hospital_name	last_updated_on	version	hospital_location	hospital_address	license_number|PR	"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated."																																																																																																																																																																																										
San Juan Capestrano Hospital 	5/31/2024	2.0.0	"Pio Piedras, Puerto Rico"	State Road 877 km1.6	license_55 | PR	TRUE																																																																																																																																																																																										
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_ACAA]|[plan_Local Government]|negotiated_dollar	standard_charge|[payer_ACAA]|[plan_Local Government] |negotiated_percentage	standard_charge|[payer_ACAA]|[plan_Local Government] |negotiated_algorithm	estimated_amount|[payer_ACAA]|[plan_Local Government] 	standard_charge|[payer_ACAA]|[plan_Local Government] |methodology	additional_payer_notes |[payer_ACAA]|[Plan_Local Government]	standard_charge|[payer_AETNA LIFE INSURANCE]|[plan_Commercial]|negotiated_dollar	standard_charge|[payer_AETNA LIFE INSURANCE]|[plan_Commercial] |negotiated_percentage	standard_charge|[payer_AETNA LIFE INSURANCE]|[plan_Commercial] |negotiated_algorithm	estimated_amount|[payer_AETNA LIFE INSURANCE]|[plan_Commercial] 	standard_charge|[payer_AETNA LIFE INSURANCE]|[plan_Commercial] |methodology	additional_payer_notes |[payer_AETNA LIFE INSURANCE]|[Plan_Commercial]	standard_charge|[payer_APS ADULTS]|[plan_Managed Medicaid]|negotiated_dollar	standard_charge|[payer_APS ADULTS]|[plan_Managed Medicaid] |negotiated_percentage	standard_charge|[payer_APS ADULTS]|[plan_Managed Medicaid] |negotiated_algorithm	estimated_amount|[payer_APS ADULTS]|[plan_Managed Medicaid] 	standard_charge|[payer_APS ADULTS]|[plan_Managed Medicaid] |methodology	additional_payer_notes |[payer_APS ADULTS]|[Plan_Managed Medicaid]	standard_charge|[payer_APS ADOLESCENTS]|[plan_Managed Medicaid]|negotiated_dollar	standard_charge|[payer_APS ADOLESCENTS]|[plan_Managed Medicaid] |negotiated_percentage	standard_charge|[payer_APS ADOLESCENTS]|[plan_Managed Medicaid] |negotiated_algorithm	estimated_amount|[payer_APS ADOLESCENTS]|[plan_Managed Medicaid] 	standard_charge|[payer_APS ADOLESCENTS]|[plan_Managed Medicaid] |methodology	additional_payer_notes |[payer_APS ADOLESCENTS]|[Plan_Managed Medicaid]	standard_charge|[payer_ASOCIACION DE MAESTROS]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_ASOCIACION DE MAESTROS]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_ASOCIACION DE MAESTROS]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_ASOCIACION DE MAESTROS]|[plan_HMO/PPO] 	standard_charge|[payer_ASOCIACION DE MAESTROS]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_ASOCIACION DE MAESTROS]|[Plan_HMO/PPO]	standard_charge|[payer_BLUE CROSS BLUE SHIELD]|[plan_BC/BS]|negotiated_dollar	standard_charge|[payer_BLUE CROSS BLUE SHIELD]|[plan_BC/BS] |negotiated_percentage	standard_charge|[payer_BLUE CROSS BLUE SHIELD]|[plan_BC/BS] |negotiated_algorithm	estimated_amount|[payer_BLUE CROSS BLUE SHIELD]|[plan_BC/BS] 	standard_charge|[payer_BLUE CROSS BLUE SHIELD]|[plan_BC/BS] |methodology	additional_payer_notes |[payer_BLUE CROSS BLUE SHIELD]|[Plan_BC/BS]	standard_charge|[payer_FHC (ELA / AXIS)]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_FHC (ELA / AXIS)]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_FHC (ELA / AXIS)]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_FHC (ELA / AXIS)]|[plan_HMO/PPO] 	standard_charge|[payer_FHC (ELA / AXIS)]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_FHC (ELA / AXIS)]|[Plan_HMO/PPO]	standard_charge|[payer_FONDO DEL SEGURO DEL ESTA]|[plan_Workers Comp]|negotiated_dollar	standard_charge|[payer_FONDO DEL SEGURO DEL ESTA]|[plan_Workers Comp] |negotiated_percentage	standard_charge|[payer_FONDO DEL SEGURO DEL ESTA]|[plan_Workers Comp] |negotiated_algorithm	estimated_amount|[payer_FONDO DEL SEGURO DEL ESTA]|[plan_Workers Comp] 	standard_charge|[payer_FONDO DEL SEGURO DEL ESTA]|[plan_Workers Comp] |methodology	additional_payer_notes |[payer_FONDO DEL SEGURO DEL ESTA]|[Plan_Workers Comp]	standard_charge|[payer_HUMANA GOLD PLUS (APS)]|[plan_Managed Medicare]|negotiated_dollar	standard_charge|[payer_HUMANA GOLD PLUS (APS)]|[plan_Managed Medicare] |negotiated_percentage	standard_charge|[payer_HUMANA GOLD PLUS (APS)]|[plan_Managed Medicare] |negotiated_algorithm	estimated_amount|[payer_HUMANA GOLD PLUS (APS)]|[plan_Managed Medicare] 	standard_charge|[payer_HUMANA GOLD PLUS (APS)]|[plan_Managed Medicare] |methodology	additional_payer_notes |[payer_HUMANA GOLD PLUS (APS)]|[Plan_Managed Medicare]	standard_charge|[payer_HUMANA INSURANCE (APS)]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_HUMANA INSURANCE (APS)]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_HUMANA INSURANCE (APS)]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_HUMANA INSURANCE (APS)]|[plan_HMO/PPO] 	standard_charge|[payer_HUMANA INSURANCE (APS)]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_HUMANA INSURANCE (APS)]|[Plan_HMO/PPO]	standard_charge|[payer_INTERNATIONAL MEDICAL CRD]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_INTERNATIONAL MEDICAL CRD]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_INTERNATIONAL MEDICAL CRD]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_INTERNATIONAL MEDICAL CRD]|[plan_HMO/PPO] 	standard_charge|[payer_INTERNATIONAL MEDICAL CRD]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_INTERNATIONAL MEDICAL CRD]|[Plan_HMO/PPO]	standard_charge|[payer_MAPFRE]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_MAPFRE]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_MAPFRE]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_MAPFRE]|[plan_HMO/PPO] 	standard_charge|[payer_MAPFRE]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_MAPFRE]|[Plan_HMO/PPO]	standard_charge|[payer_MCS]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_MCS]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_MCS]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_MCS]|[plan_HMO/PPO] 	standard_charge|[payer_MCS]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_MCS]|[Plan_HMO/PPO]	standard_charge|[payer_MCS CLASSICARE]|[plan_Managed Medicare]|negotiated_dollar	standard_charge|[payer_MCS CLASSICARE]|[plan_Managed Medicare] |negotiated_percentage	standard_charge|[payer_MCS CLASSICARE]|[plan_Managed Medicare] |negotiated_algorithm	estimated_amount|[payer_MCS CLASSICARE]|[plan_Managed Medicare] 	standard_charge|[payer_MCS CLASSICARE]|[plan_Managed Medicare] |methodology	additional_payer_notes |[payer_MCS CLASSICARE]|[Plan_Managed Medicare]	standard_charge|[payer_MEDICARE]|[plan_Medicare]|negotiated_dollar	standard_charge|[payer_MEDICARE]|[plan_Medicare] |negotiated_percentage	standard_charge|[payer_MEDICARE]|[plan_Medicare] |negotiated_algorithm	estimated_amount|[payer_MEDICARE]|[plan_Medicare] 	standard_charge|[payer_MEDICARE]|[plan_Medicare] |methodology	additional_payer_notes |[payer_MEDICARE]|[Plan_Medicare]	standard_charge|[payer_MENONITA]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_MENONITA]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_MENONITA]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_MENONITA]|[plan_HMO/PPO] 	standard_charge|[payer_MENONITA]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_MENONITA]|[Plan_HMO/PPO]	standard_charge|[payer_MMM]|[plan_Managed Medicare]|negotiated_dollar	standard_charge|[payer_MMM]|[plan_Managed Medicare] |negotiated_percentage	standard_charge|[payer_MMM]|[plan_Managed Medicare] |negotiated_algorithm	estimated_amount|[payer_MMM]|[plan_Managed Medicare] 	standard_charge|[payer_MMM]|[plan_Managed Medicare] |methodology	additional_payer_notes |[payer_MMM]|[Plan_Managed Medicare]	standard_charge|[payer_MMM MULTI HEALTH PLAN GOB]|[plan_Managed Medicaid]|negotiated_dollar	standard_charge|[payer_MMM MULTI HEALTH PLAN GOB]|[plan_Managed Medicaid] |negotiated_percentage	standard_charge|[payer_MMM MULTI HEALTH PLAN GOB]|[plan_Managed Medicaid] |negotiated_algorithm	estimated_amount|[payer_MMM MULTI HEALTH PLAN GOB]|[plan_Managed Medicaid] 	standard_charge|[payer_MMM MULTI HEALTH PLAN GOB]|[plan_Managed Medicaid] |methodology	additional_payer_notes |[payer_MMM MULTI HEALTH PLAN GOB]|[Plan_Managed Medicaid]	standard_charge|[payer_PANAMERICAN LIFE]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_PANAMERICAN LIFE]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_PANAMERICAN LIFE]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_PANAMERICAN LIFE]|[plan_HMO/PPO] 	standard_charge|[payer_PANAMERICAN LIFE]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_PANAMERICAN LIFE]|[Plan_HMO/PPO]	standard_charge|[payer_PLAN DE BIENESTAR (UTM)]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_PLAN DE BIENESTAR (UTM)]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_PLAN DE BIENESTAR (UTM)]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_PLAN DE BIENESTAR (UTM)]|[plan_HMO/PPO] 	standard_charge|[payer_PLAN DE BIENESTAR (UTM)]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_PLAN DE BIENESTAR (UTM)]|[Plan_HMO/PPO]	standard_charge|[payer_PLAN DE BIENESTAR CARPINTEROS]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_PLAN DE BIENESTAR CARPINTEROS]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_PLAN DE BIENESTAR CARPINTEROS]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_PLAN DE BIENESTAR CARPINTEROS]|[plan_HMO/PPO] 	standard_charge|[payer_PLAN DE BIENESTAR CARPINTEROS]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_PLAN DE BIENESTAR CARPINTEROS]|[Plan_HMO/PPO]	standard_charge|[payer_PLAN DE SALUD BELLA VISTA]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_PLAN DE SALUD BELLA VISTA]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_PLAN DE SALUD BELLA VISTA]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_PLAN DE SALUD BELLA VISTA]|[plan_HMO/PPO] 	standard_charge|[payer_PLAN DE SALUD BELLA VISTA]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_PLAN DE SALUD BELLA VISTA]|[Plan_HMO/PPO]	standard_charge|[payer_PMC]|[plan_Managed Medicare]|negotiated_dollar	standard_charge|[payer_PMC]|[plan_Managed Medicare] |negotiated_percentage	standard_charge|[payer_PMC]|[plan_Managed Medicare] |negotiated_algorithm	estimated_amount|[payer_PMC]|[plan_Managed Medicare] 	standard_charge|[payer_PMC]|[plan_Managed Medicare] |methodology	additional_payer_notes |[payer_PMC]|[Plan_Managed Medicare]	standard_charge|[payer_SELF PAY]|[plan_Self Pay]|negotiated_dollar	standard_charge|[payer_SELF PAY]|[plan_Self Pay] |negotiated_percentage	standard_charge|[payer_SELF PAY]|[plan_Self Pay] |negotiated_algorithm	estimated_amount|[payer_SELF PAY]|[plan_Self Pay] 	standard_charge|[payer_SELF PAY]|[plan_Self Pay] |methodology	additional_payer_notes |[payer_SELF PAY]|[Plan_Self Pay]	standard_charge|[payer_TRICARE]|[plan_Tricare]|negotiated_dollar	standard_charge|[payer_TRICARE]|[plan_Tricare] |negotiated_percentage	standard_charge|[payer_TRICARE]|[plan_Tricare] |negotiated_algorithm	estimated_amount|[payer_TRICARE]|[plan_Tricare] 	standard_charge|[payer_TRICARE]|[plan_Tricare] |methodology	additional_payer_notes |[payer_TRICARE]|[Plan_Tricare]	standard_charge|[payer_TRIPLE S (PPO)]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_TRIPLE S (PPO)]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_TRIPLE S (PPO)]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_TRIPLE S (PPO)]|[plan_HMO/PPO] 	standard_charge|[payer_TRIPLE S (PPO)]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_TRIPLE S (PPO)]|[Plan_HMO/PPO]	standard_charge|[payer_TRIPLE S (FHC)]|[plan_HMO/PPO]|negotiated_dollar	standard_charge|[payer_TRIPLE S (FHC)]|[plan_HMO/PPO] |negotiated_percentage	standard_charge|[payer_TRIPLE S (FHC)]|[plan_HMO/PPO] |negotiated_algorithm	estimated_amount|[payer_TRIPLE S (FHC)]|[plan_HMO/PPO] 	standard_charge|[payer_TRIPLE S (FHC)]|[plan_HMO/PPO] |methodology	additional_payer_notes |[payer_TRIPLE S (FHC)]|[Plan_HMO/PPO]	standard_charge|[payer_TRIPLE S (OPTIMO)]|[plan_Managed Medicare]|negotiated_dollar	standard_charge|[payer_TRIPLE S (OPTIMO)]|[plan_Managed Medicare] |negotiated_percentage	standard_charge|[payer_TRIPLE S (OPTIMO)]|[plan_Managed Medicare] |negotiated_algorithm	estimated_amount|[payer_TRIPLE S (OPTIMO)]|[plan_Managed Medicare] 	standard_charge|[payer_TRIPLE S (OPTIMO)]|[plan_Managed Medicare] |methodology	additional_payer_notes |[payer_TRIPLE S (OPTIMO)]|[Plan_Managed Medicare]	standard_charge|[payer_UNITED HEALTHCARE]|[plan_Commercial]|negotiated_dollar	standard_charge|[payer_UNITED HEALTHCARE]|[plan_Commercial] |negotiated_percentage	standard_charge|[payer_UNITED HEALTHCARE]|[plan_Commercial] |negotiated_algorithm	estimated_amount|[payer_UNITED HEALTHCARE]|[plan_Commercial] 	standard_charge|[payer_UNITED HEALTHCARE]|[plan_Commercial] |methodology	additional_payer_notes |[payer_UNITED HEALTHCARE]|[Plan_Commercial]	standard_charge|[payer_VA CCN OPTUM]|[plan_Veterans]|negotiated_dollar	standard_charge|[payer_VA CCN OPTUM]|[plan_Veterans] |negotiated_percentage	standard_charge|[payer_VA CCN OPTUM]|[plan_Veterans] |negotiated_algorithm	estimated_amount|[payer_VA CCN OPTUM]|[plan_Veterans] 	standard_charge|[payer_VA CCN OPTUM]|[plan_Veterans] |methodology	additional_payer_notes |[payer_VA CCN OPTUM]|[Plan_Veterans]	additional_generic_notes
EAST-ROOM&BOARD PSYCH ADULT/ADOLESCENT	124	RC	facility	inpatient				1400	500	425	1386	435				per diem		980				per diem		520				per diem		520				per diem		644				per diem		698				per diem		480				per diem		492				per diem		556				per diem		486				per diem		486				per diem		563				per diem		630				per diem		612				per diem		511				per diem		593				per diem		584				per diem		616				per diem		527				per diem		630				per diem		500				per diem		425				per diem		584				per diem		500				per diem		1388				per diem		590				per diem		698				per diem		556				per diem		980				per diem		502				per diem		
OBS/23hrs	762	RC	facility	outpatient				810	350	350	551					  						  		551				per diem		551				per diem						  						  						  						  						  						  						  						  						  						  						  						  						  		551				per diem						  						  						  						  						  		350				per diem						  						  						  						  						  						  		
EVALUATION/NON ADMIT	900	RC	facility	outpatient				216		61	131					  						  		72				per diem		72				per diem		85				per diem		131				per diem						  		100				per diem		66				per diem		69				per diem		69				per diem		92				per diem						  		61				per diem						  						  						  						  						  		74				per diem						  						  						  						  						  		131				per diem		131				per diem		66				per diem						  						  		
OUTPATIENT ECT	901	RC	facility	outpatient				918	650	375	650					  						  						  						  		504				per diem		465				per diem						  		400				per diem						  						  						  		525				per diem		385				per diem		416				per diem		378				per diem		420				per diem		400				per diem		400				per diem		415				per diem		405				per diem						  		450				per diem		400				per diem		650				per diem						  		465				per diem		465				per diem						  						  						  		
IOP ADULT PROGRAM	906	RC	facility	outpatient				325	100	87	130					  						  		99				per diem						  		130				per diem		98				per diem						  		100				per diem		87				per diem		90				per diem		90				per diem		122				per diem		104				per diem		110				per diem						  		120				per diem		100				per diem		99				per diem		120				per diem						  						  						  		100				per diem		100				per diem						  		98				per diem		98				per diem		87				per diem						  						  		
PHP ADULT PROGRAM	912	RC	facility	outpatient				592	200	169	414	230				per diem		414				per diem		221				per diem						  		257				per diem		250				per diem		200				per diem		198				per diem		230				per diem		208				per diem		208				per diem		278				per diem		223				per diem		228				per diem		203				per diem		232				per diem		210				per diem		221				per diem		231				per diem		325				per diem		190				per diem		225				per diem		210				per diem		200				per diem		169				per diem		250				per diem		250				per diem		246				per diem		414				per diem		206				per diem		
PHP ADOLESCENT PROGRAM	912	RC	facility	outpatient				702	250	169	414	230				per diem		414				per diem								231				per diem		334				per diem		278				per diem						  						  						  		235				per diem		235				per diem		321				per diem		223				per diem						  						  		320				per diem						  		221				per diem		252				per diem		386				per diem						  						  						  		250				per diem		169				per diem		278				per diem		278				per diem						  		414				per diem