_network_label IN ('BROAD 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 = 305
AND provider_id = '4197'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0046-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 188​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10128
- Billing Code Type: HCPCS
- Billing Code: 28024
- Networks: ['NH HMO', 'BLUECARD - BLUE CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '42'
AND provider_id = '10128'
AND billing_code_type = 'HCPCS'
AND billing_code = '28024'
AND product_network_label IN ('NH HMO', 'BLUECARD - BLUE CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '10128'
AND billing_code_type = 'HCPCS'
AND billing_code = '28024'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 189​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6089
- Billing Code Type: HCPCS
- Billing Code: J7060
- 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 = '6089'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7060'
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 = '6089'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7060'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 190​
Sample Record Details:
- Payer ID: 168
- Provider ID: 1818
- Billing Code Type: APR-DRG
- Billing Code: 0304-3
- 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 = '1818'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0304-3'
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 = '1818'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0304-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 191​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1674
- Billing Code Type: HCPCS
- Billing Code: 21125
- 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 = '1674'
AND billing_code_type = 'HCPCS'
AND billing_code = '21125'
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 = '1674'
AND billing_code_type = 'HCPCS'
AND billing_code = '21125'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 192​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9705
- Billing Code Type: HCPCS
- Billing Code: 93986
- 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 = '9705'
AND billing_code_type = 'HCPCS'
AND billing_code = '93986'
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 = '9705'
AND billing_code_type = 'HCPCS'
AND billing_code = '93986'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 193​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2161
- Billing Code Type: HCPCS
- Billing Code: 86485
- 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 = '2161'
AND billing_code_type = 'HCPCS'
AND billing_code = '86485'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 11 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 | 2161 | HCPCS | 86485 | 305 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | ea94edab64514bfd9e8e057a0932aff8 | ||||
| 643 | 2161 | HCPCS | 86485 | 306 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | 61afe1d62aa0420aa8471f546ef764bc | ||||
| 643 | 2161 | HCPCS | 86485 | 304 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | 71491f25fc8747b59371586ea8a520b4 | ||||
| 643 | 2161 | HCPCS | 86485 | 923 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | 8d2e5a0644dc40fa84cbf2851034399d | ||||
| 643 | 2161 | HCPCS | 86485 | 301 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | d29d2a977f3c41678926fc9757886781 | ||||
| 643 | 2161 | HCPCS | 86485 | 302 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | 6e32592e90e044b08f72aa1f2f6f0553 | ||||
| 643 | 2161 | HCPCS | 86485 | 307 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | ad1e6444a06545a998a902dff43059ca | ||||
| 643 | 2161 | HCPCS | 86485 | 303 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | c26ef50b66194215b2ed1005b43832de | ||||
| 643 | 2161 | HCPCS | 86485 | 309 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | a7f24a5bb21743639212b93394c5e9cb | ||||
| 643 | 2161 | HCPCS | 86485 | 925 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | e21fc5901cff4b20995d98600e2a7b0c | ||||
| 643 | 2161 | HCPCS | 86485 | 300 | Outpatient | ALLPAYERAPPENDIX | UNITED | 24.67 | 4ecdb488be71449ea1713e080dacef8c |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2161'
AND billing_code_type = 'HCPCS'
AND billing_code = '86485'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 194​
Sample Record Details:
- Payer ID: 391
- Provider ID: 4688
- Billing Code Type: HCPCS
- Billing Code: Q2056
- 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 = '4688'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2056'
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 = '4688'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2056'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 195​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6312
- Billing Code Type: HCPCS
- Billing Code: 0540T
- 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 = '6312'
AND billing_code_type = 'HCPCS'
AND billing_code = '0540T'
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 = '6312'
AND billing_code_type = 'HCPCS'
AND billing_code = '0540T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 196​
Sample Record Details:
- Payer ID: 42
- Provider ID: 547
- Billing Code Type: APR-DRG
- Billing Code: 0321-1
- Networks: ['ME 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 = '547'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0321-1'
AND product_network_label IN ('ME 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 = '547'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0321-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 197​
Sample Record Details:
- Payer ID: 633
- Provider ID: 8491
- Billing Code Type: HCPCS
- Billing Code: 93316
- Networks: ['BSW PLUS PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '633'
AND provider_id = '8491'
AND billing_code_type = 'HCPCS'
AND billing_code = '93316'
AND product_network_label IN ('BSW PLUS PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 633
AND provider_id = '8491'
AND billing_code_type = 'HCPCS'
AND billing_code = '93316'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 198​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5059
- Billing Code Type: HCPCS
- Billing Code: 21147
- 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 = '5059'
AND billing_code_type = 'HCPCS'
AND billing_code = '21147'
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 = '5059'
AND billing_code_type = 'HCPCS'
AND billing_code = '21147'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 199​
Sample Record Details:
- Payer ID: 768
- Provider ID: 3172
- Billing Code Type: HCPCS
- Billing Code: 26415
- Networks: ['ALL PRODUCTS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_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 = '768'
AND provider_id = '3172'
AND billing_code_type = 'HCPCS'
AND billing_code = '26415'
AND product_network_label IN ('ALL PRODUCTS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 768
AND provider_id = '3172'
AND billing_code_type = 'HCPCS'
AND billing_code = '26415'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 200​
Sample Record Details:
- Payer ID: 52
- Provider ID: 10520
- Billing Code Type: HCPCS
- Billing Code: 21270
- Networks: ['DUKE EMPLOYEE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_08.core_rates
WHERE payer_id = '52'
AND provider_id = '10520'
AND billing_code_type = 'HCPCS'
AND billing_code = '21270'
AND product_network_label IN ('DUKE EMPLOYEE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 52
AND provider_id = '10520'
AND billing_code_type = 'HCPCS'
AND billing_code = '21270'
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: 11 (avg: 0.055)
This analysis provides insights into the potential for filling coverage gaps by integrating data from core_rates and hospital_rates tables.