|
25004478
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$192.00
|
—
|
$192.00
|
$192.00
|
$192.00
|
2026-07-31
|
|
25003047
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$194.00
|
—
|
$194.00
|
$194.00
|
$194.00
|
2026-07-31
|
|
30100016
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$194.00
|
—
|
$194.00
|
$194.00
|
$194.00
|
2026-07-31
|
|
25004970
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$195.00
|
—
|
$195.00
|
$195.00
|
$195.00
|
2026-07-31
|
|
25004996
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$195.80
|
—
|
$195.80
|
$195.80
|
$195.80
|
2026-07-31
|
|
30100059
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$198.00
|
—
|
$198.00
|
$198.00
|
$198.00
|
2026-07-31
|
|
32000092
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$198.00
|
—
|
$198.00
|
$198.00
|
$198.00
|
2026-07-31
|
|
25003566
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$200.00
|
—
|
$200.00
|
$200.00
|
$200.00
|
2026-07-31
|
|
32000147
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$202.00
|
—
|
$202.00
|
$202.00
|
$202.00
|
2026-07-31
|
|
32000146
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$202.00
|
—
|
$202.00
|
$202.00
|
$202.00
|
2026-07-31
|
|
25004995
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$202.60
|
—
|
$202.60
|
$202.60
|
$202.60
|
2026-07-31
|
|
25002153
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$204.00
|
—
|
$204.00
|
$204.00
|
$204.00
|
2026-07-31
|
|
32000001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$205.00
|
—
|
$205.00
|
$205.00
|
$205.00
|
2026-07-31
|
|
30500061
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$205.00
|
—
|
$205.00
|
$205.00
|
$205.00
|
2026-07-31
|
|
30100092
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$206.00
|
—
|
$206.00
|
$206.00
|
$206.00
|
2026-07-31
|
|
30100200
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$208.00
|
—
|
$208.00
|
$208.00
|
$208.00
|
2026-07-31
|
|
32000127
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$209.00
|
—
|
$209.00
|
$209.00
|
$209.00
|
2026-07-31
|
|
25002284
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$209.00
|
—
|
$209.00
|
$209.00
|
$209.00
|
2026-07-31
|
|
32000137
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$209.00
|
—
|
$209.00
|
$209.00
|
$209.00
|
2026-07-31
|
|
32000065
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$209.00
|
—
|
$209.00
|
$209.00
|
$209.00
|
2026-07-31
|
|
32000104
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$209.00
|
—
|
$209.00
|
$209.00
|
$209.00
|
2026-07-31
|
|
25002531
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$210.00
|
—
|
$210.00
|
$210.00
|
$210.00
|
2026-07-31
|
|
25000289
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$213.00
|
—
|
$213.00
|
$213.00
|
$213.00
|
2026-07-31
|
|
25000516
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$213.00
|
—
|
$213.00
|
$213.00
|
$213.00
|
2026-07-31
|
|
30500036
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$216.00
|
—
|
$216.00
|
$216.00
|
$216.00
|
2026-07-31
|
|
PH000217
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$216.00
|
—
|
$216.00
|
$216.00
|
$216.00
|
2026-07-31
|
|
32000171
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$216.00
|
—
|
$216.00
|
$216.00
|
$216.00
|
2026-07-31
|
|
30200119
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$216.00
|
—
|
$216.00
|
$216.00
|
$216.00
|
2026-07-31
|
|
25000313
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$218.00
|
—
|
$218.00
|
$218.00
|
$218.00
|
2026-07-31
|
|
32000185
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$218.00
|
—
|
$218.00
|
$218.00
|
$218.00
|
2026-07-31
|
|
30000108
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$218.00
|
—
|
$218.00
|
$218.00
|
$218.00
|
2026-07-31
|
|
32000208
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$218.00
|
—
|
$218.00
|
$218.00
|
$218.00
|
2026-07-31
|
|
30100325
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$218.00
|
—
|
$218.00
|
$218.00
|
$218.00
|
2026-07-31
|
|
25001774
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$219.00
|
—
|
$219.00
|
$219.00
|
$219.00
|
2026-07-31
|
|
32400006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
25001716
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
32400001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
32000217
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
32000042
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
25003319
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$221.00
|
—
|
$221.00
|
$221.00
|
$221.00
|
2026-07-31
|
|
25004536
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$222.00
|
—
|
$222.00
|
$222.00
|
$222.00
|
2026-07-31
|
|
25002039
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$224.00
|
—
|
$224.00
|
$224.00
|
$224.00
|
2026-07-31
|
|
25003442
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$224.00
|
—
|
$224.00
|
$224.00
|
$224.00
|
2026-07-31
|
|
25000095
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$225.00
|
—
|
$225.00
|
$225.00
|
$225.00
|
2026-07-31
|
|
25002849
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$226.00
|
—
|
$226.00
|
$226.00
|
$226.00
|
2026-07-31
|
|
25002776
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$226.00
|
—
|
$226.00
|
$226.00
|
$226.00
|
2026-07-31
|
|
30100286
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$226.00
|
—
|
$226.00
|
$226.00
|
$226.00
|
2026-07-31
|
|
25002774
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$226.00
|
—
|
$226.00
|
$226.00
|
$226.00
|
2026-07-31
|
|
25002063
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$226.00
|
—
|
$226.00
|
$226.00
|
$226.00
|
2026-07-31
|
|
25005079
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$227.20
|
—
|
$227.20
|
$227.20
|
$227.20
|
2026-07-31
|
|
25001624
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$230.00
|
—
|
$230.00
|
$230.00
|
$230.00
|
2026-07-31
|
|
25000347
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$233.00
|
—
|
$233.00
|
$233.00
|
$233.00
|
2026-07-31
|
|
91600003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$233.00
|
—
|
$233.00
|
$233.00
|
$233.00
|
2026-07-31
|
|
25000936
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$233.00
|
—
|
$233.00
|
$233.00
|
$233.00
|
2026-07-31
|
|
25001367
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$235.00
|
—
|
$235.00
|
$235.00
|
$235.00
|
2026-07-31
|
|
25001693
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$237.00
|
—
|
$237.00
|
$237.00
|
$237.00
|
2026-07-31
|
|
32000122
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
30000064
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
32000063
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
25002117
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
32000061
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
32000069
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$239.00
|
—
|
$239.00
|
$239.00
|
$239.00
|
2026-07-31
|
|
32000088
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$240.00
|
—
|
$240.00
|
$240.00
|
$240.00
|
2026-07-31
|
|
25001084
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$240.00
|
—
|
$240.00
|
$240.00
|
$240.00
|
2026-07-31
|
|
30100105
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$242.00
|
—
|
$242.00
|
$242.00
|
$242.00
|
2026-07-31
|
|
30100314
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$243.00
|
—
|
$243.00
|
$243.00
|
$243.00
|
2026-07-31
|
|
32000120
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$247.00
|
—
|
$247.00
|
$247.00
|
$247.00
|
2026-07-31
|
|
32000246
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$247.00
|
—
|
$247.00
|
$247.00
|
$247.00
|
2026-07-31
|
|
32000178
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$247.00
|
—
|
$247.00
|
$247.00
|
$247.00
|
2026-07-31
|
|
90000004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$247.00
|
—
|
$247.00
|
$247.00
|
$247.00
|
2026-07-31
|
|
32000091
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$247.00
|
—
|
$247.00
|
$247.00
|
$247.00
|
2026-07-31
|
|
30100148
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$248.00
|
—
|
$248.00
|
$248.00
|
$248.00
|
2026-07-31
|
|
32000012
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$248.00
|
—
|
$248.00
|
$248.00
|
$248.00
|
2026-07-31
|
|
32000076
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$248.00
|
—
|
$248.00
|
$248.00
|
$248.00
|
2026-07-31
|
|
25001963
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$251.00
|
—
|
$251.00
|
$251.00
|
$251.00
|
2026-07-31
|
|
30100173
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$252.00
|
—
|
$252.00
|
$252.00
|
$252.00
|
2026-07-31
|
|
32000166
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$252.00
|
—
|
$252.00
|
$252.00
|
$252.00
|
2026-07-31
|
|
25004449
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$252.00
|
—
|
$252.00
|
$252.00
|
$252.00
|
2026-07-31
|
|
30100125
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$253.00
|
—
|
$253.00
|
$253.00
|
$253.00
|
2026-07-31
|
|
30100264
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$254.00
|
—
|
$254.00
|
$254.00
|
$254.00
|
2026-07-31
|
|
30500082
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$256.00
|
—
|
$256.00
|
$256.00
|
$256.00
|
2026-07-31
|
|
32000190
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$261.00
|
—
|
$261.00
|
$261.00
|
$261.00
|
2026-07-31
|
|
25000517
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$262.00
|
—
|
$262.00
|
$262.00
|
$262.00
|
2026-07-31
|
|
25001642
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$263.00
|
—
|
$263.00
|
$263.00
|
$263.00
|
2026-07-31
|
|
32000007
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$263.00
|
—
|
$263.00
|
$263.00
|
$263.00
|
2026-07-31
|
|
25002402
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$263.00
|
—
|
$263.00
|
$263.00
|
$263.00
|
2026-07-31
|
|
25001500
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$264.00
|
—
|
$264.00
|
$264.00
|
$264.00
|
2026-07-31
|
|
32000067
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$264.00
|
—
|
$264.00
|
$264.00
|
$264.00
|
2026-07-31
|
|
25004664
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$264.00
|
—
|
$264.00
|
$264.00
|
$264.00
|
2026-07-31
|
|
30500015
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$264.00
|
—
|
$264.00
|
$264.00
|
$264.00
|
2026-07-31
|
|
32000125
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$265.00
|
—
|
$265.00
|
$265.00
|
$265.00
|
2026-07-31
|
|
32000126
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$265.00
|
—
|
$265.00
|
$265.00
|
$265.00
|
2026-07-31
|
|
25002920
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$266.00
|
—
|
$266.00
|
$266.00
|
$266.00
|
2026-07-31
|
|
27000484
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$266.00
|
—
|
$266.00
|
$266.00
|
$266.00
|
2026-07-31
|
|
32000129
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$268.00
|
—
|
$268.00
|
$268.00
|
$268.00
|
2026-07-31
|
|
41900001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$268.00
|
—
|
$268.00
|
$268.00
|
$268.00
|
2026-07-31
|
|
32000215
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$269.00
|
—
|
$269.00
|
$269.00
|
$269.00
|
2026-07-31
|
|
32000210
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$269.00
|
—
|
$269.00
|
$269.00
|
$269.00
|
2026-07-31
|
|
25002379
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$269.00
|
—
|
$269.00
|
$269.00
|
$269.00
|
2026-07-31
|
|
25003107
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$271.00
|
—
|
$271.00
|
$271.00
|
$271.00
|
2026-07-31
|
|
32400010
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$271.00
|
—
|
$271.00
|
$271.00
|
$271.00
|
2026-07-31
|
|
42000005
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$271.00
|
—
|
$271.00
|
$271.00
|
$271.00
|
2026-07-31
|
|
32400011
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$278.00
|
—
|
$278.00
|
$278.00
|
$278.00
|
2026-07-31
|
|
30100103
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$278.00
|
—
|
$278.00
|
$278.00
|
$278.00
|
2026-07-31
|
|
25003585
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$278.00
|
—
|
$278.00
|
$278.00
|
$278.00
|
2026-07-31
|
|
25003583
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$278.00
|
—
|
$278.00
|
$278.00
|
$278.00
|
2026-07-31
|
|
25002478
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$279.00
|
—
|
$279.00
|
$279.00
|
$279.00
|
2026-07-31
|
|
25001545
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$279.00
|
—
|
$279.00
|
$279.00
|
$279.00
|
2026-07-31
|
|
PH001503
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$280.36
|
—
|
$280.36
|
$280.36
|
$280.36
|
2026-07-31
|
|
30100300
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$282.00
|
—
|
$282.00
|
$282.00
|
$282.00
|
2026-07-31
|
|
30100146
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$285.00
|
—
|
$285.00
|
$285.00
|
$285.00
|
2026-07-31
|
|
30000065
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$286.00
|
—
|
$286.00
|
$286.00
|
$286.00
|
2026-07-31
|
|
25004944
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$291.18
|
—
|
$291.18
|
$291.18
|
$291.18
|
2026-07-31
|
|
25000085
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$294.00
|
—
|
$294.00
|
$294.00
|
$294.00
|
2026-07-31
|
|
30000050
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$294.00
|
—
|
$294.00
|
$294.00
|
$294.00
|
2026-07-31
|
|
41000036
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$294.00
|
—
|
$294.00
|
$294.00
|
$294.00
|
2026-07-31
|
|
32000167
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$294.00
|
—
|
$294.00
|
$294.00
|
$294.00
|
2026-07-31
|
|
41200006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$294.00
|
—
|
$294.00
|
$294.00
|
$294.00
|
2026-07-31
|
|
25004422
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$299.00
|
—
|
$299.00
|
$299.00
|
$299.00
|
2026-07-31
|
|
32000204
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$299.00
|
—
|
$299.00
|
$299.00
|
$299.00
|
2026-07-31
|
|
32000071
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$299.00
|
—
|
$299.00
|
$299.00
|
$299.00
|
2026-07-31
|
|
25002226
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$304.00
|
—
|
$304.00
|
$304.00
|
$304.00
|
2026-07-31
|
|
25005048
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$304.74
|
—
|
$304.74
|
$304.74
|
$304.74
|
2026-07-31
|
|
32000086
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$306.00
|
—
|
$306.00
|
$306.00
|
$306.00
|
2026-07-31
|
|
32000117
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$307.00
|
—
|
$307.00
|
$307.00
|
$307.00
|
2026-07-31
|
|
30000098
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$309.00
|
—
|
$309.00
|
$309.00
|
$309.00
|
2026-07-31
|
|
32000153
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$311.00
|
—
|
$311.00
|
$311.00
|
$311.00
|
2026-07-31
|
|
32000152
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$311.00
|
—
|
$311.00
|
$311.00
|
$311.00
|
2026-07-31
|
|
32000169
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$311.00
|
—
|
$311.00
|
$311.00
|
$311.00
|
2026-07-31
|
|
25000967
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$312.00
|
—
|
$312.00
|
$312.00
|
$312.00
|
2026-07-31
|
|
25000806
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$318.00
|
—
|
$318.00
|
$318.00
|
$318.00
|
2026-07-31
|
|
30100154
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$323.00
|
—
|
$323.00
|
$323.00
|
$323.00
|
2026-07-31
|
|
25004279
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$323.00
|
—
|
$323.00
|
$323.00
|
$323.00
|
2026-07-31
|
|
32000077
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$323.00
|
—
|
$323.00
|
$323.00
|
$323.00
|
2026-07-31
|
|
90400001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
91400001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
25001775
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
91500001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
91500004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
91400002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
91300001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$326.00
|
—
|
$326.00
|
$326.00
|
$326.00
|
2026-07-31
|
|
30100018
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$327.00
|
—
|
$327.00
|
$327.00
|
$327.00
|
2026-07-31
|
|
32000194
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$330.00
|
—
|
$330.00
|
$330.00
|
$330.00
|
2026-07-31
|
|
30100150
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$334.00
|
—
|
$334.00
|
$334.00
|
$334.00
|
2026-07-31
|
|
32000177
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$335.00
|
—
|
$335.00
|
$335.00
|
$335.00
|
2026-07-31
|
|
32000039
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$337.00
|
—
|
$337.00
|
$337.00
|
$337.00
|
2026-07-31
|
|
32000054
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$337.00
|
—
|
$337.00
|
$337.00
|
$337.00
|
2026-07-31
|
|
32000055
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$337.00
|
—
|
$337.00
|
$337.00
|
$337.00
|
2026-07-31
|
|
25005075
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$338.84
|
—
|
$338.84
|
$338.84
|
$338.84
|
2026-07-31
|
|
44200002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$340.00
|
—
|
$340.00
|
$340.00
|
$340.00
|
2026-07-31
|
|
25003642
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$345.00
|
—
|
$345.00
|
$345.00
|
$345.00
|
2026-07-31
|
|
30000034
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$345.00
|
—
|
$345.00
|
$345.00
|
$345.00
|
2026-07-31
|
|
30100196
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$346.00
|
—
|
$346.00
|
$346.00
|
$346.00
|
2026-07-31
|
|
30000062
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$348.00
|
—
|
$348.00
|
$348.00
|
$348.00
|
2026-07-31
|
|
25000881
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$349.00
|
—
|
$349.00
|
$349.00
|
$349.00
|
2026-07-31
|
|
91500002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$350.00
|
—
|
$350.00
|
$350.00
|
$350.00
|
2026-07-31
|
|
32400003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$352.00
|
—
|
$352.00
|
$352.00
|
$352.00
|
2026-07-31
|
|
32000083
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$356.00
|
—
|
$356.00
|
$356.00
|
$356.00
|
2026-07-31
|
|
25000154
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$358.00
|
—
|
$358.00
|
$358.00
|
$358.00
|
2026-07-31
|
|
32000184
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$358.00
|
—
|
$358.00
|
$358.00
|
$358.00
|
2026-07-31
|
|
30000029
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$368.00
|
—
|
$368.00
|
$368.00
|
$368.00
|
2026-07-31
|
|
25003114
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$368.00
|
—
|
$368.00
|
$368.00
|
$368.00
|
2026-07-31
|
|
25004571
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$368.00
|
—
|
$368.00
|
$368.00
|
$368.00
|
2026-07-31
|
|
32000163
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$369.00
|
—
|
$369.00
|
$369.00
|
$369.00
|
2026-07-31
|
|
73000001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$369.00
|
—
|
$369.00
|
$369.00
|
$369.00
|
2026-07-31
|
|
32000165
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$369.00
|
—
|
$369.00
|
$369.00
|
$369.00
|
2026-07-31
|
|
PH000203
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$375.50
|
—
|
$375.50
|
$375.50
|
$375.50
|
2026-07-31
|
|
25003762
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$378.00
|
—
|
$378.00
|
$378.00
|
$378.00
|
2026-07-31
|
|
30500012
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$380.00
|
—
|
$380.00
|
$380.00
|
$380.00
|
2026-07-31
|
|
25000364
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$380.00
|
—
|
$380.00
|
$380.00
|
$380.00
|
2026-07-31
|
|
25005076
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$381.20
|
—
|
$381.20
|
$381.20
|
$381.20
|
2026-07-31
|
|
25001288
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$386.00
|
—
|
$386.00
|
$386.00
|
$386.00
|
2026-07-31
|
|
91500003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$390.00
|
—
|
$390.00
|
$390.00
|
$390.00
|
2026-07-31
|
|
25000949
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$390.00
|
—
|
$390.00
|
$390.00
|
$390.00
|
2026-07-31
|
|
90000001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$390.00
|
—
|
$390.00
|
$390.00
|
$390.00
|
2026-07-31
|
|
91600002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$392.00
|
—
|
$392.00
|
$392.00
|
$392.00
|
2026-07-31
|
|
30000081
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$393.00
|
—
|
$393.00
|
$393.00
|
$393.00
|
2026-07-31
|
|
30100277
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$396.00
|
—
|
$396.00
|
$396.00
|
$396.00
|
2026-07-31
|
|
30000104
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$397.00
|
—
|
$397.00
|
$397.00
|
$397.00
|
2026-07-31
|
|
25001709
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$399.00
|
—
|
$399.00
|
$399.00
|
$399.00
|
2026-07-31
|
|
30000006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$401.00
|
—
|
$401.00
|
$401.00
|
$401.00
|
2026-07-31
|
|
30100072
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$401.00
|
—
|
$401.00
|
$401.00
|
$401.00
|
2026-07-31
|
|
25000423
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$401.00
|
—
|
$401.00
|
$401.00
|
$401.00
|
2026-07-31
|
|
32000075
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$405.00
|
—
|
$405.00
|
$405.00
|
$405.00
|
2026-07-31
|
|
32000188
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$405.00
|
—
|
$405.00
|
$405.00
|
$405.00
|
2026-07-31
|
|
32000189
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$405.00
|
—
|
$405.00
|
$405.00
|
$405.00
|
2026-07-31
|
|
25004742
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$406.15
|
—
|
$406.15
|
$406.15
|
$406.15
|
2026-07-31
|
|
25000084
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$408.00
|
—
|
$408.00
|
$408.00
|
$408.00
|
2026-07-31
|
|
32000050
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$411.00
|
—
|
$411.00
|
$411.00
|
$411.00
|
2026-07-31
|
|
30000069
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$414.00
|
—
|
$414.00
|
$414.00
|
$414.00
|
2026-07-31
|
|
27000769
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$417.00
|
—
|
$417.00
|
$417.00
|
$417.00
|
2026-07-31
|
|
91600004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$418.00
|
—
|
$418.00
|
$418.00
|
$418.00
|
2026-07-31
|
|
25004149
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$418.00
|
—
|
$418.00
|
$418.00
|
$418.00
|
2026-07-31
|
|
25002957
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$424.00
|
—
|
$424.00
|
$424.00
|
$424.00
|
2026-07-31
|
|
25002546
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$425.00
|
—
|
$425.00
|
$425.00
|
$425.00
|
2026-07-31
|
|
32000201
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$425.00
|
—
|
$425.00
|
$425.00
|
$425.00
|
2026-07-31
|
|
25003990
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$429.00
|
—
|
$429.00
|
$429.00
|
$429.00
|
2026-07-31
|
|
25000938
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$430.00
|
—
|
$430.00
|
$430.00
|
$430.00
|
2026-07-31
|
|
25002194
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$431.00
|
—
|
$431.00
|
$431.00
|
$431.00
|
2026-07-31
|
|
25000397
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$434.00
|
—
|
$434.00
|
$434.00
|
$434.00
|
2026-07-31
|
|
91500006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$435.00
|
—
|
$435.00
|
$435.00
|
$435.00
|
2026-07-31
|
|
25003628
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$440.00
|
—
|
$440.00
|
$440.00
|
$440.00
|
2026-07-31
|
|
25001368
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$443.00
|
—
|
$443.00
|
$443.00
|
$443.00
|
2026-07-31
|
|
32000197
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$443.00
|
—
|
$443.00
|
$443.00
|
$443.00
|
2026-07-31
|
|
25000880
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$447.00
|
—
|
$447.00
|
$447.00
|
$447.00
|
2026-07-31
|
|
25005055
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$447.24
|
—
|
$447.24
|
$447.24
|
$447.24
|
2026-07-31
|
|
27000842
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$447.24
|
—
|
$447.24
|
$447.24
|
$447.24
|
2026-07-31
|
|
25000150
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$453.00
|
—
|
$453.00
|
$453.00
|
$453.00
|
2026-07-31
|
|
25002408
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$453.00
|
—
|
$453.00
|
$453.00
|
$453.00
|
2026-07-31
|
|
25002775
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$458.00
|
—
|
$458.00
|
$458.00
|
$458.00
|
2026-07-31
|
|
25000429
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$458.00
|
—
|
$458.00
|
$458.00
|
$458.00
|
2026-07-31
|
|
25002195
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$461.00
|
—
|
$461.00
|
$461.00
|
$461.00
|
2026-07-31
|
|
32000047
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$471.00
|
—
|
$471.00
|
$471.00
|
$471.00
|
2026-07-31
|
|
30100254
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$472.00
|
—
|
$472.00
|
$472.00
|
$472.00
|
2026-07-31
|
|
25000476
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$499.00
|
—
|
$499.00
|
$499.00
|
$499.00
|
2026-07-31
|
|
91600005
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$500.00
|
—
|
$500.00
|
$500.00
|
$500.00
|
2026-07-31
|
|
91400003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$500.00
|
—
|
$500.00
|
$500.00
|
$500.00
|
2026-07-31
|
|
90000002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$500.00
|
—
|
$500.00
|
$500.00
|
$500.00
|
2026-07-31
|
|
90000003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$500.00
|
—
|
$500.00
|
$500.00
|
$500.00
|
2026-07-31
|
|
32000043
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$504.00
|
—
|
$504.00
|
$504.00
|
$504.00
|
2026-07-31
|
|
25004452
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$504.00
|
—
|
$504.00
|
$504.00
|
$504.00
|
2026-07-31
|
|
25000689
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$513.00
|
—
|
$513.00
|
$513.00
|
$513.00
|
2026-07-31
|
|
25001622
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$515.00
|
—
|
$515.00
|
$515.00
|
$515.00
|
2026-07-31
|
|
25003695
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$516.00
|
—
|
$516.00
|
$516.00
|
$516.00
|
2026-07-31
|
|
30100287
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$519.00
|
—
|
$519.00
|
$519.00
|
$519.00
|
2026-07-31
|
|
25002307
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$519.00
|
—
|
$519.00
|
$519.00
|
$519.00
|
2026-07-31
|
|
30100188
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$521.00
|
—
|
$521.00
|
$521.00
|
$521.00
|
2026-07-31
|
|
25004933
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$525.00
|
—
|
$525.00
|
$525.00
|
$525.00
|
2026-07-31
|
|
25000688
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$536.00
|
—
|
$536.00
|
$536.00
|
$536.00
|
2026-07-31
|
|
32000044
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$536.00
|
—
|
$536.00
|
$536.00
|
$536.00
|
2026-07-31
|
|
PH000126
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$538.18
|
—
|
$538.18
|
$538.18
|
$538.18
|
2026-07-31
|
|
25004986
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$540.00
|
—
|
$540.00
|
$540.00
|
$540.00
|
2026-07-31
|
|
25003873
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$548.00
|
—
|
$548.00
|
$548.00
|
$548.00
|
2026-07-31
|
|
30000028
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$549.00
|
—
|
$549.00
|
$549.00
|
$549.00
|
2026-07-31
|
|
44400003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$557.00
|
—
|
$557.00
|
$557.00
|
$557.00
|
2026-07-31
|
|
25002962
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$557.00
|
—
|
$557.00
|
$557.00
|
$557.00
|
2026-07-31
|
|
23926026
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$568.00
|
—
|
$568.00
|
$568.00
|
$568.00
|
2026-07-31
|
|
32000229
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$593.00
|
—
|
$593.00
|
$593.00
|
$593.00
|
2026-07-31
|
|
25004958
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$594.00
|
—
|
$594.00
|
$594.00
|
$594.00
|
2026-07-31
|
|
30500059
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$605.00
|
—
|
$605.00
|
$605.00
|
$605.00
|
2026-07-31
|
|
32000228
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$609.00
|
—
|
$609.00
|
$609.00
|
$609.00
|
2026-07-31
|
|
25004739
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$631.00
|
—
|
$631.00
|
$631.00
|
$631.00
|
2026-07-31
|
|
25005067
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$645.27
|
—
|
$645.27
|
$645.27
|
$645.27
|
2026-07-31
|
|
32200001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$647.00
|
—
|
$647.00
|
$647.00
|
$647.00
|
2026-07-31
|
|
30000056
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$647.00
|
—
|
$647.00
|
$647.00
|
$647.00
|
2026-07-31
|
|
25000094
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$651.00
|
—
|
$651.00
|
$651.00
|
$651.00
|
2026-07-31
|
|
25001791
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$654.00
|
—
|
$654.00
|
$654.00
|
$654.00
|
2026-07-31
|
|
25004000
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$660.00
|
—
|
$660.00
|
$660.00
|
$660.00
|
2026-07-31
|
|
25004753
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$728.00
|
—
|
$728.00
|
$728.00
|
$728.00
|
2026-07-31
|
|
25001090
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$729.00
|
—
|
$729.00
|
$729.00
|
$729.00
|
2026-07-31
|
|
30100275
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$729.00
|
—
|
$729.00
|
$729.00
|
$729.00
|
2026-07-31
|
|
25000088
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$819.00
|
—
|
$819.00
|
$819.00
|
$819.00
|
2026-07-31
|
|
61400001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$835.00
|
—
|
$835.00
|
$835.00
|
$835.00
|
2026-07-31
|
|
30100280
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$895.00
|
—
|
$895.00
|
$895.00
|
$895.00
|
2026-07-31
|
|
30000096
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$911.00
|
—
|
$911.00
|
$911.00
|
$911.00
|
2026-07-31
|
|
30000043
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$911.00
|
—
|
$911.00
|
$911.00
|
$911.00
|
2026-07-31
|
|
25003774
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$932.00
|
—
|
$932.00
|
$932.00
|
$932.00
|
2026-07-31
|
|
25003785
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$946.00
|
—
|
$946.00
|
$946.00
|
$946.00
|
2026-07-31
|
|
25003580
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,002.00
|
—
|
$1,002.00
|
$1,002.00
|
$1,002.00
|
2026-07-31
|
|
25001946
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,016.00
|
—
|
$1,016.00
|
$1,016.00
|
$1,016.00
|
2026-07-31
|
|
32000242
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,016.00
|
—
|
$1,016.00
|
$1,016.00
|
$1,016.00
|
2026-07-31
|
|
110001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,050.00
|
$900.00
|
$1,050.00
|
$1,050.00
|
$1,050.00
|
2026-07-31
|
|
30100319
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,085.44
|
—
|
$1,085.44
|
$1,085.44
|
$1,085.44
|
2026-07-31
|
|
25005049
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,108.00
|
—
|
$1,108.00
|
$1,108.00
|
$1,108.00
|
2026-07-31
|
|
PH001342
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,203.20
|
—
|
$1,203.20
|
$1,203.20
|
$1,203.20
|
2026-07-31
|
|
110002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,208.00
|
$900.00
25% off
|
$1,208.00
|
$1,208.00
|
$1,208.00
|
2026-07-31
|
|
25001429
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,408.00
|
—
|
$1,408.00
|
$1,408.00
|
$1,408.00
|
2026-07-31
|
|
25004849
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,538.00
|
—
|
$1,538.00
|
$1,538.00
|
$1,538.00
|
2026-07-31
|
|
25005025
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,548.76
|
—
|
$1,548.76
|
$1,548.76
|
$1,548.76
|
2026-07-31
|
|
40000003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,598.48
|
—
|
$1,598.48
|
$1,598.48
|
$1,598.48
|
2026-07-31
|
|
25005074
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,610.73
|
—
|
$1,610.73
|
$1,610.73
|
$1,610.73
|
2026-07-31
|
|
35000006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,693.00
|
—
|
$1,693.00
|
$1,693.00
|
$1,693.00
|
2026-07-31
|
|
35000013
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,749.00
|
—
|
$1,749.00
|
$1,749.00
|
$1,749.00
|
2026-07-31
|
|
40000001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,749.00
|
—
|
$1,749.00
|
$1,749.00
|
$1,749.00
|
2026-07-31
|
|
32000157
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,762.00
|
—
|
$1,762.00
|
$1,762.00
|
$1,762.00
|
2026-07-31
|
|
35000003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,798.00
|
—
|
$1,798.00
|
$1,798.00
|
$1,798.00
|
2026-07-31
|
|
40200013
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,800.00
|
—
|
$1,800.00
|
$1,800.00
|
$1,800.00
|
2026-07-31
|
|
25003581
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,815.00
|
—
|
$1,815.00
|
$1,815.00
|
$1,815.00
|
2026-07-31
|
|
35000002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,974.00
|
—
|
$1,974.00
|
$1,974.00
|
$1,974.00
|
2026-07-31
|
|
25004934
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$1,992.40
|
—
|
$1,992.40
|
$1,992.40
|
$1,992.40
|
2026-07-31
|
|
40200014
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,040.00
|
—
|
$2,040.00
|
$2,040.00
|
$2,040.00
|
2026-07-31
|
|
35000015
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,254.00
|
—
|
$2,254.00
|
$2,254.00
|
$2,254.00
|
2026-07-31
|
|
35200006
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,356.00
|
—
|
$2,356.00
|
$2,356.00
|
$2,356.00
|
2026-07-31
|
|
35100003
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,373.00
|
—
|
$2,373.00
|
$2,373.00
|
$2,373.00
|
2026-07-31
|
|
35100004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,456.00
|
—
|
$2,456.00
|
$2,456.00
|
$2,456.00
|
2026-07-31
|
|
35200005
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,539.00
|
—
|
$2,539.00
|
$2,539.00
|
$2,539.00
|
2026-07-31
|
|
27000796
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,713.00
|
—
|
$2,713.00
|
$2,713.00
|
$2,713.00
|
2026-07-31
|
|
35000012
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$2,733.00
|
—
|
$2,733.00
|
$2,733.00
|
$2,733.00
|
2026-07-31
|
|
61100004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,007.00
|
—
|
$3,007.00
|
$3,007.00
|
$3,007.00
|
2026-07-31
|
|
61000018
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,007.00
|
—
|
$3,007.00
|
$3,007.00
|
$3,007.00
|
2026-07-31
|
|
61400002
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,007.00
|
—
|
$3,007.00
|
$3,007.00
|
$3,007.00
|
2026-07-31
|
|
32000240
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,111.00
|
—
|
$3,111.00
|
$3,111.00
|
$3,111.00
|
2026-07-31
|
|
25005073
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,209.67
|
—
|
$3,209.67
|
$3,209.67
|
$3,209.67
|
2026-07-31
|
|
35000014
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,333.00
|
—
|
$3,333.00
|
$3,333.00
|
$3,333.00
|
2026-07-31
|
|
35100005
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,380.00
|
—
|
$3,380.00
|
$3,380.00
|
$3,380.00
|
2026-07-31
|
|
61200004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$3,876.00
|
—
|
$3,876.00
|
$3,876.00
|
$3,876.00
|
2026-07-31
|
|
35000011
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$4,131.00
|
—
|
$4,131.00
|
$4,131.00
|
$4,131.00
|
2026-07-31
|
|
35200007
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$4,460.00
|
—
|
$4,460.00
|
$4,460.00
|
$4,460.00
|
2026-07-31
|
|
35000004
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$4,460.00
|
—
|
$4,460.00
|
$4,460.00
|
$4,460.00
|
2026-07-31
|
|
48300001
|
OTHER
|
Inpatient Psychiatric Services
|
5
|
5
|
$4,562.00
|
—
|
$4,562.00
|
$4,562.00
|
$4,562.00
|
2026-07-31
|