"hospital_Conway Behavioral Health, LLC" last_updated_ 2023-12-31 version_1 "hospital_Conway, Arkansas" hospital_address 2255 Sturgis Road license_ 5367| AR "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_AETNA HEALTHCARE |HMO/PPO] standard_charge|[payer_AETNA HEALTHCARE |HMO/PPO] |percent standard_charge|[payer_AETNA HEALTHCARE |HMO/PPO] |contracting_method additional_payer_notes |[payer_AETNA HEALTHCARE |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_ALASKA MEDICAID |MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MEDICAID |MEDICAID: CBS OOS] |percent standard_charge|[payer_ALASKA MEDICAID |MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_ALASKA MEDICAID |MEDICAID: CBS OOS] standard_charge|[payer_ALASKA MEDICAID |MEDICAID: OUT OF STATE] standard_charge|[payer_ALASKA MEDICAID |MEDICAID: OUT OF STATE] |percent standard_charge|[payer_ALASKA MEDICAID |MEDICAID: OUT OF STATE] |contracting_method additional_payer_notes |[payer_ALASKA MEDICAID |MEDICAID: OUT OF STATE] standard_charge|[payer_ALLWELL |MANAGED MEDICARE] standard_charge|[payer_ALLWELL |MANAGED MEDICARE] |percent standard_charge|[payer_ALLWELL |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_ALLWELL |MANAGED MEDICARE] standard_charge|[payer_AMBETTER COMMERCIAL |HMO/PPO] standard_charge|[payer_AMBETTER COMMERCIAL |HMO/PPO] |percent standard_charge|[payer_AMBETTER COMMERCIAL |HMO/PPO] |contracting_method additional_payer_notes |[payer_AMBETTER COMMERCIAL |HMO/PPO] standard_charge|[payer_AMBETTER MCD MNGD |MANAGED MEDICAID] standard_charge|[payer_AMBETTER MCD MNGD |MANAGED MEDICAID] |percent standard_charge|[payer_AMBETTER MCD MNGD |MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_AMBETTER MCD MNGD |MANAGED MEDICAID] standard_charge|[payer_AMERIVANTAGE |MANAGED MEDICARE] standard_charge|[payer_AMERIVANTAGE |MANAGED MEDICARE] |percent standard_charge|[payer_AMERIVANTAGE |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_AMERIVANTAGE |MANAGED MEDICARE] standard_charge|[payer_APC PASSE SUMMIT COMM CARMANAGED |MEDICAID] standard_charge|[payer_APC PASSE SUMMIT COMM CARMANAGED |MEDICAID] |percent standard_charge|[payer_APC PASSE SUMMIT COMM CARMANAGED |MEDICAID] |contracting_method additional_payer_notes |[payer_APC PASSE SUMMIT COMM CARMANAGED |MEDICAID] standard_charge|[payer_AR DHS |LOCAL GOVT] standard_charge|[payer_AR DHS |LOCAL GOVT] |percent standard_charge|[payer_AR DHS |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_AR DHS |LOCAL GOVT] standard_charge|[payer_ARK MEDICAID |MEDICAID] standard_charge|[payer_ARK MEDICAID |MEDICAID] |percent standard_charge|[payer_ARK MEDICAID |MEDICAID] |contracting_method additional_payer_notes |[payer_ARK MEDICAID |MEDICAID] standard_charge|[payer_ARKANSAS ADULT MEDICAID |MEDICAID] standard_charge|[payer_ARKANSAS ADULT MEDICAID |MEDICAID] |percent standard_charge|[payer_ARKANSAS ADULT MEDICAID |MEDICAID] |contracting_method additional_payer_notes |[payer_ARKANSAS ADULT MEDICAID |MEDICAID] standard_charge|[payer_ATC INC AR TOTAL CARE |MANAGED MEDICAID] standard_charge|[payer_ATC INC AR TOTAL CARE |MANAGED MEDICAID] |percent standard_charge|[payer_ATC INC AR TOTAL CARE |MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_ATC INC AR TOTAL CARE |MANAGED MEDICAID] standard_charge|[payer_BLUE CROSS MARKETPLACE AR |MANAGED MEDICAID] standard_charge|[payer_BLUE CROSS MARKETPLACE AR |MANAGED MEDICAID] |percent standard_charge|[payer_BLUE CROSS MARKETPLACE AR |MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_BLUE CROSS MARKETPLACE AR |MANAGED MEDICAID] standard_charge|[payer_BLUE CROSS OF ARKANSAS MP |MANAGED MEDICARE] standard_charge|[payer_BLUE CROSS OF ARKANSAS MP |MANAGED MEDICARE] |percent standard_charge|[payer_BLUE CROSS OF ARKANSAS MP |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_BLUE CROSS OF ARKANSAS MP |MANAGED MEDICARE] standard_charge|[payer_BLUE CROSS OF ARKANSAS |BLUE CROSS] standard_charge|[payer_BLUE CROSS OF ARKANSAS |BLUE CROSS] |percent standard_charge|[payer_BLUE CROSS OF ARKANSAS |BLUE CROSS] |contracting_method additional_payer_notes |[payer_BLUE CROSS OF ARKANSAS |BLUE CROSS] standard_charge|[payer_BLUE CROSS OOS |BLUE CROSS] standard_charge|[payer_BLUE CROSS OOS |BLUE CROSS] |percent standard_charge|[payer_BLUE CROSS OOS |BLUE CROSS] |contracting_method additional_payer_notes |[payer_BLUE CROSS OOS |BLUE CROSS] standard_charge|[payer_CARESOURCE ARKANSAS |MANAGED MEDICAID] standard_charge|[payer_CARESOURCE ARKANSAS |MANAGED MEDICAID] |percent standard_charge|[payer_CARESOURCE ARKANSAS |MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_CARESOURCE ARKANSAS |MANAGED MEDICAID] standard_charge|[payer_CENTERS FOR YOUTH & FAMIL |LOCAL GOVT] standard_charge|[payer_CENTERS FOR YOUTH & FAMIL |LOCAL GOVT] |percent standard_charge|[payer_CENTERS FOR YOUTH & FAMIL |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_CENTERS FOR YOUTH & FAMIL |LOCAL GOVT] standard_charge|[payer_CIGNA HEALTH SPRING |MANAGED MEDICARE] standard_charge|[payer_CIGNA HEALTH SPRING |MANAGED MEDICARE] |percent standard_charge|[payer_CIGNA HEALTH SPRING |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_CIGNA HEALTH SPRING |MANAGED MEDICARE] 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_COUNSELING ASSOCIATES |LOCAL GOVT] standard_charge|[payer_COUNSELING ASSOCIATES |LOCAL GOVT] |percent standard_charge|[payer_COUNSELING ASSOCIATES |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_COUNSELING ASSOCIATES |LOCAL GOVT] standard_charge|[payer_COUSELING CLINIC INC |LOCAL GOVT] standard_charge|[payer_COUSELING CLINIC INC |LOCAL GOVT] |percent standard_charge|[payer_COUSELING CLINIC INC |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_COUSELING CLINIC INC |LOCAL GOVT] standard_charge|[payer_EMPOWER HEALTHCARE SOLUTI |MANAGED MEDICAID] standard_charge|[payer_EMPOWER HEALTHCARE SOLUTI |MANAGED MEDICAID] |percent standard_charge|[payer_EMPOWER HEALTHCARE SOLUTI |MANAGED MEDICAID] |contracting_method additional_payer_notes |[payer_EMPOWER HEALTHCARE SOLUTI |MANAGED MEDICAID] standard_charge|[payer_FEDERAL BLUE CROSS |BLUE CROSS] standard_charge|[payer_FEDERAL BLUE CROSS |BLUE CROSS] |percent standard_charge|[payer_FEDERAL BLUE CROSS |BLUE CROSS] |contracting_method additional_payer_notes |[payer_FEDERAL BLUE CROSS |BLUE CROSS] standard_charge|[payer_GOLDEN RULE |HMO/PPO] standard_charge|[payer_GOLDEN RULE |HMO/PPO] |percent standard_charge|[payer_GOLDEN RULE |HMO/PPO] |contracting_method additional_payer_notes |[payer_GOLDEN RULE |HMO/PPO] standard_charge|[payer_HEALTH ADVANTAGE BC |BLUE CROSS] standard_charge|[payer_HEALTH ADVANTAGE BC |BLUE CROSS] |percent standard_charge|[payer_HEALTH ADVANTAGE BC |BLUE CROSS] |contracting_method additional_payer_notes |[payer_HEALTH ADVANTAGE BC |BLUE CROSS] standard_charge|[payer_HUMANA GOLD CHOICE |MANAGED MEDICARE] standard_charge|[payer_HUMANA GOLD CHOICE |MANAGED MEDICARE] |percent standard_charge|[payer_HUMANA GOLD CHOICE |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_HUMANA GOLD CHOICE |MANAGED MEDICARE] standard_charge|[payer_HUMANA| HMO/PPO] standard_charge|[payer_HUMANA| HMO/PPO] |percent standard_charge|[payer_HUMANA| HMO/PPO] |contracting_method additional_payer_notes |[payer_HUMANA| HMO/PPO] standard_charge|[payer_MAINECARE |MEDICAID: CBS OOS] standard_charge|[payer_MAINECARE |MEDICAID: CBS OOS] |percent standard_charge|[payer_MAINECARE |MEDICAID: CBS OOS] |contracting_method additional_payer_notes |[payer_MAINECARE |MEDICAID: CBS OOS] standard_charge|[payer_MEDICAID PENDING |PENDING MEDICAID] standard_charge|[payer_MEDICAID PENDING |PENDING MEDICAID] |percent standard_charge|[payer_MEDICAID PENDING |PENDING MEDICAID] |contracting_method additional_payer_notes |[payer_MEDICAID PENDING |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_MID SOUTH HEALTH SYSTEMS |LOCAL GOVT] standard_charge|[payer_MID SOUTH HEALTH SYSTEMS |LOCAL GOVT] |percent standard_charge|[payer_MID SOUTH HEALTH SYSTEMS |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_MID SOUTH HEALTH SYSTEMS |LOCAL GOVT] standard_charge|[payer_MUNICIPAL HEALTH BENEFIT |HMO/PPO] standard_charge|[payer_MUNICIPAL HEALTH BENEFIT |HMO/PPO] |percent standard_charge|[payer_MUNICIPAL HEALTH BENEFIT |HMO/PPO] |contracting_method additional_payer_notes |[payer_MUNICIPAL HEALTH BENEFIT |HMO/PPO] standard_charge|[payer_OUACHITA BEHAVIORAL HEALT |LOCAL GOVT] standard_charge|[payer_OUACHITA BEHAVIORAL HEALT |LOCAL GOVT] |percent standard_charge|[payer_OUACHITA BEHAVIORAL HEALT |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OUACHITA BEHAVIORAL HEALT |LOCAL GOVT] standard_charge|[payer_OZARK GUIDANCE |LOCAL GOVT] standard_charge|[payer_OZARK GUIDANCE |LOCAL GOVT] |percent standard_charge|[payer_OZARK GUIDANCE |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_OZARK GUIDANCE |LOCAL GOVT] standard_charge|[payer_PROF COUNSELING ASSOCIAT |LOCAL GOVT] standard_charge|[payer_PROF COUNSELING ASSOCIAT |LOCAL GOVT] |percent standard_charge|[payer_PROF COUNSELING ASSOCIAT |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_PROF COUNSELING ASSOCIAT |LOCAL GOVT] standard_charge|[payer_QUALCHOICE PPO |HMO/PPO] standard_charge|[payer_QUALCHOICE PPO |HMO/PPO] |percent standard_charge|[payer_QUALCHOICE PPO |HMO/PPO] |contracting_method additional_payer_notes |[payer_QUALCHOICE PPO |HMO/PPO] standard_charge|[payer_TRICARE EAST |TRICARE] standard_charge|[payer_TRICARE EAST |TRICARE] |percent standard_charge|[payer_TRICARE EAST |TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE EAST |TRICARE] standard_charge|[payer_TRICARE FOR LIFE |TRICARE] standard_charge|[payer_TRICARE FOR LIFE |TRICARE] |percent standard_charge|[payer_TRICARE FOR LIFE |TRICARE] |contracting_method additional_payer_notes |[payer_TRICARE FOR LIFE |TRICARE] standard_charge|[payer_UHC MEDICARE |MANAGED MEDICARE] standard_charge|[payer_UHC MEDICARE |MANAGED MEDICARE] |percent standard_charge|[payer_UHC MEDICARE |MANAGED MEDICARE] |contracting_method additional_payer_notes |[payer_UHC MEDICARE |MANAGED MEDICARE] 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_UNITED HEALTHCARE |HMO/PPO] standard_charge|[payer_UNITED HEALTHCARE |HMO/PPO] |percent standard_charge|[payer_UNITED HEALTHCARE |HMO/PPO] |contracting_method additional_payer_notes |[payer_UNITED HEALTHCARE |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] standard_charge|[payer_WESTERN ARK COUNSELING |LOCAL GOVT] standard_charge|[payer_WESTERN ARK COUNSELING |LOCAL GOVT] |percent standard_charge|[payer_WESTERN ARK COUNSELING |LOCAL GOVT] |contracting_method additional_payer_notes |[payer_WESTERN ARK COUNSELING |LOCAL GOVT] ACUTE PSY ROOM AND BOARD 124 RC facility inpatient 2200 800 400 1400 922 per diem 896 per diem 663 per diem 663 per diem 924 per diem 840 per diem 663 per diem 850 per diem 663 per diem 663 per diem 663 per diem 798 per diem 876 per diem 876 per diem 663 per diem 475 per diem 1070 per diem 400 per diem 480 per diem 663 per diem 876 per diem 960 per diem 876 per diem 924 per diem 1400 per diem 663 per diem 400 per diem 800 per diem 465 per diem 400 per diem 400 per diem 1062.5 per diem 989 per diem 989 per diem 485 per diem ADULT DTX ROOM AND BOARD 126 RC facility inpatient 2200 800 400 1400 922 per diem 896 per diem 663 per diem 663 per diem 924 per diem 840 per diem 663 per diem 850 per diem 663 per diem 663 per diem 663 per diem 798 per diem 876 per diem 876 per diem 663 per diem 475 1070 per diem 400 per diem 480 per diem 663 per diem 876 per diem 960 per diem 876 per diem 924 per diem 1400 per diem 663 per diem 400 per diem 654 per diem 465 per diem 400 per diem 400 per diem 1062.5 per diem 989 per diem 989 per diem 485 per diem TRANSCRANIAL MAGNETIC STIMULATION INITIAL TREAT 9001 RC facility outpatient 1000 0 233.64 315 266 per diem 239.15 per diem 239.15 per diem 242.98 per diem 242.98 per diem 242.98 per diem 242.98 per diem 233.64 per diem 242.98 per diem 239.15 per diem 315 per diem 239.15 per diem 239.15 per diem 239.15 per diem 239.15 per diem TRANSCRANIAL MAGNETIC STIMULATION SUBSEQ TREAT 9002 RC facility outpatient 850 0 127.71 315 244 per diem 239.15 per diem 239.15 per diem 132.82 per diem 132.82 per diem 132.82 per diem 132.82 per diem 127.71 per diem 132.82 per diem 239.15 per diem 315 per diem 239.15 per diem 239.15 per diem 239.15 per diem 239.15 per diem TRANSCRANIAL MAGNETIC STIMULATION REMAPPING 9003 RC facility outpatient 1000 0 127.71 315 222 per diem 239.15 per diem 239.15 per diem 132.82 per diem 132.82 per diem 132.82 per diem 132.82 per diem 127.71 per diem 132.82 per diem 239.15 per diem 315 per diem 239.15 per diem 239.15 per diem 239.15 per diem 239.15 per diem INTENSIVE OUTPATIENT PROGRAM 905 RC facility outpatient 480 200 0 236 234 per diem 138.6 per diem 126 per diem 0 0 0 0 162.24 per diem 162.24 per diem 162.24 per diem 162.24 per diem 0 189 per diem 0 200 per diem 229 per diem 200 per diem 236 per diem 0 0 159.4 per diem 229 per diem 229 per diem 229 per diem TH INTENSIVE OUTPATIENT PROGRAM COMMERCIAL 905 RC facility outpatient 480 200 0 236 234 per diem 138.6 per diem 126 per diem 0 0 0 0 162.24 per diem 162.24 per diem 162.24 per diem 162.24 per diem 0 189 per diem 0 200 per diem 229 per diem 200 per diem 236 per diem 0 0 159.4 per diem 229 per diem 229 per diem 229 per diem PARTIAL HOSPITALIZATION PROGRAM PROGRAM 912 RC facility outpatient 800 300 0 492 492 per diem 346.5 per diem 315 per diem 0 286 per diem 286 per diem 286 per diem 286 per diem 439 per diem 150 per diem 330 per diem 451 per diem 300 per diem 347 per diem 0 0 398.48 per diem 451 per diem 451 per diem 451 per diem TH PARTIAL HOSPITALIZATION PROGRAM COMMERCIAL 912 RC facility outpatient 800 300 0 492 492 per diem 346.5 per diem 315 per diem 0 286 per diem 286 per diem 286 per diem 286 per diem 439 per diem 150 per diem 330 per diem 451 per diem 300 per diem 347 per diem 0 0 398.48 per diem 451 per diem 451 per diem 451 per diem "INTENSIVE OUTPATIENT PROGRAM PROCESS GROUP 1, 2, 3" 915 RC facility outpatient 480 0 0 206.15 206.15 per diem 206.15 per diem 206.15 per diem 206.15 per diem 206.15 per diem 206.15 per diem 206.15 per diem 206.15 per diem "PARTIAL HOSPITALIZATION PROGRAM MCR PROC GRP 1, 2, 3, 4" 915 RC facility outpatient 160 0 0 239.16 239.16 per diem 239.16 per diem 239.16 per diem 239.16 per diem 239.16 per diem 239.16 per diem 239.16 per diem 239.16 per diem PARTIAL HOSPITALIZATION PROGRAM PASSE MCAID 9912 RC facility outpatient 800 0 214.05 214.05 214.05 per diem 214.05 per diem 214.05 per diem 214.05 per diem 214.05 per diem Psych Diagnostic Eval 90791 RC facility pro fees 310 0 135.57 135.57 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem 135.57 per diem Psych Eval With Medical Services 90792 RC facility pro fees 310 0 154.09 154.09 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem 154.09 per diem Admit Eval 99221 RC facility pro fees 165 0 72.33 72.33 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem 72.33 per diem Admit Eval 99222 RC facility pro fees 225 0 114.77 114.77 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem 114.77 per diem Initial Hospital Care 99223 RC facility pro fees 250 0 152.72 152.72 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 152.72 per diem 15 Min Eval 99231 RC facility pro fees 120 0 43.5 43.5 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 43.5 per diem 25 Min Eval 99232 RC facility pro fees 140 0 69.5 69.5 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 69.5 per diem 35 Min Eval 99233 RC facility pro fees 210 0 104.57 104.57 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem 104.57 per diem D/c Eval 99238 RC facility pro fees 160 0 71.3 71.3 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem 71.3 per diem Discharge Day Mgmt >30 Min 99239 RC facility pro fees 160 0 100.75 100.75 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem 100.75 per diem