hospital_Haverhill Pavilion Behavioral Health	last_updated_ 2023-12-31	version_1	"hospital_Haverhill, Massachusetts"	hospital_address 76 Summer Street		license_ 1189 | MA	"To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded in this machine-readable file is true, accurate, and complete as of the date indicated in this file"																																																																																																																																																																				
																																																																																																																																																																											
description 	code |1	code|1|type	billing_class	setting	drug_unit_of_measurement	drug_type_of_measurement	modifiers	standard_charge | gross	standard_charge|discounted_cash	standard_charge|min	standard_charge | max	standard_charge|[payer_AARP MCARE COMPLETE|MANAGED MEDICARE]	standard_charge|[payer_AARP MCARE COMPLETE|MANAGED MEDICARE] |percent	standard_charge|[payer_AARP MCARE COMPLETE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_AARP MCARE COMPLETE|MANAGED MEDICARE]	standard_charge|[payer_AETNA|HMO/PPO]	standard_charge|[payer_AETNA|HMO/PPO] |percent	standard_charge|[payer_AETNA|HMO/PPO] |contracting_method	additional_payer_notes |[payer_AETNA|HMO/PPO]	standard_charge|[payer_AETNA MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_AETNA MANAGED MEDICARE|MANAGED MEDICARE] |percent	standard_charge|[payer_AETNA MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_AETNA MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_BCBS FEDERAL|BLUE CROSS]	standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |percent	standard_charge|[payer_BCBS FEDERAL|BLUE CROSS] |contracting_method	additional_payer_notes |[payer_BCBS FEDERAL|BLUE CROSS]	standard_charge|[payer_BCBS MCARE ADVANTAGE|MANAGED MEDICARE]	standard_charge|[payer_BCBS MCARE ADVANTAGE|MANAGED MEDICARE] |percent	standard_charge|[payer_BCBS MCARE ADVANTAGE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_BCBS MCARE ADVANTAGE|MANAGED MEDICARE]	standard_charge|[payer_BCBS OF MA|BLUE CROSS]	standard_charge|[payer_BCBS OF MA|BLUE CROSS] |percent	standard_charge|[payer_BCBS OF MA|BLUE CROSS] |contracting_method	additional_payer_notes |[payer_BCBS OF MA|BLUE CROSS]	standard_charge|[payer_BCBS OUT OF STATE|BLUE CROSS]	standard_charge|[payer_BCBS OUT OF STATE|BLUE CROSS] |percent	standard_charge|[payer_BCBS OUT OF STATE|BLUE CROSS] |contracting_method	additional_payer_notes |[payer_BCBS OUT OF STATE|BLUE CROSS]	standard_charge|[payer_BEACON HEALTH MEDICAID|MANAGED MEDICAID]	standard_charge|[payer_BEACON HEALTH MEDICAID|MANAGED MEDICAID] |percent	standard_charge|[payer_BEACON HEALTH MEDICAID|MANAGED MEDICAID] |contracting_method	additional_payer_notes |[payer_BEACON HEALTH MEDICAID|MANAGED MEDICAID]	standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO]	standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO] |percent	standard_charge|[payer_BEACON HEALTH STRATEGIES|HMO/PPO] |contracting_method	additional_payer_notes |[payer_BEACON HEALTH STRATEGIES|HMO/PPO]	standard_charge|[payer_BEACON SENIOR WHOLE HEALT|MANAGED MEDICARE]	standard_charge|[payer_BEACON SENIOR WHOLE HEALT|MANAGED MEDICARE] |percent	standard_charge|[payer_BEACON SENIOR WHOLE HEALT|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_BEACON SENIOR WHOLE HEALT|MANAGED MEDICARE]	standard_charge|[payer_BLUE BENEFITS|BLUE CROSS]	standard_charge|[payer_BLUE BENEFITS|BLUE CROSS] |percent	standard_charge|[payer_BLUE BENEFITS|BLUE CROSS] |contracting_method	additional_payer_notes |[payer_BLUE BENEFITS|BLUE CROSS]	standard_charge|[payer_CDPHP|HMO/PPO]	standard_charge|[payer_CDPHP|HMO/PPO] |percent	standard_charge|[payer_CDPHP|HMO/PPO] |contracting_method	additional_payer_notes |[payer_CDPHP|HMO/PPO]	standard_charge|[payer_CHAMPVA|VETERANS ADMIN]	standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |percent	standard_charge|[payer_CHAMPVA|VETERANS ADMIN] |contracting_method	additional_payer_notes |[payer_CHAMPVA|VETERANS ADMIN]	standard_charge|[payer_CIGNA|HMO/PPO]	standard_charge|[payer_CIGNA|HMO/PPO] |percent	standard_charge|[payer_CIGNA|HMO/PPO] |contracting_method	additional_payer_notes |[payer_CIGNA|HMO/PPO]	standard_charge|[payer_CIGNA MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_CIGNA MANAGED MEDICARE|MANAGED MEDICARE] |percent	standard_charge|[payer_CIGNA MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_CIGNA MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_COMMONWEALTH CARE ALLIANC|MANAGED MEDICARE]	standard_charge|[payer_COMMONWEALTH CARE ALLIANC|MANAGED MEDICARE] |percent	standard_charge|[payer_COMMONWEALTH CARE ALLIANC|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_COMMONWEALTH CARE ALLIANC|MANAGED MEDICARE]	standard_charge|[payer_ELEMENT CARE|MANAGED MEDICARE]	standard_charge|[payer_ELEMENT CARE|MANAGED MEDICARE] |percent	standard_charge|[payer_ELEMENT CARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_ELEMENT CARE|MANAGED MEDICARE]	standard_charge|[payer_FALLON MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_FALLON MANAGED MEDICARE|MANAGED MEDICARE] |percent	standard_charge|[payer_FALLON MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_FALLON MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_GIC UNICARE|HMO/PPO]	standard_charge|[payer_GIC UNICARE|HMO/PPO] |percent	standard_charge|[payer_GIC UNICARE|HMO/PPO] |contracting_method	additional_payer_notes |[payer_GIC UNICARE|HMO/PPO]	"standard_charge|[payer_HEALTH PLANS, INC|HMO/PPO]"	"standard_charge|[payer_HEALTH PLANS, INC|HMO/PPO] |percent"	"standard_charge|[payer_HEALTH PLANS, INC|HMO/PPO] |contracting_method"	"additional_payer_notes |[payer_HEALTH PLANS, INC|HMO/PPO]"	standard_charge|[payer_HUMANA|MANAGED MEDICARE]	standard_charge|[payer_HUMANA|MANAGED MEDICARE] |percent	standard_charge|[payer_HUMANA|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_HUMANA|MANAGED MEDICARE]	standard_charge|[payer_MASS HEALTH MEDICAID|MEDICAID ]	standard_charge|[payer_MASS HEALTH MEDICAID|MEDICAID ] |percent	standard_charge|[payer_MASS HEALTH MEDICAID|MEDICAID ] |contracting_method	additional_payer_notes |[payer_MASS HEALTH MEDICAID|MEDICAID ]	standard_charge|[payer_MBHP|MANAGED MEDICAID]	standard_charge|[payer_MBHP|MANAGED MEDICAID] |percent	standard_charge|[payer_MBHP|MANAGED MEDICAID] |contracting_method	additional_payer_notes |[payer_MBHP|MANAGED MEDICAID]	standard_charge|[payer_MEDICAID PENDING|MEDICAID ]	standard_charge|[payer_MEDICAID PENDING|MEDICAID ] |percent	standard_charge|[payer_MEDICAID PENDING|MEDICAID ] |contracting_method	additional_payer_notes |[payer_MEDICAID PENDING|MEDICAID ]	standard_charge|[payer_MEDICARE|MEDICARE]	standard_charge|[payer_MEDICARE|MEDICARE] |percent	standard_charge|[payer_MEDICARE|MEDICARE] |contracting_method	additional_payer_notes |[payer_MEDICARE|MEDICARE]	standard_charge|[payer_MODERN ASSISTANCE PLAN|HMO/PPO]	standard_charge|[payer_MODERN ASSISTANCE PLAN|HMO/PPO] |percent	standard_charge|[payer_MODERN ASSISTANCE PLAN|HMO/PPO] |contracting_method	additional_payer_notes |[payer_MODERN ASSISTANCE PLAN|HMO/PPO]	standard_charge|[payer_OXFORD HEALTH|HMO/PPO]	standard_charge|[payer_OXFORD HEALTH|HMO/PPO] |percent	standard_charge|[payer_OXFORD HEALTH|HMO/PPO] |contracting_method	additional_payer_notes |[payer_OXFORD HEALTH|HMO/PPO]	standard_charge|[payer_PACE|MANAGED MEDICARE]	standard_charge|[payer_PACE|MANAGED MEDICARE] |percent	standard_charge|[payer_PACE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_PACE|MANAGED MEDICARE]	standard_charge|[payer_SENIOR WHOLE HEALTH MA|MANAGED MEDICARE]	standard_charge|[payer_SENIOR WHOLE HEALTH MA|MANAGED MEDICARE] |percent	standard_charge|[payer_SENIOR WHOLE HEALTH MA|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_SENIOR WHOLE HEALTH MA|MANAGED MEDICARE]	standard_charge|[payer_TRICARE FOR LIFE|HMO/PPO]	standard_charge|[payer_TRICARE FOR LIFE|HMO/PPO] |percent	standard_charge|[payer_TRICARE FOR LIFE|HMO/PPO] |contracting_method	additional_payer_notes |[payer_TRICARE FOR LIFE|HMO/PPO]	standard_charge|[payer_TUFTS|HMO/PPO]	standard_charge|[payer_TUFTS|HMO/PPO] |percent	standard_charge|[payer_TUFTS|HMO/PPO] |contracting_method	additional_payer_notes |[payer_TUFTS|HMO/PPO]	standard_charge|[payer_TUFTS HEALTH DIRECT|HMO/PPO]	standard_charge|[payer_TUFTS HEALTH DIRECT|HMO/PPO] |percent	standard_charge|[payer_TUFTS HEALTH DIRECT|HMO/PPO] |contracting_method	additional_payer_notes |[payer_TUFTS HEALTH DIRECT|HMO/PPO]	standard_charge|[payer_TUFTS MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_TUFTS MANAGED MEDICARE|MANAGED MEDICARE] |percent	standard_charge|[payer_TUFTS MANAGED MEDICARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_TUFTS MANAGED MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_TUFTS MGD MCAID|MANAGED MEDICAID]	standard_charge|[payer_TUFTS MGD MCAID|MANAGED MEDICAID] |percent	standard_charge|[payer_TUFTS MGD MCAID|MANAGED MEDICAID] |contracting_method	additional_payer_notes |[payer_TUFTS MGD MCAID|MANAGED MEDICAID]	standard_charge|[payer_TUFTS UNIFY|MANAGED MEDICARE]	standard_charge|[payer_TUFTS UNIFY|MANAGED MEDICARE] |percent	standard_charge|[payer_TUFTS UNIFY|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_TUFTS UNIFY|MANAGED MEDICARE]	standard_charge|[payer_UBH|HMO/PPO]	standard_charge|[payer_UBH|HMO/PPO] |percent	standard_charge|[payer_UBH|HMO/PPO] |contracting_method	additional_payer_notes |[payer_UBH|HMO/PPO]	standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE] |percent	standard_charge|[payer_UBH MEDICARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_UBH MEDICARE|MANAGED MEDICARE]	standard_charge|[payer_UBH MY CARE FAMILY MGD MD|MANAGED MEDICAID]	standard_charge|[payer_UBH MY CARE FAMILY MGD MD|MANAGED MEDICAID] |percent	standard_charge|[payer_UBH MY CARE FAMILY MGD MD|MANAGED MEDICAID] |contracting_method	additional_payer_notes |[payer_UBH MY CARE FAMILY MGD MD|MANAGED MEDICAID]	standard_charge|[payer_UMR|HMO/PPO]	standard_charge|[payer_UMR|HMO/PPO] |percent	standard_charge|[payer_UMR|HMO/PPO] |contracting_method	additional_payer_notes |[payer_UMR|HMO/PPO]	standard_charge|[payer_WELLCARE|MANAGED MEDICARE]	standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |percent	standard_charge|[payer_WELLCARE|MANAGED MEDICARE] |contracting_method	additional_payer_notes |[payer_WELLCARE|MANAGED MEDICARE]
ROOM & BOARD ADULT PSYCH - WE	124	RC	facility	inpatient				1400.00	1000	840	1209.03	DRG		DRG		1065		per diem		1065		per diem		1058.21		per diem		1058.21		per diem		1058.21		per diem		1058.21		per diem		973.75		per diem		1091		per diem		973.75		per diem		1058.21		per diem		840		per diem		DRG		DRG		1152		per diem		DRG		DRG		DRG		DRG		DRG		DRG		973.75		per diem		973.75		per diem		1065		per diem		DRG		DRG		954.59		per diem		954.59		per diem		954.59		per diem		DRG		DRG		995		per diem		882		per diem		DRG		DRG		1202		per diem		1209.03		per diem		1079		per diem		954.59		per diem		1079		per diem		954.59		per diem		DRG		DRG		1065		per diem		DRG		DRG		1005		per diem		1065		per diem		DRG		DRG	
ROOM AND BOARD GERO PSYCH	124	RC	facility	inpatient				1400.00	1000	840	1209.03	DRGE		DRG		1065		per diem		1065		per diem		1058.21		per diem		1058.21		per diem		1058.21		per diem		1058.21		per diem		973.75		per diem		1091		per diem		973.75		per diem		1058.21		per diem		840		per diem		DRG		DRG		1152		per diem		DRG		DRG		DRG		DRG		DRG		DRG		973.75		per diem		973.75		per diem		1065		per diem		DRG		DRG		954.59		per diem		954.59		per diem		954.59		per diem		DRG		DRG		995		per diem		882		per diem		DRG		DRG		1202		per diem		1209.03		per diem		1079		per diem		954.59		per diem		1079		per diem		954.59		per diem		DRG		DRG		1065		per diem		DRG		DRG		1005		per diem		1065		per diem		DRG		DRG	
PSYCH EVAL - NO MEDS	90791	RC	facility	inpatient				310	0	154.1	178.84			  		178.84		fee schedule		178.84		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		154.1		fee schedule				  				  				  				  				  				  				  		154.1		fee schedule		154.1		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
PSYCH EVAL - WITH MEDS	90792	RC	facility	inpatient				310	0	175.67	201.48			  		201.48		fee schedule		201.48		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		175.67		fee schedule				  				  				  				  				  				  				  		175.67		fee schedule		175.67		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
SUBSEQUENT CARE - HIGH COMPLEXITY	99233	RC	facility	inpatient				175	0	121.91	136			  		136		fee schedule		136		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		121.91		fee schedule				  				  				  				  				  				  				  		121.91		fee schedule		121.91		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
SUBSEQUENT CARE - MODERATE COMPLEXITY	99232	RC	facility	inpatient				120	0	81.05	95.24			  		95.24		fee schedule		95.24		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		81.05		fee schedule				  				  				  				  				  				  				  		81.05		fee schedule		81.05		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
SUBSEQUENT CARE - LOW COMPLEXITY	99231	RC	facility	inpatient				120	0	50.71	51.49			  		51.49		fee schedule		51.49		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		50.71		fee schedule				  				  				  				  				  				  				  		50.71		fee schedule		50.71		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
DISCHARGE - LESS THANK 30 MINUTES	99238	RC	facility	inpatient				160	0	83.05	96.49			  		96.49		fee schedule		96.49		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		83.05		fee schedule				  				  				  				  				  				  				  		83.05		fee schedule		83.05		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  				  				  				  	
DISCHARGE -MORE THAN30 MINUTES	99239	RC	facility	inpatient				160	0	117.65	141.37			  		141.37		fee schedule		141.37		fee schedule				  				  				  				  				  				  				  				  				  				  				  				  		117.65		fee schedule				  				  				  				  				  				  				  		117.65		fee schedule		117.65		fee schedule