v2_2_2
Core Rates Month: 2025_09 Generated: 2025-11-13 18:36:40
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: 2,709,138,454.0
- Records with canonical_rate: 626,075,036.0
- Records without canonical_rate: 2,083,063,418.0
- NULL Rate Percentage: 77.0%
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_2.prod_combined_all
Coverage Statistics by Provider Type​
| provider_type | total_records | records_with_rate | records_without_rate | coverage_percentage | null_rate_percentage |
|---|---|---|---|---|---|
| Imaging Center | 47,597,521 | 3,784,181 | 43,813,340 | 8.0% | 92.0% |
| Physician Group | 1,673,580,496 | 271,003,676 | 1,402,576,820 | 16.0% | 84.0% |
| Laboratory | 13,041,990 | 2,661,716 | 10,380,274 | 20.0% | 80.0% |
| ASC | 191,995,517 | 39,996,206 | 151,999,311 | 21.0% | 79.0% |
| Hospital | 782,922,930 | 308,629,257 | 474,293,673 | 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_2.prod_combined_all
GROUP BY provider_type
ORDER BY coverage_percentage ASC
2. Sample Analysis of Hospital Coverage Gaps​
Look for ✅ to indicate matches found in the respective tables.
Sample Record 1​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2784
- Billing Code Type: HCPCS
- Billing Code: J7196
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2784'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7196'
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 = '2784'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7196'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 2​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5123
- Billing Code Type: HCPCS
- Billing Code: 96156
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '5123'
AND billing_code_type = 'HCPCS'
AND billing_code = '96156'
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 = '5123'
AND billing_code_type = 'HCPCS'
AND billing_code = '96156'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 3​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9171
- Billing Code Type: HCPCS
- Billing Code: J0248
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '9171'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0248'
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 = '9171'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0248'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 4​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5614
- Billing Code Type: HCPCS
- Billing Code: 54055
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '5614'
AND billing_code_type = 'HCPCS'
AND billing_code = '54055'
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 = '5614'
AND billing_code_type = 'HCPCS'
AND billing_code = '54055'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 5​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4481
- Billing Code Type: HCPCS
- Billing Code: 22532
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4481'
AND billing_code_type = 'HCPCS'
AND billing_code = '22532'
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 = '4481'
AND billing_code_type = 'HCPCS'
AND billing_code = '22532'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 6​
Sample Record Details:
- Payer ID: 76
- Provider ID: 576
- Billing Code Type: APR-DRG
- Billing Code: 0082-3
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '576'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0082-3'
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 = '576'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0082-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 7​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2743
- Billing Code Type: APR-DRG
- Billing Code: 0625-4
- Networks: ['CHOICE PLUS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2743'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0625-4'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 643
AND provider_id = '2743'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0625-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 8​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1418
- Billing Code Type: APR-DRG
- Billing Code: 0892-1
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1418'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0892-1'
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 = '1418'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0892-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 9​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3697
- Billing Code Type: HCPCS
- Billing Code: 11106
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3697'
AND billing_code_type = 'HCPCS'
AND billing_code = '11106'
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 = '3697'
AND billing_code_type = 'HCPCS'
AND billing_code = '11106'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 10​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4350
- Billing Code Type: HCPCS
- Billing Code: 68330
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4350'
AND billing_code_type = 'HCPCS'
AND billing_code = '68330'
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 = '4350'
AND billing_code_type = 'HCPCS'
AND billing_code = '68330'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 11​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5111
- Billing Code Type: HCPCS
- Billing Code: 28264
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '5111'
AND billing_code_type = 'HCPCS'
AND billing_code = '28264'
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 = '5111'
AND billing_code_type = 'HCPCS'
AND billing_code = '28264'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 12​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5745
- Billing Code Type: HCPCS
- Billing Code: 19396
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '5745'
AND billing_code_type = 'HCPCS'
AND billing_code = '19396'
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 = '5745'
AND billing_code_type = 'HCPCS'
AND billing_code = '19396'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 13​
Sample Record Details:
- Payer ID: 76
- Provider ID: 2031
- Billing Code Type: HCPCS
- Billing Code: 65850
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '2031'
AND billing_code_type = 'HCPCS'
AND billing_code = '65850'
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 = '2031'
AND billing_code_type = 'HCPCS'
AND billing_code = '65850'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 14​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1861
- Billing Code Type: HCPCS
- Billing Code: J7194
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '1861'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7194'
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 = '1861'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7194'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 15​
Sample Record Details:
- Payer ID: 42
- Provider ID: 7950
- Billing Code Type: HCPCS
- Billing Code: 31634
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '7950'
AND billing_code_type = 'HCPCS'
AND billing_code = '31634'
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 = '7950'
AND billing_code_type = 'HCPCS'
AND billing_code = '31634'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 16​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2051
- Billing Code Type: HCPCS
- Billing Code: 27097
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2051'
AND billing_code_type = 'HCPCS'
AND billing_code = '27097'
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 = '2051'
AND billing_code_type = 'HCPCS'
AND billing_code = '27097'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 17​
Sample Record Details:
- Payer ID: 151
- Provider ID: 2996
- Billing Code Type: HCPCS
- Billing Code: 20910
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '2996'
AND billing_code_type = 'HCPCS'
AND billing_code = '20910'
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 = '2996'
AND billing_code_type = 'HCPCS'
AND billing_code = '20910'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 18​
Sample Record Details:
- Payer ID: 403
- Provider ID: 6373
- Billing Code Type: HCPCS
- Billing Code: G0412
- 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_09.core_rates
WHERE payer_id = '403'
AND provider_id = '6373'
AND billing_code_type = 'HCPCS'
AND billing_code = 'G0412'
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 = '6373'
AND billing_code_type = 'HCPCS'
AND billing_code = 'G0412'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 19​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1331
- Billing Code Type: MS-DRG
- Billing Code: 121
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '1331'
AND billing_code_type = 'MS-DRG'
AND billing_code = '121'
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 = '1331'
AND billing_code_type = 'MS-DRG'
AND billing_code = '121'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 20​
Sample Record Details:
- Payer ID: 390
- Provider ID: 3977
- Billing Code Type: HCPCS
- Billing Code: 22865
- Networks: ['BLUE CHOICE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '390'
AND provider_id = '3977'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
AND product_network_label IN ('BLUE CHOICE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 390
AND provider_id = '3977'
AND billing_code_type = 'HCPCS'
AND billing_code = '22865'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 21​
Sample Record Details:
- Payer ID: 389
- Provider ID: 4086
- Billing Code Type: HCPCS
- Billing Code: 11302
- Networks: ['BLUE PRECISION HMO', 'BLUE ADVANTAGE HMO - NON STANDARD', 'BLUE ADVANTAGE HMO HMO NON STANDARD', 'BLUE PRECISION HMO - NON STANDARD', 'BLUE ADVANTAGE HMO', 'HMO ILLINOIS STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO - STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS', 'BLUE PRECISION HMO - STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS HMO NON STANDARD', 'HMO ILLINOIS - NON STANDARD', 'HMO ILLINOIS - STANDARD AND ADVOCATE HEALTH']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '389'
AND provider_id = '4086'
AND billing_code_type = 'HCPCS'
AND billing_code = '11302'
AND product_network_label IN ('BLUE PRECISION HMO', 'BLUE ADVANTAGE HMO - NON STANDARD', 'BLUE ADVANTAGE HMO HMO NON STANDARD', 'BLUE PRECISION HMO - NON STANDARD', 'BLUE ADVANTAGE HMO', 'HMO ILLINOIS STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO - STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS', 'BLUE PRECISION HMO - STANDARD AND ADVOCATE HEALTH', 'BLUE ADVANTAGE HMO STANDARD AND ADVOCATE HEALTH', 'HMO ILLINOIS HMO NON STANDARD', 'HMO ILLINOIS - NON STANDARD', 'HMO ILLINOIS - STANDARD AND ADVOCATE HEALTH')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 389
AND provider_id = '4086'
AND billing_code_type = 'HCPCS'
AND billing_code = '11302'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 22​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2471
- Billing Code Type: APR-DRG
- Billing Code: 0284-4
- Networks: ['KY HMO', 'KY PATHWAY X HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '2471'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0284-4'
AND product_network_label IN ('KY HMO', 'KY PATHWAY X HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '2471'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0284-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 23​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3034
- Billing Code Type: HCPCS
- Billing Code: 31645
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3034'
AND billing_code_type = 'HCPCS'
AND billing_code = '31645'
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 = '3034'
AND billing_code_type = 'HCPCS'
AND billing_code = '31645'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 24​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2887
- Billing Code Type: HCPCS
- Billing Code: J1520
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2887'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1520'
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 = '2887'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1520'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 25​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9077
- Billing Code Type: HCPCS
- Billing Code: 23174
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '9077'
AND billing_code_type = 'HCPCS'
AND billing_code = '23174'
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 = '9077'
AND billing_code_type = 'HCPCS'
AND billing_code = '23174'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 26​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10076
- Billing Code Type: HCPCS
- Billing Code: Q5147
- Networks: ['NY PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '10076'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5147'
AND product_network_label IN ('NY PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '10076'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5147'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 27​
Sample Record Details:
- Payer ID: 272
- Provider ID: 2463
- Billing Code Type: HCPCS
- Billing Code: J2801
- 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_09.core_rates
WHERE payer_id = '272'
AND provider_id = '2463'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2801'
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 = '2463'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2801'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 28​
Sample Record Details:
- Payer ID: 7
- Provider ID: 2714
- Billing Code Type: MS-DRG
- Billing Code: 454
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '2714'
AND billing_code_type = 'MS-DRG'
AND billing_code = '454'
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 = '2714'
AND billing_code_type = 'MS-DRG'
AND billing_code = '454'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 29​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1112
- Billing Code Type: HCPCS
- Billing Code: Q4263
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '1112'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4263'
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 = '1112'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4263'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 30​
Sample Record Details:
- Payer ID: 624
- Provider ID: 5979
- Billing Code Type: HCPCS
- Billing Code: 53420
- 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_09.core_rates
WHERE payer_id = '624'
AND provider_id = '5979'
AND billing_code_type = 'HCPCS'
AND billing_code = '53420'
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 = '5979'
AND billing_code_type = 'HCPCS'
AND billing_code = '53420'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 31​
Sample Record Details:
- Payer ID: 111
- Provider ID: 8612
- Billing Code Type: HCPCS
- Billing Code: 28240
- 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_09.core_rates
WHERE payer_id = '111'
AND provider_id = '8612'
AND billing_code_type = 'HCPCS'
AND billing_code = '28240'
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 = '8612'
AND billing_code_type = 'HCPCS'
AND billing_code = '28240'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 32​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6508
- Billing Code Type: HCPCS
- Billing Code: J9097
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '6508'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9097'
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 = '6508'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9097'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 33​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10197
- Billing Code Type: HCPCS
- Billing Code: 90880
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '10197'
AND billing_code_type = 'HCPCS'
AND billing_code = '90880'
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 = '10197'
AND billing_code_type = 'HCPCS'
AND billing_code = '90880'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 34​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3154
- Billing Code Type: HCPCS
- Billing Code: 59897
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3154'
AND billing_code_type = 'HCPCS'
AND billing_code = '59897'
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 = '3154'
AND billing_code_type = 'HCPCS'
AND billing_code = '59897'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 35​
Sample Record Details:
- Payer ID: 174
- Provider ID: 329
- Billing Code Type: HCPCS
- Billing Code: 86890
- 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_09.core_rates
WHERE payer_id = '174'
AND provider_id = '329'
AND billing_code_type = 'HCPCS'
AND billing_code = '86890'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '329'
AND billing_code_type = 'HCPCS'
AND billing_code = '86890'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 36​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10566
- Billing Code Type: HCPCS
- Billing Code: J9294
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '10566'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9294'
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 = '10566'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9294'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 37​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2555
- Billing Code Type: HCPCS
- Billing Code: J1300
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '2555'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1300'
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 = '2555'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1300'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 38​
Sample Record Details:
- Payer ID: 461
- Provider ID: 3944
- Billing Code Type: APR-DRG
- Billing Code: 0246-4
- 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_09.core_rates
WHERE payer_id = '461'
AND provider_id = '3944'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0246-4'
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 = 461
AND provider_id = '3944'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0246-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 39​
Sample Record Details:
- Payer ID: 7
- Provider ID: 9933
- Billing Code Type: HCPCS
- Billing Code: J3402
- Networks: ['CA INDIVIDUAL HMO', 'CA GROUP HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '7'
AND provider_id = '9933'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3402'
AND product_network_label IN ('CA INDIVIDUAL HMO', 'CA GROUP HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '9933'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J3402'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 40​
Sample Record Details:
- Payer ID: 101
- Provider ID: 876
- Billing Code Type: HCPCS
- Billing Code: 29044
- 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_09.core_rates
WHERE payer_id = '101'
AND provider_id = '876'
AND billing_code_type = 'HCPCS'
AND billing_code = '29044'
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 = '876'
AND billing_code_type = 'HCPCS'
AND billing_code = '29044'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 41​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4112
- Billing Code Type: HCPCS
- Billing Code: 66989
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '4112'
AND billing_code_type = 'HCPCS'
AND billing_code = '66989'
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 = '4112'
AND billing_code_type = 'HCPCS'
AND billing_code = '66989'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 42​
Sample Record Details:
- Payer ID: 76
- Provider ID: 783
- Billing Code Type: HCPCS
- Billing Code: 21150
- Networks: ['NEW ENGLAND HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '76'
AND provider_id = '783'
AND billing_code_type = 'HCPCS'
AND billing_code = '21150'
AND product_network_label IN ('NEW ENGLAND HMO/POS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '783'
AND billing_code_type = 'HCPCS'
AND billing_code = '21150'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 43​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6689
- Billing Code Type: HCPCS
- Billing Code: J2272
- 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_09.core_rates
WHERE payer_id = '728'
AND provider_id = '6689'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2272'
AND product_network_label IN ('SUTTER HEALTH PLUS LARGE GROUP PLANS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 728
AND provider_id = '6689'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2272'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 44​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8335
- Billing Code Type: APR-DRG
- Billing Code: 0441-3
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '8335'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0441-3'
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 = '8335'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0441-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 45​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4402
- Billing Code Type: HCPCS
- Billing Code: 92997
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '4402'
AND billing_code_type = 'HCPCS'
AND billing_code = '92997'
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 = '4402'
AND billing_code_type = 'HCPCS'
AND billing_code = '92997'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 46​
Sample Record Details:
- Payer ID: 97
- Provider ID: 961
- Billing Code Type: HCPCS
- Billing Code: J0175
- 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_09.core_rates
WHERE payer_id = '97'
AND provider_id = '961'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0175'
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 = '961'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0175'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 47​
Sample Record Details:
- Payer ID: 169
- Provider ID: 9126
- Billing Code Type: MS-DRG
- Billing Code: 257
- 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_09.core_rates
WHERE payer_id = '169'
AND provider_id = '9126'
AND billing_code_type = 'MS-DRG'
AND billing_code = '257'
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 = '9126'
AND billing_code_type = 'MS-DRG'
AND billing_code = '257'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 48​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1246
- Billing Code Type: HCPCS
- Billing Code: C9146
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '1246'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9146'
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 = '1246'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9146'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 49​
Sample Record Details:
- Payer ID: 643
- Provider ID: 178
- Billing Code Type: HCPCS
- Billing Code: 0418T
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '178'
AND billing_code_type = 'HCPCS'
AND billing_code = '0418T'
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 = '178'
AND billing_code_type = 'HCPCS'
AND billing_code = '0418T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 50​
Sample Record Details:
- Payer ID: 958
- Provider ID: 1060
- Billing Code Type: APR-DRG
- Billing Code: 0207-1
- 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_09.core_rates
WHERE payer_id = '958'
AND provider_id = '1060'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0207-1'
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 = '1060'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0207-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 51​
Sample Record Details:
- Payer ID: 42
- Provider ID: 8612
- Billing Code Type: HCPCS
- Billing Code: Q4314
- Networks: ['NY EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '8612'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4314'
AND product_network_label IN ('NY EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '8612'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4314'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 52​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10575
- Billing Code Type: HCPCS
- Billing Code: 27726
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '10575'
AND billing_code_type = 'HCPCS'
AND billing_code = '27726'
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 = '10575'
AND billing_code_type = 'HCPCS'
AND billing_code = '27726'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 53​
Sample Record Details:
- Payer ID: 49
- Provider ID: 2952
- Billing Code Type: HCPCS
- Billing Code: 66179
- Networks: ['HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '49'
AND provider_id = '2952'
AND billing_code_type = 'HCPCS'
AND billing_code = '66179'
AND product_network_label IN ('HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 49
AND provider_id = '2952'
AND billing_code_type = 'HCPCS'
AND billing_code = '66179'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 54​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9632
- Billing Code Type: HCPCS
- Billing Code: 25290
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '9632'
AND billing_code_type = 'HCPCS'
AND billing_code = '25290'
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 = '9632'
AND billing_code_type = 'HCPCS'
AND billing_code = '25290'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 55​
Sample Record Details:
- Payer ID: 229
- Provider ID: 326
- Billing Code Type: HCPCS
- Billing Code: 74455
- Networks: ['OMNIA TIER 1']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '229'
AND provider_id = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = '74455'
AND product_network_label IN ('OMNIA TIER 1')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '326'
AND billing_code_type = 'HCPCS'
AND billing_code = '74455'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 56​
Sample Record Details:
- Payer ID: 7
- Provider ID: 9009
- Billing Code Type: HCPCS
- Billing Code: J1850
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '9009'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1850'
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 = '9009'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1850'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 57​
Sample Record Details:
- Payer ID: 151
- Provider ID: 831
- Billing Code Type: HCPCS
- Billing Code: 15830
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '831'
AND billing_code_type = 'HCPCS'
AND billing_code = '15830'
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 = '831'
AND billing_code_type = 'HCPCS'
AND billing_code = '15830'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 58​
Sample Record Details:
- Payer ID: 42
- Provider ID: 569
- Billing Code Type: HCPCS
- Billing Code: 36835
- Networks: ['ME BLUE CHOICE PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '569'
AND billing_code_type = 'HCPCS'
AND billing_code = '36835'
AND product_network_label IN ('ME BLUE CHOICE PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '569'
AND billing_code_type = 'HCPCS'
AND billing_code = '36835'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 59​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9464
- Billing Code Type: HCPCS
- Billing Code: 22849
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '9464'
AND billing_code_type = 'HCPCS'
AND billing_code = '22849'
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 = '9464'
AND billing_code_type = 'HCPCS'
AND billing_code = '22849'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 60​
Sample Record Details:
- Payer ID: 229
- Provider ID: 327
- Billing Code Type: MS-DRG
- Billing Code: 235
- Networks: ['OMNIA TIER 1']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '229'
AND provider_id = '327'
AND billing_code_type = 'MS-DRG'
AND billing_code = '235'
AND product_network_label IN ('OMNIA TIER 1')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '327'
AND billing_code_type = 'MS-DRG'
AND billing_code = '235'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 61​
Sample Record Details:
- Payer ID: 356
- Provider ID: 3161
- Billing Code Type: MS-DRG
- Billing Code: 139
- 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_09.core_rates
WHERE payer_id = '356'
AND provider_id = '3161'
AND billing_code_type = 'MS-DRG'
AND billing_code = '139'
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 = '3161'
AND billing_code_type = 'MS-DRG'
AND billing_code = '139'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 62​
Sample Record Details:
- Payer ID: 42
- Provider ID: 6282
- Billing Code Type: APR-DRG
- Billing Code: 0230-1
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '6282'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0230-1'
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 = '6282'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0230-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 63​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2558
- Billing Code Type: HCPCS
- Billing Code: 21206
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '2558'
AND billing_code_type = 'HCPCS'
AND billing_code = '21206'
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 = '2558'
AND billing_code_type = 'HCPCS'
AND billing_code = '21206'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 64​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1799
- Billing Code Type: HCPCS
- Billing Code: 0661T
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '1799'
AND billing_code_type = 'HCPCS'
AND billing_code = '0661T'
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 = '1799'
AND billing_code_type = 'HCPCS'
AND billing_code = '0661T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 65​
Sample Record Details:
- Payer ID: 42
- Provider ID: 1017
- Billing Code Type: APR-DRG
- Billing Code: 0681-4
- Networks: ['NY EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '1017'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0681-4'
AND product_network_label IN ('NY EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '1017'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0681-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 66​
Sample Record Details:
- Payer ID: 76
- Provider ID: 838
- Billing Code Type: HCPCS
- Billing Code: 26706
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '838'
AND billing_code_type = 'HCPCS'
AND billing_code = '26706'
AND product_network_label IN ('LOCALPLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 1 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 76 | 838 | HCPCS | 26706 | Facility | Outpatient | COMMERCIAL HMO | CIGNA | 4,995.40 | 915bb7f2e1e5494e82493b1d22d1a228 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '838'
AND billing_code_type = 'HCPCS'
AND billing_code = '26706'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 67​
Sample Record Details:
- Payer ID: 643
- Provider ID: 8054
- Billing Code Type: HCPCS
- Billing Code: 96372
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '8054'
AND billing_code_type = 'HCPCS'
AND billing_code = '96372'
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 = '8054'
AND billing_code_type = 'HCPCS'
AND billing_code = '96372'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 68​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5760
- Billing Code Type: HCPCS
- Billing Code: J1413
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '5760'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1413'
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 = '5760'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1413'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 69​
Sample Record Details:
- Payer ID: 728
- Provider ID: 6332
- Billing Code Type: HCPCS
- Billing Code: 32960
- 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_09.core_rates
WHERE payer_id = '728'
AND provider_id = '6332'
AND billing_code_type = 'HCPCS'
AND billing_code = '32960'
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 = '6332'
AND billing_code_type = 'HCPCS'
AND billing_code = '32960'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 70​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9878
- Billing Code Type: HCPCS
- Billing Code: 15002
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '9878'
AND billing_code_type = 'HCPCS'
AND billing_code = '15002'
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 = '9878'
AND billing_code_type = 'HCPCS'
AND billing_code = '15002'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 71​
Sample Record Details:
- Payer ID: 43
- Provider ID: 9540
- Billing Code Type: HCPCS
- Billing Code: 64430
- Networks: ['STATEWIDE 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_09.core_rates
WHERE payer_id = '43'
AND provider_id = '9540'
AND billing_code_type = 'HCPCS'
AND billing_code = '64430'
AND product_network_label IN ('STATEWIDE 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 = 43
AND provider_id = '9540'
AND billing_code_type = 'HCPCS'
AND billing_code = '64430'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 72​
Sample Record Details:
- Payer ID: 388
- Provider ID: 2144
- Billing Code Type: HCPCS
- Billing Code: Q4210
- Networks: ['SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '388'
AND provider_id = '2144'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4210'
AND product_network_label IN ('SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 388
AND provider_id = '2144'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4210'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 73​
Sample Record Details:
- Payer ID: 849
- Provider ID: 8521
- Billing Code Type: APR-DRG
- Billing Code: 0284-1
- Networks: ['COMMERCIAL FULLY FUNDED (GROUP AND INDIVIDUAL)']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '849'
AND provider_id = '8521'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0284-1'
AND product_network_label IN ('COMMERCIAL FULLY FUNDED (GROUP AND INDIVIDUAL)')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 849
AND provider_id = '8521'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0284-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 74​
Sample Record Details:
- Payer ID: 42
- Provider ID: 8956
- Billing Code Type: HCPCS
- Billing Code: 77306
- Networks: ['CO BLUE PREFERRED PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '8956'
AND billing_code_type = 'HCPCS'
AND billing_code = '77306'
AND product_network_label IN ('CO BLUE PREFERRED PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '8956'
AND billing_code_type = 'HCPCS'
AND billing_code = '77306'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 75​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4932
- Billing Code Type: HCPCS
- Billing Code: J2430
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4932'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2430'
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 = '4932'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2430'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 76​
Sample Record Details:
- Payer ID: 76
- Provider ID: 1660
- Billing Code Type: HCPCS
- Billing Code: 0467T
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '1660'
AND billing_code_type = 'HCPCS'
AND billing_code = '0467T'
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 = '1660'
AND billing_code_type = 'HCPCS'
AND billing_code = '0467T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 77​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10586
- Billing Code Type: HCPCS
- Billing Code: J2503
- Networks: ['NY EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '10586'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2503'
AND product_network_label IN ('NY EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '10586'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2503'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 78​
Sample Record Details:
- Payer ID: 49
- Provider ID: 9353
- Billing Code Type: HCPCS
- Billing Code: 28606
- Networks: ['HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '49'
AND provider_id = '9353'
AND billing_code_type = 'HCPCS'
AND billing_code = '28606'
AND product_network_label IN ('HMO', 'NORTHWOOD DME - HMO', 'METRO DETROIT - HMO', 'SELECT - HMO', 'VIRTUAL OPTION - HMO', 'CARECENTRIX HOME INFUSION - HMO / PPO', 'LOCAL - HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 49
AND provider_id = '9353'
AND billing_code_type = 'HCPCS'
AND billing_code = '28606'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 79​
Sample Record Details:
- Payer ID: 151
- Provider ID: 10634
- Billing Code Type: APR-DRG
- Billing Code: 0248-2
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '10634'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0248-2'
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 = '10634'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0248-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 80​
Sample Record Details:
- Payer ID: 958
- Provider ID: 858
- Billing Code Type: HCPCS
- Billing Code: 97610
- Networks: ['METROPLUS FFS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '958'
AND provider_id = '858'
AND billing_code_type = 'HCPCS'
AND billing_code = '97610'
AND product_network_label IN ('METROPLUS FFS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 958
AND provider_id = '858'
AND billing_code_type = 'HCPCS'
AND billing_code = '97610'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 81​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1631
- Billing Code Type: HCPCS
- Billing Code: 78072
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '1631'
AND billing_code_type = 'HCPCS'
AND billing_code = '78072'
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 = '1631'
AND billing_code_type = 'HCPCS'
AND billing_code = '78072'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 82​
Sample Record Details:
- Payer ID: 52
- Provider ID: 1532
- Billing Code Type: HCPCS
- Billing Code: 23195
- 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_09.core_rates
WHERE payer_id = '52'
AND provider_id = '1532'
AND billing_code_type = 'HCPCS'
AND billing_code = '23195'
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 = 52
AND provider_id = '1532'
AND billing_code_type = 'HCPCS'
AND billing_code = '23195'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 83​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4365
- Billing Code Type: HCPCS
- Billing Code: C9766
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4365'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9766'
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 = '4365'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9766'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 84​
Sample Record Details:
- Payer ID: 151
- Provider ID: 1712
- Billing Code Type: HCPCS
- Billing Code: 70371
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '1712'
AND billing_code_type = 'HCPCS'
AND billing_code = '70371'
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 = '1712'
AND billing_code_type = 'HCPCS'
AND billing_code = '70371'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 85​
Sample Record Details:
- Payer ID: 720
- Provider ID: 692
- Billing Code Type: HCPCS
- Billing Code: 15946
- Networks: ['CHOICENET 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_09.core_rates
WHERE payer_id = '720'
AND provider_id = '692'
AND billing_code_type = 'HCPCS'
AND billing_code = '15946'
AND product_network_label IN ('CHOICENET 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 = 720
AND provider_id = '692'
AND billing_code_type = 'HCPCS'
AND billing_code = '15946'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 86​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5239
- Billing Code Type: HCPCS
- Billing Code: 21720
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '5239'
AND billing_code_type = 'HCPCS'
AND billing_code = '21720'
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 = '5239'
AND billing_code_type = 'HCPCS'
AND billing_code = '21720'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 87​
Sample Record Details:
- Payer ID: 42
- Provider ID: 3106
- Billing Code Type: HCPCS
- Billing Code: 95864
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '3106'
AND billing_code_type = 'HCPCS'
AND billing_code = '95864'
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 = '3106'
AND billing_code_type = 'HCPCS'
AND billing_code = '95864'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 88​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1496
- Billing Code Type: HCPCS
- Billing Code: 22590
- Networks: ['NC INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '7'
AND provider_id = '1496'
AND billing_code_type = 'HCPCS'
AND billing_code = '22590'
AND product_network_label IN ('NC INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '1496'
AND billing_code_type = 'HCPCS'
AND billing_code = '22590'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 89​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2697
- Billing Code Type: HCPCS
- Billing Code: J1921
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2697'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1921'
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 = '2697'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1921'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 90​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3840
- Billing Code Type: MS-DRG
- Billing Code: 145
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3840'
AND billing_code_type = 'MS-DRG'
AND billing_code = '145'
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 = '3840'
AND billing_code_type = 'MS-DRG'
AND billing_code = '145'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 91​
Sample Record Details:
- Payer ID: 111
- Provider ID: 1291
- Billing Code Type: MS-DRG
- Billing Code: 876
- 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_09.core_rates
WHERE payer_id = '111'
AND provider_id = '1291'
AND billing_code_type = 'MS-DRG'
AND billing_code = '876'
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 = '1291'
AND billing_code_type = 'MS-DRG'
AND billing_code = '876'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 92​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1143
- Billing Code Type: HCPCS
- Billing Code: 59612
- 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_09.core_rates
WHERE payer_id = '56'
AND provider_id = '1143'
AND billing_code_type = 'HCPCS'
AND billing_code = '59612'
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 = '1143'
AND billing_code_type = 'HCPCS'
AND billing_code = '59612'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 93​
Sample Record Details:
- Payer ID: 796
- Provider ID: 343
- Billing Code Type: HCPCS
- Billing Code: 23525
- Networks: ['EXCHANGE MARKETPLACE']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '796'
AND provider_id = '343'
AND billing_code_type = 'HCPCS'
AND billing_code = '23525'
AND product_network_label IN ('EXCHANGE MARKETPLACE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 796
AND provider_id = '343'
AND billing_code_type = 'HCPCS'
AND billing_code = '23525'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 94​
Sample Record Details:
- Payer ID: 7
- Provider ID: 609
- Billing Code Type: HCPCS
- Billing Code: 26037
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '609'
AND billing_code_type = 'HCPCS'
AND billing_code = '26037'
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 = '609'
AND billing_code_type = 'HCPCS'
AND billing_code = '26037'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 95​
Sample Record Details:
- Payer ID: 174
- Provider ID: 7159
- Billing Code Type: MS-DRG
- Billing Code: 333
- 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_09.core_rates
WHERE payer_id = '174'
AND provider_id = '7159'
AND billing_code_type = 'MS-DRG'
AND billing_code = '333'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '7159'
AND billing_code_type = 'MS-DRG'
AND billing_code = '333'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 96​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3901
- Billing Code Type: MS-DRG
- Billing Code: 442
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3901'
AND billing_code_type = 'MS-DRG'
AND billing_code = '442'
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 = '3901'
AND billing_code_type = 'MS-DRG'
AND billing_code = '442'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 97​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4590
- Billing Code Type: HCPCS
- Billing Code: 28315
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4590'
AND billing_code_type = 'HCPCS'
AND billing_code = '28315'
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 = '4590'
AND billing_code_type = 'HCPCS'
AND billing_code = '28315'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 98​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9588
- Billing Code Type: HCPCS
- Billing Code: C9777
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '9588'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9777'
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 = '9588'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9777'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 99​
Sample Record Details:
- Payer ID: 56
- Provider ID: 9977
- Billing Code Type: HCPCS
- Billing Code: 66989
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '56'
AND provider_id = '9977'
AND billing_code_type = 'HCPCS'
AND billing_code = '66989'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '9977'
AND billing_code_type = 'HCPCS'
AND billing_code = '66989'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 100​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6131
- Billing Code Type: APR-DRG
- Billing Code: 0282-2
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '6131'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0282-2'
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 = '6131'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0282-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 101​
Sample Record Details:
- Payer ID: 7
- Provider ID: 2237
- Billing Code Type: HCPCS
- Billing Code: 92651
- Networks: ['FL GROUP HMO', 'FL INDIVIDUAL HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '7'
AND provider_id = '2237'
AND billing_code_type = 'HCPCS'
AND billing_code = '92651'
AND product_network_label IN ('FL GROUP HMO', 'FL INDIVIDUAL HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 7
AND provider_id = '2237'
AND billing_code_type = 'HCPCS'
AND billing_code = '92651'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 102​
Sample Record Details:
- Payer ID: 633
- Provider ID: 8633
- Billing Code Type: HCPCS
- Billing Code: 88355
- 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_09.core_rates
WHERE payer_id = '633'
AND provider_id = '8633'
AND billing_code_type = 'HCPCS'
AND billing_code = '88355'
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 = '8633'
AND billing_code_type = 'HCPCS'
AND billing_code = '88355'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 103​
Sample Record Details:
- Payer ID: 97
- Provider ID: 790
- Billing Code Type: HCPCS
- Billing Code: Q5158
- 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_09.core_rates
WHERE payer_id = '97'
AND provider_id = '790'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5158'
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 = '790'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q5158'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 104​
Sample Record Details:
- Payer ID: 174
- Provider ID: 1015
- Billing Code Type: APR-DRG
- Billing Code: 0650-1
- 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_09.core_rates
WHERE payer_id = '174'
AND provider_id = '1015'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0650-1'
AND product_network_label IN ('BLUECARD - PREFERRED')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 174
AND provider_id = '1015'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0650-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 105​
Sample Record Details:
- Payer ID: 43
- Provider ID: 10341
- Billing Code Type: APR-DRG
- Billing Code: 0815-1
- Networks: ['INDIVIDUAL AND FAMILY HMO - MARICOPA', 'SMALL GROUP HMO - ALLIANCE', 'SMALL GROUP HMO', 'INDIVIDUAL AND FAMILY HMO - PIMA', 'INDIVIDUAL AND FAMILY HMO', 'INDIVIDUAL AND FAMILY HMO - NEIGHBORHOOD']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '43'
AND provider_id = '10341'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0815-1'
AND product_network_label IN ('INDIVIDUAL AND FAMILY HMO - MARICOPA', 'SMALL GROUP HMO - ALLIANCE', 'SMALL GROUP HMO', 'INDIVIDUAL AND FAMILY HMO - PIMA', 'INDIVIDUAL AND FAMILY HMO', 'INDIVIDUAL AND FAMILY HMO - NEIGHBORHOOD')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 43
AND provider_id = '10341'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0815-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 106​
Sample Record Details:
- Payer ID: 522
- Provider ID: 10370
- Billing Code Type: HCPCS
- Billing Code: 96910
- Networks: ['KFHP HAWAII', 'KPIC HAWAII']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '522'
AND provider_id = '10370'
AND billing_code_type = 'HCPCS'
AND billing_code = '96910'
AND product_network_label IN ('KFHP HAWAII', 'KPIC HAWAII')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '10370'
AND billing_code_type = 'HCPCS'
AND billing_code = '96910'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 107​
Sample Record Details:
- Payer ID: 403
- Provider ID: 6553
- Billing Code Type: HCPCS
- Billing Code: 93292
- 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_09.core_rates
WHERE payer_id = '403'
AND provider_id = '6553'
AND billing_code_type = 'HCPCS'
AND billing_code = '93292'
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 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 403 | 6553 | HCPCS | 93292 | Facility | Outpatient | HMO/POS/PPO | BLUE SHIELD | 58.28 | 6b9c2f71ddb14c9097227c5e26fe19a7 | ||||
| 403 | 6553 | HCPCS | 93292 | Facility | Outpatient | HMO/POS/PPO | BLUE SHIELD | 58.28 | d053b8ba54dc4a748a3750b9e73ee6c5 | ||||
| 403 | 6553 | HCPCS | 93292 | Facility | Outpatient | HMO/POS/PPO | BLUE SHIELD | 58.28 | ce4035488ea442e99fbafb4a72dcea49 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6553'
AND billing_code_type = 'HCPCS'
AND billing_code = '93292'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 108​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2339
- Billing Code Type: HCPCS
- Billing Code: 58545
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2339'
AND billing_code_type = 'HCPCS'
AND billing_code = '58545'
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 = '2339'
AND billing_code_type = 'HCPCS'
AND billing_code = '58545'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 109​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6382
- Billing Code Type: HCPCS
- Billing Code: 66682
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '6382'
AND billing_code_type = 'HCPCS'
AND billing_code = '66682'
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 = '6382'
AND billing_code_type = 'HCPCS'
AND billing_code = '66682'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 110​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6410
- Billing Code Type: HCPCS
- Billing Code: J2274
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '6410'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2274'
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 = '6410'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2274'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 111​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3466
- Billing Code Type: HCPCS
- Billing Code: 96521
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '3466'
AND billing_code_type = 'HCPCS'
AND billing_code = '96521'
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 | 3466 | HCPCS | 96521 | 940 | Inpatient & Outpatient | AMBETTER TN | AMBETTER | 0.01 | 271.63 | f9fcf5bef5474805a6fbdb54e8a25446 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3466'
AND billing_code_type = 'HCPCS'
AND billing_code = '96521'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 112​
Sample Record Details:
- Payer ID: 42
- Provider ID: 7209
- Billing Code Type: HCPCS
- Billing Code: J0216
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '7209'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0216'
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 = '7209'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0216'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 113​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3539
- Billing Code Type: APR-DRG
- Billing Code: 0893-2
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3539'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0893-2'
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 = '3539'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0893-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 114​
Sample Record Details:
- Payer ID: 388
- Provider ID: 2084
- Billing Code Type: HCPCS
- Billing Code: J0896
- Networks: ['SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '388'
AND provider_id = '2084'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0896'
AND product_network_label IN ('SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 388
AND provider_id = '2084'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0896'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 115​
Sample Record Details:
- Payer ID: 958
- Provider ID: 927
- Billing Code Type: APR-DRG
- Billing Code: 0817-3
- 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_09.core_rates
WHERE payer_id = '958'
AND provider_id = '927'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0817-3'
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 = '927'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0817-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 116​
Sample Record Details:
- Payer ID: 97
- Provider ID: 1017
- Billing Code Type: HCPCS
- Billing Code: 21015
- 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_09.core_rates
WHERE payer_id = '97'
AND provider_id = '1017'
AND billing_code_type = 'HCPCS'
AND billing_code = '21015'
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 = '1017'
AND billing_code_type = 'HCPCS'
AND billing_code = '21015'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 117​
Sample Record Details:
- Payer ID: 52
- Provider ID: 9756
- Billing Code Type: HCPCS
- Billing Code: 90476
- 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_09.core_rates
WHERE payer_id = '52'
AND provider_id = '9756'
AND billing_code_type = 'HCPCS'
AND billing_code = '90476'
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 = '9756'
AND billing_code_type = 'HCPCS'
AND billing_code = '90476'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 118​
Sample Record Details:
- Payer ID: 50
- Provider ID: 3845
- Billing Code Type: APR-DRG
- Billing Code: 0022-1
- Networks: ['AWARE 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_09.core_rates
WHERE payer_id = '50'
AND provider_id = '3845'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0022-1'
AND product_network_label IN ('AWARE 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 = 50
AND provider_id = '3845'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0022-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 119​
Sample Record Details:
- Payer ID: 44
- Provider ID: 1461
- Billing Code Type: HCPCS
- Billing Code: 78740
- Networks: ['PREFERRED PROVIDER NETWORK (PPO)']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '44'
AND provider_id = '1461'
AND billing_code_type = 'HCPCS'
AND billing_code = '78740'
AND product_network_label IN ('PREFERRED PROVIDER NETWORK (PPO)')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 44
AND provider_id = '1461'
AND billing_code_type = 'HCPCS'
AND billing_code = '78740'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 120​
Sample Record Details:
- Payer ID: 42
- Provider ID: 6039
- Billing Code Type: APR-DRG
- Billing Code: 0530-1
- Networks: ['NV 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '6039'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0530-1'
AND product_network_label IN ('NV 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 = '6039'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0530-1'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 121​
Sample Record Details:
- Payer ID: 76
- Provider ID: 6518
- Billing Code Type: HCPCS
- Billing Code: 74183
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '6518'
AND billing_code_type = 'HCPCS'
AND billing_code = '74183'
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 = '6518'
AND billing_code_type = 'HCPCS'
AND billing_code = '74183'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 122​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5390
- Billing Code Type: HCPCS
- Billing Code: C9162
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '5390'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9162'
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 = '5390'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9162'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 123​
Sample Record Details:
- Payer ID: 151
- Provider ID: 10
- Billing Code Type: HCPCS
- Billing Code: C9781
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '10'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9781'
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 = '10'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9781'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 124​
Sample Record Details:
- Payer ID: 7
- Provider ID: 3829
- Billing Code Type: HCPCS
- Billing Code: 90705
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '3829'
AND billing_code_type = 'HCPCS'
AND billing_code = '90705'
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 = '3829'
AND billing_code_type = 'HCPCS'
AND billing_code = '90705'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 125​
Sample Record Details:
- Payer ID: 522
- Provider ID: 1861
- Billing Code Type: HCPCS
- Billing Code: 75743
- Networks: ['KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '522'
AND provider_id = '1861'
AND billing_code_type = 'HCPCS'
AND billing_code = '75743'
AND product_network_label IN ('KFHP GEORGIA', 'KPIC GEORGIA', 'SELF FUNDED GEORGIA')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 522
AND provider_id = '1861'
AND billing_code_type = 'HCPCS'
AND billing_code = '75743'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 126​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10065
- Billing Code Type: HCPCS
- Billing Code: 49411
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '10065'
AND billing_code_type = 'HCPCS'
AND billing_code = '49411'
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 = '10065'
AND billing_code_type = 'HCPCS'
AND billing_code = '49411'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 127​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8664
- Billing Code Type: HCPCS
- Billing Code: 23125
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '8664'
AND billing_code_type = 'HCPCS'
AND billing_code = '23125'
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 = '8664'
AND billing_code_type = 'HCPCS'
AND billing_code = '23125'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 128​
Sample Record Details:
- Payer ID: 403
- Provider ID: 10138
- Billing Code Type: MS-DRG
- Billing Code: 080
- 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_09.core_rates
WHERE payer_id = '403'
AND provider_id = '10138'
AND billing_code_type = 'MS-DRG'
AND billing_code = '080'
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 = '10138'
AND billing_code_type = 'MS-DRG'
AND billing_code = '080'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 129​
Sample Record Details:
- Payer ID: 76
- Provider ID: 9726
- Billing Code Type: HCPCS
- Billing Code: 67950
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '9726'
AND billing_code_type = 'HCPCS'
AND billing_code = '67950'
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 = '9726'
AND billing_code_type = 'HCPCS'
AND billing_code = '67950'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 130​
Sample Record Details:
- Payer ID: 813
- Provider ID: 3025
- Billing Code Type: HCPCS
- Billing Code: 25652
- Networks: ['EPO/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_09.core_rates
WHERE payer_id = '813'
AND provider_id = '3025'
AND billing_code_type = 'HCPCS'
AND billing_code = '25652'
AND product_network_label IN ('EPO/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 = 813
AND provider_id = '3025'
AND billing_code_type = 'HCPCS'
AND billing_code = '25652'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 131​
Sample Record Details:
- Payer ID: 50
- Provider ID: 3836
- Billing Code Type: HCPCS
- Billing Code: 27591
- Networks: ['AWARE 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_09.core_rates
WHERE payer_id = '50'
AND provider_id = '3836'
AND billing_code_type = 'HCPCS'
AND billing_code = '27591'
AND product_network_label IN ('AWARE 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 = 50
AND provider_id = '3836'
AND billing_code_type = 'HCPCS'
AND billing_code = '27591'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 132​
Sample Record Details:
- Payer ID: 151
- Provider ID: 5377
- Billing Code Type: HCPCS
- Billing Code: 74190
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '5377'
AND billing_code_type = 'HCPCS'
AND billing_code = '74190'
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 = '5377'
AND billing_code_type = 'HCPCS'
AND billing_code = '74190'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 133​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6314
- Billing Code Type: HCPCS
- Billing Code: J7612
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '6314'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7612'
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 = '6314'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7612'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 134​
Sample Record Details:
- Payer ID: 720
- Provider ID: 10128
- Billing Code Type: MS-DRG
- Billing Code: 906
- Networks: ['CHOICENET 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_09.core_rates
WHERE payer_id = '720'
AND provider_id = '10128'
AND billing_code_type = 'MS-DRG'
AND billing_code = '906'
AND product_network_label IN ('CHOICENET 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 = 720
AND provider_id = '10128'
AND billing_code_type = 'MS-DRG'
AND billing_code = '906'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 135​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3142
- Billing Code Type: HCPCS
- Billing Code: Q4174
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3142'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4174'
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 = '3142'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q4174'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 136​
Sample Record Details:
- Payer ID: 522
- Provider ID: 1369
- Billing Code Type: HCPCS
- Billing Code: 28660
- Networks: ['KPIC MID ATLANTIC', 'SELF FUNDED MID ATLANTIC']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '522'
AND provider_id = '1369'
AND billing_code_type = 'HCPCS'
AND billing_code = '28660'
AND product_network_label IN ('KPIC MID ATLANTIC', 'SELF FUNDED MID ATLANTIC')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 522
AND provider_id = '1369'
AND billing_code_type = 'HCPCS'
AND billing_code = '28660'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 137​
Sample Record Details:
- Payer ID: 54
- Provider ID: 9788
- Billing Code Type: HCPCS
- Billing Code: 50386
- 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_09.core_rates
WHERE payer_id = '54'
AND provider_id = '9788'
AND billing_code_type = 'HCPCS'
AND billing_code = '50386'
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 = '9788'
AND billing_code_type = 'HCPCS'
AND billing_code = '50386'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 138​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5977
- Billing Code Type: HCPCS
- Billing Code: 61215
- Networks: ['ARIZONA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '76'
AND provider_id = '5977'
AND billing_code_type = 'HCPCS'
AND billing_code = '61215'
AND product_network_label IN ('ARIZONA HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 76
AND provider_id = '5977'
AND billing_code_type = 'HCPCS'
AND billing_code = '61215'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 139​
Sample Record Details:
- Payer ID: 151
- Provider ID: 9553
- Billing Code Type: HCPCS
- Billing Code: 22319
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '9553'
AND billing_code_type = 'HCPCS'
AND billing_code = '22319'
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 = '9553'
AND billing_code_type = 'HCPCS'
AND billing_code = '22319'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 140​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5413
- Billing Code Type: MS-DRG
- Billing Code: 076
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '5413'
AND billing_code_type = 'MS-DRG'
AND billing_code = '076'
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 = '5413'
AND billing_code_type = 'MS-DRG'
AND billing_code = '076'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 141​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1252
- Billing Code Type: HCPCS
- Billing Code: 92201
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1252'
AND billing_code_type = 'HCPCS'
AND billing_code = '92201'
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 = '1252'
AND billing_code_type = 'HCPCS'
AND billing_code = '92201'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 142​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4449
- Billing Code Type: HCPCS
- Billing Code: J1938
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '4449'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1938'
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 = '4449'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1938'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 143​
Sample Record Details:
- Payer ID: 76
- Provider ID: 10232
- Billing Code Type: HCPCS
- Billing Code: 91040
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '10232'
AND billing_code_type = 'HCPCS'
AND billing_code = '91040'
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 = '10232'
AND billing_code_type = 'HCPCS'
AND billing_code = '91040'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 144​
Sample Record Details:
- Payer ID: 42
- Provider ID: 711
- Billing Code Type: APR-DRG
- Billing Code: 0720-4
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '711'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0720-4'
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 = '711'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0720-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 145​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5567
- Billing Code Type: HCPCS
- Billing Code: C9164
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '5567'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9164'
AND product_network_label IN ('CHOICE PLUS')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 2 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 5567 | HCPCS | C9164 | Facility | Outpatient | PPO | UNITED HEALTHCARE | 10000.0% | 87f6244a86a149d69abeb4bd68499e62 | ||||
| 643 | 5567 | HCPCS | C9164 | Facility | Outpatient | HMO | UNITED HEALTHCARE | 10000.0% | 467b22f5a22948e7a1d47091739fc8a5 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '5567'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9164'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 146​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2659
- Billing Code Type: HCPCS
- Billing Code: 29131
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2659'
AND billing_code_type = 'HCPCS'
AND billing_code = '29131'
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 = '2659'
AND billing_code_type = 'HCPCS'
AND billing_code = '29131'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 147​
Sample Record Details:
- Payer ID: 76
- Provider ID: 5217
- Billing Code Type: HCPCS
- Billing Code: 67101
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '5217'
AND billing_code_type = 'HCPCS'
AND billing_code = '67101'
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 = '5217'
AND billing_code_type = 'HCPCS'
AND billing_code = '67101'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 148​
Sample Record Details:
- Payer ID: 403
- Provider ID: 6369
- Billing Code Type: HCPCS
- Billing Code: 66840
- 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_09.core_rates
WHERE payer_id = '403'
AND provider_id = '6369'
AND billing_code_type = 'HCPCS'
AND billing_code = '66840'
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 = '6369'
AND billing_code_type = 'HCPCS'
AND billing_code = '66840'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 149​
Sample Record Details:
- Payer ID: 151
- Provider ID: 6565
- Billing Code Type: HCPCS
- Billing Code: J1165
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '6565'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1165'
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 = '6565'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J1165'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 150​
Sample Record Details:
- Payer ID: 7
- Provider ID: 6425
- Billing Code Type: HCPCS
- Billing Code: J7345
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '6425'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7345'
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 = '6425'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7345'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 151​
Sample Record Details:
- Payer ID: 76
- Provider ID: 10253
- Billing Code Type: HCPCS
- Billing Code: 30580
- Networks: ['GEORGIA HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '76'
AND provider_id = '10253'
AND billing_code_type = 'HCPCS'
AND billing_code = '30580'
AND product_network_label IN ('GEORGIA 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 = '10253'
AND billing_code_type = 'HCPCS'
AND billing_code = '30580'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 152​
Sample Record Details:
- Payer ID: 522
- Provider ID: 6543
- Billing Code Type: HCPCS
- Billing Code: 49657
- 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_09.core_rates
WHERE payer_id = '522'
AND provider_id = '6543'
AND billing_code_type = 'HCPCS'
AND billing_code = '49657'
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 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 522 | 6543 | HCPCS | 49657 | Outpatient | COMMERCIAL | ALL PLANS | KAISER | 6200.0% |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '6543'
AND billing_code_type = 'HCPCS'
AND billing_code = '49657'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 153​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1056
- Billing Code Type: MS-DRG
- Billing Code: 432
- Networks: ['QCC COMMERCIAL PPO/EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '56'
AND provider_id = '1056'
AND billing_code_type = 'MS-DRG'
AND billing_code = '432'
AND product_network_label IN ('QCC COMMERCIAL PPO/EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 56
AND provider_id = '1056'
AND billing_code_type = 'MS-DRG'
AND billing_code = '432'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 154​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6271
- Billing Code Type: HCPCS
- Billing Code: 88321
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '6271'
AND billing_code_type = 'HCPCS'
AND billing_code = '88321'
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 = '6271'
AND billing_code_type = 'HCPCS'
AND billing_code = '88321'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 155​
Sample Record Details:
- Payer ID: 42
- Provider ID: 602
- Billing Code Type: HCPCS
- Billing Code: 25077
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '602'
AND billing_code_type = 'HCPCS'
AND billing_code = '25077'
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 = '602'
AND billing_code_type = 'HCPCS'
AND billing_code = '25077'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 156​
Sample Record Details:
- Payer ID: 643
- Provider ID: 9717
- Billing Code Type: HCPCS
- Billing Code: 27600
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '9717'
AND billing_code_type = 'HCPCS'
AND billing_code = '27600'
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 = '9717'
AND billing_code_type = 'HCPCS'
AND billing_code = '27600'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 157​
Sample Record Details:
- Payer ID: 403
- Provider ID: 8757
- Billing Code Type: HCPCS
- Billing Code: C9778
- 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_09.core_rates
WHERE payer_id = '403'
AND provider_id = '8757'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9778'
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 = '8757'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9778'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 158​
Sample Record Details:
- Payer ID: 151
- Provider ID: 3248
- Billing Code Type: HCPCS
- Billing Code: J0220
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '3248'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0220'
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 = '3248'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0220'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 159​
Sample Record Details:
- Payer ID: 628
- Provider ID: 6250
- Billing Code Type: HCPCS
- Billing Code: J2430
- Networks: ['PBC PPO (HERITAGE) NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '628'
AND provider_id = '6250'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2430'
AND product_network_label IN ('PBC PPO (HERITAGE) NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 628
AND provider_id = '6250'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J2430'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 160​
Sample Record Details:
- Payer ID: 7
- Provider ID: 2820
- Billing Code Type: HCPCS
- Billing Code: 73000
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '2820'
AND billing_code_type = 'HCPCS'
AND billing_code = '73000'
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 = '2820'
AND billing_code_type = 'HCPCS'
AND billing_code = '73000'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 161​
Sample Record Details:
- Payer ID: 42
- Provider ID: 1041
- Billing Code Type: APR-DRG
- Billing Code: 0541-2
- Networks: ['NY PPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '1041'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0541-2'
AND product_network_label IN ('NY PPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '1041'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0541-2'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 162​
Sample Record Details:
- Payer ID: 151
- Provider ID: 10627
- Billing Code Type: HCPCS
- Billing Code: 67120
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '10627'
AND billing_code_type = 'HCPCS'
AND billing_code = '67120'
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 = '10627'
AND billing_code_type = 'HCPCS'
AND billing_code = '67120'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 163​
Sample Record Details:
- Payer ID: 42
- Provider ID: 10033
- Billing Code Type: HCPCS
- Billing Code: 54115
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '10033'
AND billing_code_type = 'HCPCS'
AND billing_code = '54115'
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 = '10033'
AND billing_code_type = 'HCPCS'
AND billing_code = '54115'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 164​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1880
- Billing Code Type: HCPCS
- Billing Code: 78579
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1880'
AND billing_code_type = 'HCPCS'
AND billing_code = '78579'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 2 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 1880 | HCPCS | 78579 | Facility | Outpatient | HMO | UNITEDHEALTHCARE | 853.37 | b4a2ef480ef945f0a40af8650b703e85 | ||||
| 643 | 1880 | HCPCS | 78579 | Facility | Outpatient | PPO | UNITEDHEALTHCARE | 920.33 | 57943ecc85ef4f3c8aa2bed6c0f8c293 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1880'
AND billing_code_type = 'HCPCS'
AND billing_code = '78579'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 165​
Sample Record Details:
- Payer ID: 151
- Provider ID: 8755
- Billing Code Type: HCPCS
- Billing Code: 95199
- Networks: ['AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '151'
AND provider_id = '8755'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '8755'
AND billing_code_type = 'HCPCS'
AND billing_code = '95199'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 166​
Sample Record Details:
- Payer ID: 461
- Provider ID: 10115
- Billing Code Type: HCPCS
- Billing Code: 0707T
- 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_09.core_rates
WHERE payer_id = '461'
AND provider_id = '10115'
AND billing_code_type = 'HCPCS'
AND billing_code = '0707T'
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 = 461
AND provider_id = '10115'
AND billing_code_type = 'HCPCS'
AND billing_code = '0707T'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 167​
Sample Record Details:
- Payer ID: 643
- Provider ID: 6812
- Billing Code Type: HCPCS
- Billing Code: 26553
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '6812'
AND billing_code_type = 'HCPCS'
AND billing_code = '26553'
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 = '6812'
AND billing_code_type = 'HCPCS'
AND billing_code = '26553'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 168​
Sample Record Details:
- Payer ID: 354
- Provider ID: 6813
- Billing Code Type: APR-DRG
- Billing Code: 0583-3
- 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_09.core_rates
WHERE payer_id = '354'
AND provider_id = '6813'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0583-3'
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 = '6813'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0583-3'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 169​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2616
- Billing Code Type: HCPCS
- Billing Code: 12014
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2616'
AND billing_code_type = 'HCPCS'
AND billing_code = '12014'
AND product_network_label IN ('NAVIGATE')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 2 potential matches in hospital_rates:
✅ Matches found in hospital_rates.
| payer_id | provider_id | billing_code_type | billing_code | billing_class | revenue_code | billing_code_modifiers | setting | plan_name | raw_payer_name | negotiated_dollar | negotiated_percentage | estimated_allowed_amount | id |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 643 | 2616 | HCPCS | 12014 | Facility | 450 | Outpatient | UNITED COMMERCIAL FACILITY | UNITED COMMERCIAL FACILITY | 678.04 | 553433ebe7c642bb863d3af09a903732 | |||
| 643 | 2616 | HCPCS | 12014 | Facility | 450 | Outpatient | UNITED CHARTER (SG COMMERCIAL) FACILITY | UNITED CHARTER (SG COMMERCIAL) FACILITY | 597.08 | 0a063bd8ddf4440e9499a3fd3fbee4ab |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '2616'
AND billing_code_type = 'HCPCS'
AND billing_code = '12014'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 170​
Sample Record Details:
- Payer ID: 286
- Provider ID: 927
- Billing Code Type: HCPCS
- Billing Code: 25335
- 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_09.core_rates
WHERE payer_id = '286'
AND provider_id = '927'
AND billing_code_type = 'HCPCS'
AND billing_code = '25335'
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 = '927'
AND billing_code_type = 'HCPCS'
AND billing_code = '25335'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 171​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1078
- Billing Code Type: HCPCS
- Billing Code: 15731
- Networks: ['PA GROUP HMO/POS']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '7'
AND provider_id = '1078'
AND billing_code_type = 'HCPCS'
AND billing_code = '15731'
AND product_network_label IN ('PA GROUP HMO/POS')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7 | 1078 | HCPCS | 15731 | Facility | 360 | Outpatient | ASA | AETNA | 5,097.95 | 7130.0% | b5c06311e6374721a5f97eebebc1af61 | ||
| 7 | 1078 | HCPCS | 15731 | Facility | 360 | Outpatient | HMO | AETNA | 6,845.00 | f5783a2e86254bef9bd6fc3e3d9fbb88 | |||
| 7 | 1078 | HCPCS | 15731 | Facility | 360 | Outpatient | PPO | AETNA | 6,845.00 | df6daf50baba453990097c7ca1d1f70c |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '1078'
AND billing_code_type = 'HCPCS'
AND billing_code = '15731'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 172​
Sample Record Details:
- Payer ID: 636
- Provider ID: 6970
- Billing Code Type: HCPCS
- Billing Code: C9783
- Networks: ['VALUE HMO', 'MED HMO - UT', 'MED HMO', 'VALUE HMO - UT', 'CARE HMO - UT', 'SHARE HMO', 'MED HMO - NV', 'VALUE HMO - NV']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '636'
AND provider_id = '6970'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9783'
AND product_network_label IN ('VALUE HMO', 'MED HMO - UT', 'MED HMO', 'VALUE HMO - UT', 'CARE HMO - UT', 'SHARE HMO', 'MED HMO - NV', 'VALUE HMO - NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 636
AND provider_id = '6970'
AND billing_code_type = 'HCPCS'
AND billing_code = 'C9783'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 173​
Sample Record Details:
- Payer ID: 166
- Provider ID: 5824
- Billing Code Type: HCPCS
- Billing Code: Q2042
- Networks: ['BLUE ADVANTAGE HMO', 'HEALTH MAINTENANCE ORGANIZATION HMO', 'BLUE COMMUNITY HMO NETWORK']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '166'
AND provider_id = '5824'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2042'
AND product_network_label IN ('BLUE ADVANTAGE HMO', 'HEALTH MAINTENANCE ORGANIZATION HMO', 'BLUE COMMUNITY HMO NETWORK')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 166
AND provider_id = '5824'
AND billing_code_type = 'HCPCS'
AND billing_code = 'Q2042'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 174​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1018
- Billing Code Type: HCPCS
- Billing Code: J7205
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1018'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7205'
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 = '1018'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J7205'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 175​
Sample Record Details:
- Payer ID: 958
- Provider ID: 9274
- Billing Code Type: HCPCS
- Billing Code: 11106
- 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_09.core_rates
WHERE payer_id = '958'
AND provider_id = '9274'
AND billing_code_type = 'HCPCS'
AND billing_code = '11106'
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 = '9274'
AND billing_code_type = 'HCPCS'
AND billing_code = '11106'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 176​
Sample Record Details:
- Payer ID: 76
- Provider ID: 8586
- Billing Code Type: HCPCS
- Billing Code: 28312
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '8586'
AND billing_code_type = 'HCPCS'
AND billing_code = '28312'
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 = '8586'
AND billing_code_type = 'HCPCS'
AND billing_code = '28312'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 177​
Sample Record Details:
- Payer ID: 56
- Provider ID: 1001
- Billing Code Type: HCPCS
- Billing Code: 92953
- 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_09.core_rates
WHERE payer_id = '56'
AND provider_id = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = '92953'
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 = '1001'
AND billing_code_type = 'HCPCS'
AND billing_code = '92953'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 178​
Sample Record Details:
- Payer ID: 7
- Provider ID: 3102
- Billing Code Type: HCPCS
- Billing Code: J9266
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '3102'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9266'
AND product_network_label IN ('OPEN ACCESS MANAGED CHOICE')
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7 | 3102 | HCPCS | J9266 | Facility | Outpatient | HMO | AETNA | 26,554.90 | d9604edd294d42288274ef18c0419193 |
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3102'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J9266'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 179​
Sample Record Details:
- Payer ID: 7
- Provider ID: 5591
- Billing Code Type: HCPCS
- Billing Code: 81519
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '5591'
AND billing_code_type = 'HCPCS'
AND billing_code = '81519'
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 = '5591'
AND billing_code_type = 'HCPCS'
AND billing_code = '81519'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 180​
Sample Record Details:
- Payer ID: 643
- Provider ID: 4645
- Billing Code Type: HCPCS
- Billing Code: J0687
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '4645'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0687'
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 = '4645'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0687'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 181​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1223
- Billing Code Type: HCPCS
- Billing Code: 77081
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1223'
AND billing_code_type = 'HCPCS'
AND billing_code = '77081'
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 = '1223'
AND billing_code_type = 'HCPCS'
AND billing_code = '77081'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 182​
Sample Record Details:
- Payer ID: 7
- Provider ID: 10154
- Billing Code Type: HCPCS
- Billing Code: 68525
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '10154'
AND billing_code_type = 'HCPCS'
AND billing_code = '68525'
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 = '10154'
AND billing_code_type = 'HCPCS'
AND billing_code = '68525'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 183​
Sample Record Details:
- Payer ID: 643
- Provider ID: 3815
- Billing Code Type: HCPCS
- Billing Code: 66720
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '3815'
AND billing_code_type = 'HCPCS'
AND billing_code = '66720'
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 = '3815'
AND billing_code_type = 'HCPCS'
AND billing_code = '66720'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 184​
Sample Record Details:
- Payer ID: 42
- Provider ID: 993
- Billing Code Type: HCPCS
- Billing Code: 55530
- Networks: ['NY EPO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '42'
AND provider_id = '993'
AND billing_code_type = 'HCPCS'
AND billing_code = '55530'
AND product_network_label IN ('NY EPO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 42
AND provider_id = '993'
AND billing_code_type = 'HCPCS'
AND billing_code = '55530'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 185​
Sample Record Details:
- Payer ID: 643
- Provider ID: 5168
- Billing Code Type: HCPCS
- Billing Code: J0163
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '5168'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0163'
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 = '5168'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0163'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 186​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1471
- Billing Code Type: HCPCS
- Billing Code: 98925
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1471'
AND billing_code_type = 'HCPCS'
AND billing_code = '98925'
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 = '1471'
AND billing_code_type = 'HCPCS'
AND billing_code = '98925'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 187​
Sample Record Details:
- Payer ID: 388
- Provider ID: 9238
- Billing Code Type: HCPCS
- Billing Code: 92552
- Networks: ['SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '388'
AND provider_id = '9238'
AND billing_code_type = 'HCPCS'
AND billing_code = '92552'
AND product_network_label IN ('SIMPLYBLUE HMO', 'BLUECARE HMO', 'MYBLUE HMO')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 388
AND provider_id = '9238'
AND billing_code_type = 'HCPCS'
AND billing_code = '92552'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 188​
Sample Record Details:
- Payer ID: 97
- Provider ID: 866
- Billing Code Type: HCPCS
- Billing Code: 22804
- 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_09.core_rates
WHERE payer_id = '97'
AND provider_id = '866'
AND billing_code_type = 'HCPCS'
AND billing_code = '22804'
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 = '866'
AND billing_code_type = 'HCPCS'
AND billing_code = '22804'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 189​
Sample Record Details:
- Payer ID: 42
- Provider ID: 2378
- Billing Code Type: HCPCS
- Billing Code: 22114
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '2378'
AND billing_code_type = 'HCPCS'
AND billing_code = '22114'
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 = '2378'
AND billing_code_type = 'HCPCS'
AND billing_code = '22114'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 190​
Sample Record Details:
- Payer ID: 7
- Provider ID: 1495
- Billing Code Type: HCPCS
- Billing Code: 31629
- 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_09.core_rates
WHERE payer_id = '7'
AND provider_id = '1495'
AND billing_code_type = 'HCPCS'
AND billing_code = '31629'
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 = '1495'
AND billing_code_type = 'HCPCS'
AND billing_code = '31629'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 191​
Sample Record Details:
- Payer ID: 398
- Provider ID: 3359
- Billing Code Type: APR-DRG
- Billing Code: 0711-4
- Networks: ['NETWORK P']
Core Rates Lookup Results​
Found 0 potential matches in core_rates:
No matches found in core_rates.
Click to see SQL
SELECT payer_id, provider_id, billing_code_type, billing_code,
product_network_label, billing_class,
billing_code_modifier,
negotiation_arrangement, negotiated_type,
negotiated_rate, id
FROM tq_production.public_2025_09.core_rates
WHERE payer_id = '398'
AND provider_id = '3359'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0711-4'
AND product_network_label IN ('NETWORK P')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
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 = '3359'
AND billing_code_type = 'APR-DRG'
AND billing_code = '0711-4'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 192​
Sample Record Details:
- Payer ID: 42
- Provider ID: 6883
- Billing Code Type: HCPCS
- Billing Code: 75833
- Networks: ['VA HMO INDIVIDUAL 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '6883'
AND billing_code_type = 'HCPCS'
AND billing_code = '75833'
AND product_network_label IN ('VA HMO INDIVIDUAL 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 = 42
AND provider_id = '6883'
AND billing_code_type = 'HCPCS'
AND billing_code = '75833'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 193​
Sample Record Details:
- Payer ID: 76
- Provider ID: 4893
- Billing Code Type: HCPCS
- Billing Code: 68040
- 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_09.core_rates
WHERE payer_id = '76'
AND provider_id = '4893'
AND billing_code_type = 'HCPCS'
AND billing_code = '68040'
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 = '4893'
AND billing_code_type = 'HCPCS'
AND billing_code = '68040'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 194​
Sample Record Details:
- Payer ID: 392
- Provider ID: 606
- Billing Code Type: HCPCS
- Billing Code: 40831
- 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_09.core_rates
WHERE payer_id = '392'
AND provider_id = '606'
AND billing_code_type = 'HCPCS'
AND billing_code = '40831'
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 = 392
AND provider_id = '606'
AND billing_code_type = 'HCPCS'
AND billing_code = '40831'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 195​
Sample Record Details:
- Payer ID: 643
- Provider ID: 2789
- Billing Code Type: HCPCS
- Billing Code: 64821
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '2789'
AND billing_code_type = 'HCPCS'
AND billing_code = '64821'
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 = '2789'
AND billing_code_type = 'HCPCS'
AND billing_code = '64821'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 196​
Sample Record Details:
- Payer ID: 643
- Provider ID: 1759
- Billing Code Type: HCPCS
- Billing Code: 44360
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '1759'
AND billing_code_type = 'HCPCS'
AND billing_code = '44360'
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 = '1759'
AND billing_code_type = 'HCPCS'
AND billing_code = '44360'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 197​
Sample Record Details:
- Payer ID: 42
- Provider ID: 3322
- Billing Code Type: HCPCS
- Billing Code: 44391
- 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_09.core_rates
WHERE payer_id = '42'
AND provider_id = '3322'
AND billing_code_type = 'HCPCS'
AND billing_code = '44391'
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 = '3322'
AND billing_code_type = 'HCPCS'
AND billing_code = '44391'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 198​
Sample Record Details:
- Payer ID: 151
- Provider ID: 852
- Billing Code Type: HCPCS
- Billing Code: 11604
- 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_09.core_rates
WHERE payer_id = '151'
AND provider_id = '852'
AND billing_code_type = 'HCPCS'
AND billing_code = '11604'
AND product_network_label IN ('AMBETTER TX', 'AMBETTER GA', 'AMBETTER FL', 'AMBETTER OH', 'AMBETTER MI', 'AMBETTER AR', 'AMBETTER AZ', 'AMBETTER MS', 'AMBETTER WA', 'AMBETTER KS', 'AMBETTER NC', 'AMBETTER TN', 'AMBETTER SC', 'AMBETTER CA', 'AMBETTER NE', 'AMBETTER IL', 'AMBETTER MO', 'AMBETTER IN', 'AMBETTER PA', 'AMBETTER LA', 'AMBETTER AL', 'AMBETTER OK', 'AMBETTER KY', 'AMBETTER NV')
AND billing_class IN ('Inpatient', 'Outpatient')
LIMIT 20
Hospital Rates Lookup Results​
Found 0 potential matches in hospital_rates:
No matches found in hospital_rates.
Click to see SQL
SELECT
payer_id, provider_id, billing_code_type, billing_code,
billing_class, revenue_code, billing_code_modifiers,
setting, plan_name, raw_payer_name,
negotiated_dollar, negotiated_percentage,
estimated_allowed_amount, id
FROM tq_production.hospital_data.hospital_rates
WHERE payer_id = 151
AND provider_id = '852'
AND billing_code_type = 'HCPCS'
AND billing_code = '11604'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 199​
Sample Record Details:
- Payer ID: 54
- Provider ID: 9274
- Billing Code Type: HCPCS
- Billing Code: J0540
- 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_09.core_rates
WHERE payer_id = '54'
AND provider_id = '9274'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0540'
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 = '9274'
AND billing_code_type = 'HCPCS'
AND billing_code = 'J0540'
AND payer_class_name = 'Commercial'
AND COALESCE(billing_class, '') != 'Professional'
LIMIT 20
Sample Record 200​
Sample Record Details:
- Payer ID: 643
- Provider ID: 10034
- Billing Code Type: HCPCS
- Billing Code: 24125
- 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_09.core_rates
WHERE payer_id = '643'
AND provider_id = '10034'
AND billing_code_type = 'HCPCS'
AND billing_code = '24125'
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 = '10034'
AND billing_code_type = 'HCPCS'
AND billing_code = '24125'
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: 9 (avg: 0.045)
This analysis provides insights into the potential for filling coverage gaps by integrating data from core_rates and hospital_rates tables.