Exhibit 41a - Cal Yr 2025 City of Miami CIGNA Medical - Disruption Detail with Provider TIN - Option 1 - OAP-OA001 RITM9284277_TC19.xlsx
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- RFP No. 2130386 - Employee Health Benefits Plan
- Solicitation number
- RFP No. 2130386 - Employee Health Benefits Plan
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CITY_OF__TC19
| _ | ||||||||||||||||||||||||||
| CITY OF MIAMI | ||||||||||||||||||||||||||
| Account Numbers: ('3202272') | ||||||||||||||||||||||||||
| TC 19 REPORT | ||||||||||||||||||||||||||
| DATE : Paid Date Between 12/01/2023 and 02/28/2025 | ||||||||||||||||||||||||||
| EXHIBIT 41a | ||||||||||||||||||||||||||
| _ | ||||||||||||||||||||||||||
| _ | Cigna - Disruption Analysis Results | |||||||||||||||||||||||||
| Open Access Plus - BH (OA001) | ||||||||||||||||||||||||||
| CLIENT_ACCT_NUM | PROVIDER_TAX_ID | CPF_ID | PROV_NPI | PROV_NM | ADDR_LN_1 | ADDR_LN_2 | CITY_NM | ST_CD | POSTL_CD | NT_ID | PART_INDICATOR | PRODT_TY_CD | PROV_SPEC_CD | PROVIDER_SPECIALTY | PROVIDER_TYPE | CLAIM_PAID_NETWORK_IND | CLAIMANTS | CLAIMS | VISIT_COUNT | SVC_UNIT_CNT | ELIGIBLE_BILLED_CHARGES | Category | Spec_Type | Open Access Plus_Match | Open Access Plus_Match_Type | Collaborative Accountable Care |
| 3202272 | 202971876 | 1912442 | WEST GABLES REHABILITATION HOSPITAL | 2525 SW 75TH AVE | MIAMI | FL | 33155 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 521245746 | 0564774 | RIVERSIDE REGIONAL MEDICAL CENTER | 500 J CLYDE MORRIS BLVD | NEWPORT NEWS | VA | 23601 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 929 | $10,081.87 | YES | CPF | N | |||||
| 3202272 | 621372389 | 1832768 | HCA FLORIDA MERCY HOSPITAL | 401 NW 42ND AVE | PLANTATION | FL | 33317 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 608 | $10,997.50 | Non-Par | Non-Par | YES | TIN+NAME+ADDRESS+STATE | N | |||
| 3202272 | 610947837 | 0631974 | HCA FL BRANDON HOSPITAL | 119 OAKFIELD DR | BRANDON | FL | 33511 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 325 | $43,907.64 | YES | CPF | N | |||||
| 3202272 | 862724926 | 0918561 | PALMETTO GENERAL HOSPITAL | 2001 W 68TH ST | HIALEAH | FL | 33016 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 3 | 3 | 242 | $225,142.25 | YES | CPF | N | |||||
| 3202272 | 582032904 | 0618702 | KENNESTONE HOSPITAL | 4550 COBB PARKWAY NORTH NW 109 | ACWORTH | GA | 30101 | GA811 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $58,334.22 | YES | CPF | N | |||||
| 3202272 | 596014973 | 0633318 | MEMORIAL REGIONAL HOSPITAL | 3501 JOHNSON ST | HOLLYWOOD | FL | 33021 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 14 | 17 | 18 | 10736 | $2,154,419.82 | YES | CPF | N | |||||
| 3202272 | 371787739 | 5159041 | ASSURANCE HEALTH INDIANAPOLIS LLC | 900 N HIGH SCHOOL RD | INDIANAPOLIS | IN | 46214 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 2 | 59 | $10,124.97 | Non-Par | Non-Par | YES | TIN+STATE | N | |||
| 3202272 | 630974715 | 0745815 | HEALTHSOUTH COLUMBIA REHAB HOSPITAL | 2935 COLONIAL DR | COLUMBIA | SC | 29203 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1691 | $26,182.99 | YES | CPF | N | |||||
| 3202272 | 621777534 | 0563472 | RESTON HOSPITAL CENTER | 1850 TOWN CENTER PKWY | RESTON | VA | 20190 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 882288563 | 0021824 | ADVENTHEALTH PALM COAST PARKWAY | 1 ADVENTHEALTH WAY | PALM COAST | FL | 32137 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 530 | $12,432.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 3853165 | JACKSON HEALTH SYSTEM | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | CPF | N | ||||
| 3202272 | 596014973 | 0635670 | MEMORIAL HOSPITAL PEMBROKE | 7800 SHERIDAN ST | PEMBROKE PINES | FL | 33024 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 6 | 6 | 6 | 1966 | $153,708.28 | YES | CPF | N | |||||
| 3202272 | 650729921 | 0637518 | LARKIN COMMUNITY HOSPITAL | 7031 SW 62ND AVE | SOUTH MIAMI | FL | 33143 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | NAME+STATE | N | |||
| 3202272 | 752922687 | 0643251 | DELRAY MEDICAL CENTER | 5352 LINTON BLVD | DELRAY BEACH | FL | 33484 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 995 | $27,239.55 | YES | CPF | N | |||||
| 3202272 | 592043026 | 0637140 | ST ANTHONYS HOSPITAL | 3986 TAMPA RD | OLDSMAR | FL | 34677 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $34,161.56 | YES | CPF | N | |||||
| 3202272 | 611103898 | 3230860 | 1518916154 | HUMANA MEDICAID RECOVERY | PO BOX 934604 | ATLANTA | GA | 31193 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | NPI | N | ||
| 3202272 | 650729921 | 0637518 | LARKIN COMMUNITY HOSPITAL | 7031 SW 62ND AVE | SOUTH MIAMI | FL | 33143 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 93 | $33,907.00 | Non-Par | Non-Par | YES | NAME+STATE | N | |||
| 3202272 | 752379007 | 0774459 | HCA FLORIDA ADVENTURA HOSPITAL | 20900 BISCAYNE BLVD | MIAMI | FL | 33180 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | -13 | $-34,090.85 | YES | CPF | N | |||||
| 3202272 | 591713947 | 2944001 | JACKSON WEST MEDICAL CENTER | 2801 NW 79TH AVE | DORAL | FL | 33122 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 521245746 | 0564774 | RIVERSIDE REGIONAL MEDICAL CENTER | 500 J CLYDE MORRIS BLVD | NEWPORT NEWS | VA | 23601 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 473793197 | 0769902 | ADVENTHEALTH NEW SMYRNA BEACH | 401 PALMETTO ST | NEW SMYRNA BEACH | FL | 32168 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 3 | 3 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 590725553 | 6610713 | ADVENTHEALTH SEBRING | 4200 SUN N LAKE BLVD | SEBRING | FL | 33872 | NONPAR | COMP | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 2 | 88 | $6,966.09 | Non-Par | Non-Par | YES | CPF | N | ||||
| 3202272 | 596014973 | 3021946 | MEMORIAL HOSPITAL WEST | 703 N FLAMINGO RD | PEMBROKE PINES | FL | 33028 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 364177158 | 3504497 | CC-AVENTURA INC | 19333 W COUNTRY CLUB DR | AVENTURA | FL | 33180 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 6 | 0 | $1,282.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 592522488 | 8889558 | ST ANNES NURSING CENTER ST ANNES RESIDENCE | 11855 QUAIL ROOST DR | MIAMI | FL | 33177 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 737 | $13,405.09 | YES | CPF | N | |||||
| 3202272 | 591713947 | 7289076 | JACKSON SOUTH MEDICAL CENTER | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591006663 | 0631743 | 1609856285 | BOCA RATON REGIONAL HOSPITAL | 800 MEADOWS RD | BOCA RATON | FL | 33486 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 185 | $5,812.84 | YES | CPF | N | ||||
| 3202272 | 320583104 | 9174303 | HCA FLORIDA UNIVERSITY HOSPITAL | 3476 S UNIVERSITY DR | DAVIE | FL | 33328 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 3 | 474 | $224,259.25 | YES | CPF | N | |||||
| 3202272 | 591713947 | 2944001 | JACKSON WEST MEDICAL CENTER | 2801 NW 79TH AVE | DORAL | FL | 33122 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 6 | 6 | 1251 | $128,386.21 | YES | CPF | N | |||||
| 3202272 | 203616113 | 1067144 | NEW RIVIERA NURSING & REHAB | 6901 YUMURI ST | CORAL GABLES | FL | 33146 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 43 | $8,563.46 | YES | CPF | N | |||||
| 3202272 | 812070561 | 3626440 | DETOX CENTER | 2700 BROADWAY | WEST PALM BEACH | FL | 33407 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 21 | 21 | 21 | $82,200.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 591713947 | 0634725 | JACKSON MEMORIAL HOSPITAL | 15055 NW 27TH AVE | OPA LOCKA | FL | 33054 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 27 | 36 | 34 | 32254 | $1,859,085.41 | YES | CPF | N | |||||
| 3202272 | 650640606 | 8982700 | 1861652125 | MOBILE QUALITY DIAGNOSTIC | 1751 W 38TH PL 1003A | HIALEAH | FL | 33012 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $203.97 | YES | CPF | N | ||||
| 3202272 | 043775926 | 0632205 | DOCTORS HOSPITAL INC | 5000 UNIVERSITY DR | CORAL GABLES | FL | 33146 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 340 | $104,597.00 | YES | CPF | N | |||||
| 3202272 | 202971876 | 1912442 | WEST GABLES REHABILITATION HOSPITAL | 2525 SW 75TH AVE | MIAMI | FL | 33155 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1694 | $57,481.62 | YES | CPF | N | |||||
| 3202272 | 871625272 | 6705185 | CLARIDGE REGENTS OPCO LLC | 13900 NE 3RD CT | MIAMI | FL | 33161 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 7 | 41 | $1,042.77 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 862695690 | 0634872 | STEWARD NORTH SHORE MEDICAL CENTER | 1100 NW 95TH ST | MIAMI | FL | 33150 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $3,135.31 | YES | TIN+STATE | N | |||||
| 3202272 | 590638499 | 0634935 | NICKLAUS CHILDRENS HOSPITAL | 3915 BISCAYNE BLVD | MIAMI | FL | 33137 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 2 | 2 | $-4,843.17 | YES | CPF | N | |||||
| 3202272 | 590624449 | 0633654 | ASCENSION ST VINCENTS RIVERSIDE | 14841 SW 42ND TER | MIAMI | FL | 33185 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 590791028 | 0632751 | HOLY CROSS HOSPITAL | 4725 N FEDERAL HWY | FORT LAUDERDALE | FL | 33308 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 406 | $16,804.98 | YES | CPF | N | |||||
| 3202272 | 596014973 | 7365552 | MEMORIAL MANOR | 777 S DOUGLAS RD | PEMBROKE PINES | FL | 33025 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 043775926 | 0632205 | DOCTORS HOSPITAL INC | 5000 UNIVERSITY DR | CORAL GABLES | FL | 33146 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 3 | 3 | 3 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 364177158 | 3504497 | CC-AVENTURA INC | 19333 W COUNTRY CLUB DR | AVENTURA | FL | 33180 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 5 | 32 | 81 | $2,676.02 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 471130508 | 2940297 | FT LAUDERDALE HEALTH & REHABILITATION CENTER | 2000 E COMMERCIAL BLVD | FORT LAUDERDALE | FL | 33308 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 21 | 0 | $4,566.73 | YES | CPF | N | |||||
| 3202272 | 596014973 | 3021946 | MEMORIAL HOSPITAL WEST | 703 N FLAMINGO RD | PEMBROKE PINES | FL | 33028 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 9 | 6 | 140 | $2,995,856.59 | YES | CPF | N | |||||
| 3202272 | 593725585 | 4998271 | 1396408829 | NEOGENOMICS LABORATORIES INC | PO BOX 946110 | ATLANTA | GA | 30394 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 16 | $371.56 | YES | CPF | N | ||||
| 3202272 | 540548200 | 0564732 | MARY IMMACULATE HOSPITAL LLC | 2 BERNADINE DR | NEWPORT NEWS | VA | 23602 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591198552 | 2231694 | PEDIATRIC ASSOCIATES PA | 900 S PINE ISLAND RD 800 | PLANTATION | FL | 33324 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | TIN+NAME | N | |||
| 3202272 | 621372389 | 0768306 | HCA FLORIDA MERCY HOSPITAL | 3663 S MIAMI AVE | MIAMI | FL | 33133 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 20 | 25 | 24 | 8506 | $3,302,392.47 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0941850 | JACKSON NORTH MEDICAL CENTER | 160 NW 170TH ST | NORTH MIAMI BEACH | FL | 33169 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 39 | $128,885.80 | YES | CPF | N | |||||
| 3202272 | 741152597 | 0919800 | MEMORIAL HERMANN HEALTH SYSTEM | 1635 NORTH LOOP W | HOUSTON | TX | 77008 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 177 | $14,501.17 | YES | CPF | N | |||||
| 3202272 | 043775926 | 0632205 | DOCTORS HOSPITAL INC | 5000 UNIVERSITY DR | CORAL GABLES | FL | 33146 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 7 | 12 | 10 | 16550 | $1,057,604.29 | YES | CPF | N | |||||
| 3202272 | 596012065 | 0632667 | BROWARD HEALTH MEDICAL CENTER | 1600 S ANDREWS AVE | FORT LAUDERDALE | FL | 33316 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 0 | $38,041.70 | YES | CPF | N | |||||
| 3202272 | 592616017 | 3438105 | UMHC | 1475 NW 12TH AVE | MIAMI | FL | 33136 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0941850 | JACKSON NORTH MEDICAL CENTER | 160 NW 170TH ST | NORTH MIAMI BEACH | FL | 33169 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 8 | 8 | 9 | 6401 | $322,070.26 | YES | CPF | N | |||||
| 3202272 | 752379007 | 0774459 | HCA FLORIDA ADVENTURA HOSPITAL | 20900 BISCAYNE BLVD | MIAMI | FL | 33180 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 596014973 | 3021946 | MEMORIAL HOSPITAL WEST | 703 N FLAMINGO RD | PEMBROKE PINES | FL | 33028 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 19 | 21 | 20 | 7307 | $1,181,478.11 | YES | CPF | N | |||||
| 3202272 | 591006663 | 0631743 | BOCA RATON REGIONAL HOSPITAL | 800 MEADOWS RD | BOCA RATON | FL | 33486 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 352528741 | 5128300 | VANDERBILT UNIVERSITY MEDICAL CENTER | 2200 CHILDRENS WAY | NASHVILLE | TN | 37232 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 824 | $138,618.15 | YES | CPF | N | |||||
| 3202272 | 611103898 | 3230860 | 1730259649 | HUMANA MEDICAID RECOVERY | PO BOX 934604 | ATLANTA | GA | 31193 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | NPI | N | ||
| 3202272 | 882288563 | 0021824 | ADVENTHEALTH PALM COAST PARKWAY | 1 ADVENTHEALTH WAY | PALM COAST | FL | 32137 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 823992351 | 4935727 | SKYWARD TREATMENT SOLUTIONS LLC | 11352 SUGAR PARK LN | SUGAR LAND | TX | 77478 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 2 | $12,500.00 | Non-Par | Non-Par | YES | TIN+STATE | Y | |||
| 3202272 | 650134197 | 0851655 | 1093759276 | PORTABLE MEDICAL DIAGNOSTIC INC | 2370 HARBOR BLVD | PORT CHARLOTTE | FL | 33952 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 3 | $255.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 596014973 | 5718056 | MEMORIAL HOSPITAL MIRAMAR | 3162 MOMENTUM PL | CHICAGO | IL | 60689 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 862578577 | 7164158 | BURKE HEALTH AND REHABILITATION CENTER | 9640 BURKE LAKE RD | BURKE | VA | 22015 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 22 | $40,785.54 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 472762362 | 2014630 | HCA FLORIDA PUTNAM HOSPITAL | 611 ZEAGLER DR | PALATKA | FL | 32177 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 5 | $345,161.00 | YES | CPF | N | |||||
| 3202272 | 596012500 | 0637287 | SARASOTA MEMORIAL HOSPITAL | 1700 S TAMIAMI TRL | SARASOTA | FL | 34239 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | NAME+STATE | N | ||||
| 3202272 | 540548200 | 0564732 | MARY IMMACULATE HOSPITAL LLC | 2 BERNADINE DR | NEWPORT NEWS | VA | 23602 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2952 | $9,015.23 | YES | CPF | N | |||||
| 3202272 | 426004813 | 1919213 | 1376544320 | UNIVERSITY OF IOWA HOSPITALS AND CLINICS | 200 HAWKINS DR | IOWA CITY | IA | 52242 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 11 | $15,393.81 | YES | CPF | N | ||||
| 3202272 | 621372389 | 0768306 | HCA FLORIDA MERCY HOSPITAL | 3663 S MIAMI AVE | MIAMI | FL | 33133 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 630974715 | 0745815 | HEALTHSOUTH COLUMBIA REHAB HOSPITAL | 2935 COLONIAL DR | COLUMBIA | SC | 29203 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 833331871 | 7535514 | SELECT SPECIALTY HOSPITAL MIAMI LAKES INC | 14001 NW 82ND AVE | MIAMI LAKES | FL | 33016 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 5489 | $105,504.65 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0634725 | JACKSON MEMORIAL HOSPITAL | 15055 NW 27TH AVE | OPA LOCKA | FL | 33054 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 6 | 8 | 7 | 938 | $679,567.66 | YES | CPF | N | |||||
| 3202272 | 851242690 | 1894737 | MALLARD LAKE RANCH DETOX CENTER LLC | 18407 HOPFE RD | HOCKLEY | TX | 77447 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 20 | 20 | 20 | $112,400.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 590624424 | 0635019 | MOUNT SINAI MEDICAL CENTER | 4300 ALTON RD | MIAMI BEACH | FL | 33140 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 14 | 17 | 17 | 9304 | $1,152,394.07 | YES | CPF | N | |||||
| 3202272 | 264019868 | 2565699 | 1770743908 | VIERA HOSPITAL | 8745 N WICKHAM RD | MELBOURNE | FL | 32940 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 48 | $5,331.72 | YES | CPF | N | ||||
| 3202272 | 540601803 | 7092704 | GARDENS AT WARWICK FOREST | 1000 OLD DENBIGH BLVD | NEWPORT NEWS | VA | 23602 | MD802 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 592616017 | 3438105 | UMHC | 1475 NW 12TH AVE | MIAMI | FL | 33136 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 7 | 19 | 11 | 33 | $2,088,087.00 | YES | CPF | N | |||||
| 3202272 | 592447554 | 0631806 | BETHESDA HOSPITAL INC | 3800 S CONGRESS AVE | BOYNTON BEACH | FL | 33426 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 3 | 916 | $79,911.38 | YES | CPF | N | |||||
| 3202272 | 650844880 | 6733327 | CLEVELAND CLINIC HOSPITAL | 3100 WESTON RD | WESTON | FL | 33331 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 9 | $146,761.30 | YES | CPF | N | |||||
| 3202272 | 593725585 | 4998271 | 1740240753 | NEOGENOMICS LABORATORIES INC | PO BOX 946110 | ATLANTA | GA | 30394 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $43.12 | YES | CPF | N | ||||
| 3202272 | 742730328 | 0930447 | METHODIST HOSPITAL | 7700 FLOYD CURL DR | SAN ANTONIO | TX | 78229 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 246 | $0.00 | YES | CPF | N | |||||
| 3202272 | 275253818 | 0839412 | EMCOMPASS HEALTH REHABILITATION HOSPITAL | 20601 OLD CUTLER RD | CUTLER BAY | FL | 33189 | OA001 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0634725 | JACKSON MEMORIAL HOSPITAL | 15055 NW 27TH AVE | OPA LOCKA | FL | 33054 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 3 | 3 | 3 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591943502 | 0633192 | SHANDS AT THE UNIVERSITY OF FLORIDA | 1600 SW ARCHER RD | GAINESVILLE | FL | 32610 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 2 | 0 | $0.00 | YES | CPF | N | ||||||
| 3202272 | 621694180 | 0634158 | HCA FLORIDA JFK HOSPITAL | 5301 S CONGRESS AVE | LAKE WORTH | FL | 33462 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 3 | 3 | 882 | $295,563.50 | YES | CPF | N | |||||
| 3202272 | 953268980 | 0261671 | 1366612301 | MOBILEX USA | 13773 ICOT BLVD | CLEARWATER | FL | 33760 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 3 | 3 | 3 | $25.34 | Hospital Based Providers | Radiology | YES | Hospital-Based | N | ||
| 3202272 | 852276627 | 1821284 | 1336750801 | ASURE WOUND SOLUTIONS LLC | 20801 BISCAYNE BLVD 403444 | MIAMI | FL | 33180 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 590903331 | 9556277 | EAST RIDGE RETIREMENT VILLAGE | 19301 SW 87TH AVE | CUTLER BAY | FL | 33157 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 44 | $3,209.38 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 590624424 | 0635019 | MOUNT SINAI MEDICAL CENTER | 4300 ALTON RD | MIAMI BEACH | FL | 33140 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 3 | 4 | 4 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 590624424 | 0635019 | MOUNT SINAI MEDICAL CENTER | 4300 ALTON RD | MIAMI BEACH | FL | 33140 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 8 | 5 | 2079 | $463,236.44 | YES | CPF | N | |||||
| 3202272 | 752922687 | 0643251 | DELRAY MEDICAL CENTER | 5352 LINTON BLVD | DELRAY BEACH | FL | 33484 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 833331871 | 7535514 | SELECT SPECIALTY HOSPITAL MIAMI LAKES INC | 14001 NW 82ND AVE | MIAMI LAKES | FL | 33016 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 471130508 | 2940297 | FT LAUDERDALE HEALTH & REHABILITATION CENTER | 2000 E COMMERCIAL BLVD | FORT LAUDERDALE | FL | 33308 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 5 | 28 | $888.95 | YES | CPF | N | |||||
| 3202272 | 522438452 | 8174876 | WEST KENDALL BAPTIST HSP | 9555 SW 162ND AVE | MIAMI | FL | 33196 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 243 | $77,185.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 7207912 | JACKSON MEMORIAL HOSPITAL | 1611 NW 12TH AVE | MIAMI | FL | 33136 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 1249 | $46,368.14 | Non-Par | Non-Par | YES | TIN+NAME+ADDRESS+STATE | N | |||
| 3202272 | 591713947 | 7289076 | JACKSON SOUTH MEDICAL CENTER | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 30942 | $157,036.63 | YES | CPF | N | |||||
| 3202272 | 621372389 | 1832768 | HCA FLORIDA MERCY HOSPITAL | 401 NW 42ND AVE | PLANTATION | FL | 33317 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | TIN+NAME+ADDRESS+STATE | N | |||
| 3202272 | 650640606 | 8982700 | 1104819648 | MOBILE QUALITY DIAGNOSTIC | 1751 W 38TH PL 1003A | HIALEAH | FL | 33012 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 8 | $15.53 | YES | CPF | N | ||||
| 3202272 | 596014973 | 5718056 | MEMORIAL HOSPITAL MIRAMAR | 3162 MOMENTUM PL | CHICAGO | IL | 60689 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 862669849 | 0633255 | STEWARD HIALEAH HOSPITAL | 651 E 25TH ST | HIALEAH | FL | 33013 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 3 | 322 | $283,655.68 | YES | CPF | N | |||||
| 3202272 | 830821846 | 0573972 | NINTY FOUR ZERO ZERO SW ONE THIRTY SEVENTH AVENUE OPERATIONS LLC | 9400 SW 137TH AVE | MIAMI | FL | 33186 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 32 | $16,932.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 2944001 | JACKSON WEST MEDICAL CENTER | 2801 NW 79TH AVE | DORAL | FL | 33122 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 545 | $62,791.93 | YES | CPF | N | ||||||
| 3202272 | 160743209 | 2982729 | UNIV OF ROCHESTER STRONG MEMORIAL HOSPITAL | 601 ELMWOOD AVE 684 | ROCHESTER | NY | 14642 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 2 | $0.00 | YES | CPF | N | |||||
| 3202272 | 474063232 | 0706020 | ASCENSION SAINT THOMAS STONES RIVER | 324 DOOLITTLE RD | WOODBURY | TN | 37190 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 393 | $23,156.85 | YES | CPF | N | |||||
| 3202272 | 862695690 | 7234854 | STEWARD FLORIDA MEDICAL CENTER | 5000 W OAKLAND PARK BLVD | LAUDERDALE LAKES | FL | 33313 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 166 | $62,129.11 | YES | CPF | N | |||||
| 3202272 | 592447554 | 0631806 | BETHESDA HOSPITAL INC | 3800 S CONGRESS AVE | BOYNTON BEACH | FL | 33426 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 841905194 | 3735981 | 1386240786 | NOMI HEALTH INC | 1141 E 3900 S 150 | SALT LAKE CITY | UT | 84124 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | TIN | N | ||
| 3202272 | 651005595 | 7560619 | LIFESKILLS SOUTH FLORIDA | 236 SE 23RD AVE | BOYNTON BEACH | FL | 33435 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 6 | 32 | 32 | $94,880.00 | Non-Par | Non-Par | YES | TIN+STATE | Y | |||
| 3202272 | 621777534 | 0563472 | RESTON HOSPITAL CENTER | 1850 TOWN CENTER PKWY | RESTON | VA | 20190 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 82 | $7,564.25 | YES | CPF | N | |||||
| 3202272 | 590872594 | 0637539 | SOUTH MIAMI HOSPITAL INC | 6200 SW 73RD ST | SOUTH MIAMI | FL | 33143 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 4 | 4 | 4 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 160743209 | 2982729 | UNIV OF ROCHESTER STRONG MEMORIAL HOSPITAL | 601 ELMWOOD AVE 684 | ROCHESTER | NY | 14642 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $96,456.60 | YES | CPF | N | |||||
| 3202272 | 591713947 | 7289076 | JACKSON SOUTH MEDICAL CENTER | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 8 | 9 | 3564 | $336,736.36 | YES | CPF | N | |||||
| 3202272 | 871625272 | 6705185 | CLARIDGE REGENTS OPCO LLC | 13900 NE 3RD CT | MIAMI | FL | 33161 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 3 | 10 | $384.87 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 591713947 | 3853165 | JACKSON HEALTH SYSTEM | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 325 | $25,993.66 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 591226176 | 9944423 | 1750801031 | MBB RADIOLOGY | 2700 UNIVERSITY SQUARE DR | TAMPA | FL | 33612 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 2 | $278.00 | Non-Par | Non-Par | YES | Hospital-Based | N | ||
| 3202272 | 953268980 | 4796904 | 1932376233 | SYMPHONY DIAGNOSTIC SERVICES | 13773 ICOT BLVD | CLEARWATER | FL | 33760 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $77.48 | YES | CPF | N | ||||
| 3202272 | 590638499 | 0634935 | NICKLAUS CHILDRENS HOSPITAL | 3915 BISCAYNE BLVD | MIAMI | FL | 33137 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 7 | 8 | 8 | 1938 | $437,332.77 | YES | CPF | N | |||||
| 3202272 | 871577410 | 8802472 | AVENTURA REGENTS OPCO LLC | 18905 NE 25TH AVE | MIAMI | FL | 33180 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 4 | 6 | 49 | $5,940.97 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 650134197 | 0851655 | 1093759276 | PORTABLE MEDICAL DIAGNOSTIC INC | 2370 HARBOR BLVD | PORT CHARLOTTE | FL | 33952 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 7 | 4 | 15 | $804.58 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 596014973 | 5718056 | MEMORIAL HOSPITAL MIRAMAR | 3162 MOMENTUM PL | CHICAGO | IL | 60689 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 8 | 3 | 10 | $53,848.95 | YES | CPF | N | |||||
| 3202272 | 592142859 | 0778659 | SHANDS JACKSONVILLE MEDICAL CENTER | 11251 LAMB TAIL LN | JACKSONVILLE | FL | 32256 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 3 | $16,581.66 | YES | CPF | N | |||||
| 3202272 | 522438452 | 8174876 | WEST KENDALL BAPTIST HSP | 9555 SW 162ND AVE | MIAMI | FL | 33196 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 760545192 | 4808111 | HOUSTON METHODIST WEST HOSPITAL | 3162 MOMENTUM PLAC | CHICAGO | IL | 60689 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 183 | $0.00 | YES | CPF | N | |||||
| 3202272 | 741152597 | 0919800 | MEMORIAL HERMANN HEALTH SYSTEM | 1635 NORTH LOOP W | HOUSTON | TX | 77008 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 541141438 | 5965822 | COLISEUM CONVALESCENT CENTER | 540 ABERTHAW AVE | NEWPORT NEWS | VA | 23601 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 2 | 62 | $17,860.36 | Non-Par | Non-Par | YES | TIN+STATE | N | |||
| 3202272 | 364177158 | 3504497 | CC-AVENTURA INC | 19333 W COUNTRY CLUB DR | AVENTURA | FL | 33180 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 12 | 0 | $1,071.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 591006663 | 0631743 | 1609856285 | BOCA RATON REGIONAL HOSPITAL | 800 MEADOWS RD | BOCA RATON | FL | 33486 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | ||||
| 3202272 | 582032904 | 0618702 | KENNESTONE HOSPITAL | 4550 COBB PARKWAY NORTH NW 109 | ACWORTH | GA | 30101 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $11,380.40 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 830821846 | 0573972 | NINTY FOUR ZERO ZERO SW ONE THIRTY SEVENTH AVENUE OPERATIONS LLC | 9400 SW 137TH AVE | MIAMI | FL | 33186 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 25 | $27,888.00 | YES | CPF | N | |||||
| 3202272 | 621372389 | 0768306 | HCA FLORIDA MERCY HOSPITAL | 3663 S MIAMI AVE | MIAMI | FL | 33133 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 7 | $8,064.00 | YES | CPF | N | |||||
| 3202272 | 591943502 | 0633192 | SHANDS AT THE UNIVERSITY OF FLORIDA | 1600 SW ARCHER RD | GAINESVILLE | FL | 32610 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 1524 | $121,072.92 | YES | CPF | N | |||||
| 3202272 | 590624449 | 0633654 | ASCENSION ST VINCENTS RIVERSIDE | 14841 SW 42ND TER | MIAMI | FL | 33185 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 133 | $20,145.05 | YES | CPF | N | |||||
| 3202272 | 752379007 | 0774459 | HCA FLORIDA ADVENTURA HOSPITAL | 20900 BISCAYNE BLVD | MIAMI | FL | 33180 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 8 | 8 | 1599 | $464,006.75 | YES | CPF | N | |||||
| 3202272 | 592318357 | 9625768 | VITAS HEALTHCARE CORP | 199 PARK ROAD EXT 102 | MIDDLEBURY | CT | 06762 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 14 | 197 | $8,503.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0941850 | JACKSON NORTH MEDICAL CENTER | 160 NW 170TH ST | NORTH MIAMI BEACH | FL | 33169 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 590910342 | 2730538 | BAPTIST HOSPITAL OF MIAMI | 8900 N KENDALL DR | MIAMI | FL | 33176 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 6 | 7 | 6 | 1624 | $313,829.00 | YES | CPF | N | |||||
| 3202272 | 591006663 | 0631743 | BOCA RATON REGIONAL HOSPITAL | 800 MEADOWS RD | BOCA RATON | FL | 33486 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 72 | $5,043.25 | YES | CPF | N | |||||
| 3202272 | 275253818 | 0839412 | EMCOMPASS HEALTH REHABILITATION HOSPITAL | 20601 OLD CUTLER RD | CUTLER BAY | FL | 33189 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1272 | $19,638.76 | YES | CPF | N | |||||
| 3202272 | 203616113 | 1067144 | NEW RIVIERA NURSING & REHAB | 6901 YUMURI ST | CORAL GABLES | FL | 33146 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 592868487 | 7948542 | 1033185889 | ATLAS DIAGNOSTICS | 4023 N ARMENIA AVE 101 | TAMPA | FL | 33607 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 3 | 3 | 3 | $107.93 | YES | CPF | N | ||||
| 3202272 | 650844880 | 6733327 | CLEVELAND CLINIC HOSPITAL | 3100 WESTON RD | WESTON | FL | 33331 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 4 | 4 | 2019 | $320,990.22 | YES | CPF | N | |||||
| 3202272 | 596014973 | 0635670 | MEMORIAL HOSPITAL PEMBROKE | 7800 SHERIDAN ST | PEMBROKE PINES | FL | 33024 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 2 | 60 | $129,260.43 | YES | CPF | N | |||||
| 3202272 | 596014973 | 5718056 | MEMORIAL HOSPITAL MIRAMAR | 3162 MOMENTUM PL | CHICAGO | IL | 60689 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 7 | 8 | 8 | 1504 | $334,591.69 | YES | CPF | N | |||||
| 3202272 | 650260078 | 4831131 | HCA FLORIDA KENDALL HOSPITAL | 11750 BIRD RD | MIAMI | FL | 33175 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 99 | $172,816.00 | YES | CPF | N | |||||
| 3202272 | 830821846 | 0573972 | NINTY FOUR ZERO ZERO SW ONE THIRTY SEVENTH AVENUE OPERATIONS LLC | 9400 SW 137TH AVE | MIAMI | FL | 33186 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 473793197 | 0769902 | ADVENTHEALTH NEW SMYRNA BEACH | 401 PALMETTO ST | NEW SMYRNA BEACH | FL | 32168 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 3 | 3 | 1297 | $35,587.47 | YES | CPF | N | |||||
| 3202272 | 471630903 | 4784283 | SEASONS HOSPICE AND PALLIATIVE CARE OF BROWARD FLORIDA LLC | 1200 S PINE ISLAND RD 350 | PLANTATION | FL | 33324 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $734.00 | Invalid | Home Health | Excluded | Invalid - Home Health | N | |||
| 3202272 | 650134197 | 0851655 | 1093759276 | PORTABLE MEDICAL DIAGNOSTIC INC | 2370 HARBOR BLVD | PORT CHARLOTTE | FL | 33952 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 3 | $470.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 592616017 | 3438105 | UMHC | 1475 NW 12TH AVE | MIAMI | FL | 33136 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 15 | 26 | 23 | 25392 | $2,594,099.98 | YES | CPF | N | |||||
| 3202272 | 862724926 | 0918561 | PALMETTO GENERAL HOSPITAL | 2001 W 68TH ST | HIALEAH | FL | 33016 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 5 | $52,395.96 | YES | CPF | N | |||||
| 3202272 | 590903331 | 9556277 | EAST RIDGE RETIREMENT VILLAGE | 19301 SW 87TH AVE | CUTLER BAY | FL | 33157 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||||
| 3202272 | 232810852 | 0508515 | UPHS PRESBYTERIAN MEDICAL CENTER | 51 N 39TH ST | PHILADELPHIA | PA | 19104 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 4 | $0.00 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 204464277 | 7064940 | 1457365355 | ABILITY MEDICAL SUPPLY INC | 5253 NW 108TH AVE | SUNRISE | FL | 33351 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 6 | $1,576.80 | Invalid | DME | Excluded | Invalid - DME | N | ||
| 3202272 | 232810852 | 0508515 | UPHS PRESBYTERIAN MEDICAL CENTER | 51 N 39TH ST | PHILADELPHIA | PA | 19104 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 590624414 | 2760610 | MIAMI JEWISH HOME & HOSPITAL FOR THE AGED INC | 5200 NE 2ND AVE | MIAMI | FL | 33137 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 6 | 10 | 256 | $46,355.94 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 590910342 | 2730538 | BAPTIST HOSPITAL OF MIAMI | 8900 N KENDALL DR | MIAMI | FL | 33176 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 33 | 45 | 44 | 27010 | $3,965,520.24 | YES | CPF | N | |||||
| 3202272 | 590910342 | 2730538 | BAPTIST HOSPITAL OF MIAMI | 8900 N KENDALL DR | MIAMI | FL | 33176 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 4 | 5 | 5 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 883138660 | 5183875 | BROOKWOOD GARDENS REHABILITATION AND NURSING CENTER | 1990 S CANAL DR | HOMESTEAD | FL | 33035 | FL851 | NONPAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 474063232 | 0706020 | ASCENSION SAINT THOMAS STONES RIVER | 324 DOOLITTLE RD | WOODBURY | TN | 37190 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 590791028 | 0632751 | HOLY CROSS HOSPITAL | 4725 N FEDERAL HWY | FORT LAUDERDALE | FL | 33308 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 542129332 | 7262473 | VITAL MD | 9750 NW 33RD ST | POMPANO BEACH | FL | 33065 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 1 | $0.00 | Non-Par | Non-Par | YES | TIN+STATE | N | |||
| 3202272 | 591726273 | 4477823 | ORLANDO HEALTH INC | 1414 KUHL AVE | ORLANDO | FL | 32806 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1479 | $127,032.24 | YES | CPF | N | |||||
| 3202272 | 590872594 | 0637539 | SOUTH MIAMI HOSPITAL INC | 6200 SW 73RD ST | SOUTH MIAMI | FL | 33143 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 16 | 20 | 20 | 5287 | $1,058,950.77 | YES | CPF | N | |||||
| 3202272 | 953268980 | 0261671 | 1700865094 | MOBILEX USA | 13773 ICOT BLVD | CLEARWATER | FL | 33760 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $19.10 | Hospital Based Providers | Radiology | YES | Hospital-Based | N | ||
| 3202272 | 591713947 | 7207912 | JACKSON MEMORIAL HOSPITAL | 1611 NW 12TH AVE | MIAMI | FL | 33136 | OA001 | NONPAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | TIN+NAME+ADDRESS+STATE | N | |||
| 3202272 | 590872594 | 0637539 | SOUTH MIAMI HOSPITAL INC | 6200 SW 73RD ST | SOUTH MIAMI | FL | 33143 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 3 | 3 | 760 | $382,974.00 | YES | CPF | N | |||||
| 3202272 | 596014973 | 0635670 | MEMORIAL HOSPITAL PEMBROKE | 7800 SHERIDAN ST | PEMBROKE PINES | FL | 33024 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 596014973 | 7365552 | MEMORIAL MANOR | 777 S DOUGLAS RD | PEMBROKE PINES | FL | 33025 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 93 | $3,370.15 | YES | CPF | N | |||||
| 3202272 | 264019868 | 2565699 | 1770743908 | VIERA HOSPITAL | 8745 N WICKHAM RD | MELBOURNE | FL | 32940 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | ||||
| 3202272 | 522438452 | 8174876 | WEST KENDALL BAPTIST HSP | 9555 SW 162ND AVE | MIAMI | FL | 33196 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 6 | 7 | 7 | 4164 | $666,932.18 | YES | CPF | N | |||||
| 3202272 | 596014973 | 0633318 | MEMORIAL REGIONAL HOSPITAL | 3501 JOHNSON ST | HOLLYWOOD | FL | 33021 | FL851 | PAR | DPP4 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 2 | 3 | $65,282.03 | YES | CPF | N | |||||
| 3202272 | 650260078 | 4831131 | HCA FLORIDA KENDALL HOSPITAL | 11750 BIRD RD | MIAMI | FL | 33175 | OA001 | PAR | OAP1 | OTHER | FACILITY INPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 4 | 3 | 2755 | $835,480.08 | YES | CPF | N | |||||
| 3202272 | 350868178 | 0582099 | 1649241084 | SOUTH BEND MEDICAL FOUNDATION INC | 530 N LAFAYETTE BLVD | SOUTH BEND | IN | 46601 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 5 | $0.00 | YES | CPF | N | ||||
| 3202272 | 113412370 | 4092275 | 1366543795 | NORTHWELL HEALTH LABORATORIES | 800 NORTHERN BLVD 5 | GREAT NECK | NY | 11021 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 4 | 4 | 4 | $204.00 | Non-Par | Non-Par | YES | CPF | N | ||
| 3202272 | 208283421 | 0724096 | GOOD SHEPHERD PENN SPECIALTY HOSPITAL | 250 KING OF PRUSSIA RD 100FL1 | RADNOR | PA | 19087 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 3 | 3 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 3853165 | JACKSON HEALTH SYSTEM | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | OA001 | NONPAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 2 | 0 | $121.69 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 593140669 | 2599397 | ADVENTHEALTH HOME CARE WATERMAN | 1000 WATERMAN WAY | TAVARES | FL | 32778 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 4 | $13,777.16 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | |||
| 3202272 | 202001489 | 0812448 | CAPE CORAL SURGERY CENTER | 2721 DEL PRADO BLVD S 100 | CAPE CORAL | FL | 33904 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | 3 | $15,890.00 | YES | CPF | N | |||||
| 3202272 | 850620744 | 2199945 | 1679229942 | ONE PATH DIAGNOSTICS LLC | 6800 SOUTHPOINT PKWY 950 | JACKSONVILLE | FL | 32216 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 1 | $200.00 | Non-Par | Non-Par | YES | Hospital-Based | N | ||
| 3202272 | 331168930 | 9388593 | 1184814014 | BAKOTIC PATHOLOGY ASSOCIATES LLC | 6240 SHILOH RD | ALPHARETTA | GA | 30005 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 8 | 11 | 10 | 44 | $4,285.00 | Hospital Based Providers | Pathology | YES | Hospital-Based | N | ||
| 3202272 | 270081366 | 6217655 | 1851344378 | CARESPOT EXPRESS HEALTHCARE | 4450 N STATE ROAD 7 1 | CORAL SPRINGS | FL | 33073 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 5 | 5 | 5 | $826.20 | YES | CPF | N | ||||
| 3202272 | 752932830 | 0639072 | ST MARYS MEDICAL CENTER | 901 45TH ST | MANGONIA PARK | FL | 33407 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 7 | $3,812.50 | YES | CPF | N | |||||
| 3202272 | 591713947 | 7289076 | JACKSON SOUTH MEDICAL CENTER | 9333 SW 152ND ST | PALMETTO BAY | FL | 33157 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 7 | 7 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 2031620 | UHEALTH JACKSON URGENT CARE - CORAL GABLES | 3737 SW 8TH ST A | CORAL GABLES | FL | 33134 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 473793197 | 0769902 | ADVENTHEALTH NEW SMYRNA BEACH | 401 PALMETTO ST | NEW SMYRNA BEACH | FL | 32168 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 3 | 3 | 4 | $3,661.01 | YES | CPF | N | |||||
| 3202272 | 650641688 | 4520944 | 1952381477 | AMERIPATH FLORIDA LLC | 895 SW 30TH AVE 101 | POMPANO BEACH | FL | 33069 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $135.00 | Non-Par | Non-Par | YES | Hospital-Based | N | ||
| 3202272 | 010790511 | 7678739 | 1689660227 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 12 | 12 | 12 | 13 | $3,549.23 | YES | CPF | N | ||||
| 3202272 | 010790511 | 7678739 | 1376579268 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $873.00 | YES | CPF | N | ||||
| 3202272 | 331216751 | 0617001 | PIEDMONT COLUMBUS REGIONAL NORTHSIDE | 100 FRIST CT | COLUMBUS | GA | 31909 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 592249372 | 4416741 | BROOKS REHABILITATION CENTER | 4575 US HIGHWAY 17 | FLEMING ISLAND | FL | 32003 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 5 | 5 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 591713947 | 0139365 | PHTJEFFERSON REAVES SR H | 1009 NW 5TH AVE | MIAMI | FL | 33136 | OA001 | NONPAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 5 | 24 | 23 | 1 | $176.00 | Non-Par | Non-Par | YES | TIN+STATE | N | |||
| 3202272 | 752433596 | 0850416 | OUTPATIENT SURGICAL SERVICES | 301 NW 82ND AVE | PLANTATION | FL | 33324 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $15,140.00 | YES | CPF | N | |||||
| 3202272 | 952977916 | 9811883 | GREATER MIAMI DIALYSIS | 160 NW 176TH ST 100 | MIAMI | FL | 33169 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 108 | 236 | 248 | $1,618,268.00 | YES | CPF | N | |||||
| 3202272 | 650260078 | 4831131 | HCA FLORIDA KENDALL HOSPITAL | 11750 BIRD RD | MIAMI | FL | 33175 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | ||||||
| 3202272 | 650844880 | 6733327 | CLEVELAND CLINIC HOSPITAL | 3100 WESTON RD | WESTON | FL | 33331 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 13 | 20 | 19 | 14 | $32,410.37 | YES | CPF | N | |||||
| 3202272 | 133757370 | 4017812 | 1215914288 | LABCORP HOLDINGS | 133 E DAVIS ST | GLEN RAVEN | NC | 27215 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 5 | 5 | 24 | $2,474.85 | YES | CPF | N | ||||
| 3202272 | 264427866 | 8989898 | 1356379721 | EMERGENCY PHYSICIANS MEDICAL CENTER | 2445 SW 76TH ST 110 | GAINESVILLE | FL | 32608 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $100.00 | Hospital Based Providers | Emergency | YES | Hospital-Based | N | ||
| 3202272 | 010790511 | 7678739 | 1629304456 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 3 | 3 | 3 | $708.00 | YES | CPF | N | ||||
| 3202272 | 593452939 | 9635245 | 1063495836 | FL AHCA | 1945 SE PORT ST LUCIE BLVD | FORT PIERCE | FL | 34952 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 3 | 1 | $3,077.00 | Non-Par | Non-Par | YES | NPI | N | ||
| 3202272 | 650641688 | 4520944 | 1952381477 | AMERIPATH FLORIDA LLC | 895 SW 30TH AVE 101 | POMPANO BEACH | FL | 33069 | OA001 | NONPAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 10 | 12 | 12 | 12 | $3,929.19 | Non-Par | Non-Par | YES | Hospital-Based | N | ||
| 3202272 | 462511072 | 2854131 | 1265977458 | HUB MEDICAL LLC | 4604 31ST AVE | LONG ISLAND CITY | NY | 11103 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 0 | $0.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 471018860 | 5669567 | 1760514921 | FM URGENT CARE | 3560 A1A S | SAINT AUGUSTINE | FL | 32080 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $310.17 | YES | CPF | N | ||||
| 3202272 | 596014973 | 3021946 | MEMORIAL HOSPITAL WEST | 703 N FLAMINGO RD | PEMBROKE PINES | FL | 33028 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 22 | 79 | 84 | 474 | $418,362.55 | YES | CPF | N | |||||
| 3202272 | 205077249 | 0619038 | PIEDMONT NEWNAN HOSPITAL | 745 POPLAR RD | NEWNAN | GA | 30265 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 010790511 | 7678739 | 1144575002 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 3 | 3 | 3 | 3 | $1,010.00 | YES | CPF | N | ||||
| 3202272 | 562290370 | 9817107 | 1942849369 | BAPTIST OUTPATIENT SERVICES INC | 6855 S RED RD 200 | MIAMI | FL | 33143 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 4 | 4 | 4 | 4 | $1,947.00 | YES | CPF | N | ||||
| 3202272 | 461554217 | 1714038 | FMC CORAL GABLES | 238 PALERMO AVE | CORAL GABLES | FL | 33134 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 7 | 65 | 304 | $163,228.80 | YES | CPF | N | |||||
| 3202272 | 010790511 | 7678739 | 1003482506 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $472.00 | YES | CPF | N | ||||
| 3202272 | 621695507 | 3220313 | 1003863580 | APLLC | 1010 AIRPARK CENTER DR | NASHVILLE | TN | 37217 | TX833 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $204.00 | YES | CPF | N | ||||
| 3202272 | 133757370 | 4017812 | 1295726032 | LABCORP HOLDINGS | 133 E DAVIS ST | GLEN RAVEN | NC | 27215 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 3 | $372.77 | YES | CPF | N | ||||
| 3202272 | 010790511 | 7678739 | 1528578861 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 8 | 8 | 8 | 8 | $3,708.00 | YES | CPF | N | ||||
| 3202272 | 752829740 | 1012221 | 1982677191 | SHEPHERD EYE SURGICENTER | 3575 PECOS MCLEOD | LAS VEGAS | NV | 89121 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $1,568.37 | YES | CPF | N | ||||
| 3202272 | 472408339 | 8070969 | 1992789721 | CARESOURCE GEORGIA | PO BOX 678515 | DALLAS | TX | 75267 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | NPI | N | ||
| 3202272 | 465056917 | 8426965 | 1902372816 | GUIDEWELL EMERGENCY MEDICINE DOCTORS | 113 N ORLANDO AVE | WINTER PARK | FL | 32789 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 4 | $1,386.20 | Hospital Based Providers | Emergency | YES | Hospital-Based | N | ||
| 3202272 | 743238060 | 6868385 | 1346479169 | MYRIAD WOMENS HEALTH | PO BOX 645693 | CINCINNATI | OH | 45264 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 3 | 2 | 2 | $1,601.88 | YES | CPF | N | ||||
| 3202272 | 591006663 | 0631743 | 1710470695 | BOCA RATON REGIONAL HOSPITAL | 800 MEADOWS RD | BOCA RATON | FL | 33486 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 3 | 2 | 0 | $0.00 | YES | CPF | N | ||||
| 3202272 | 621827649 | 5946183 | SURGERY CENTER OF CORAL GABLES LLC | 1097 S LE JEUNE RD FL 2 | CORAL GABLES | FL | 33134 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 2 | $2,000.00 | YES | CPF | N | |||||
| 3202272 | 581954432 | 0616875 | NORTHSIDE HOSPITAL CHEROKEE | 450 NORTHSIDE CHEROKEE BLVD | CANTON | GA | 30115 | GA811 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 473727159 | 5919569 | 1912521568 | HELIX OPCO LLC | 3162 MOMENTUM PL | CHICAGO | IL | 60689 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 1 | $25.00 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 592753716 | 0300102 | AMBULATORY SURGICAL FACILITY | 501 N FLAMINGO RD | PEMBROKE PINES | FL | 33028 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $3,782.00 | YES | CPF | N | |||||
| 3202272 | 590624449 | 0633654 | ASCENSION ST VINCENTS RIVERSIDE | 14841 SW 42ND TER | MIAMI | FL | 33185 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 4 | 37 | $32,412.15 | YES | CPF | N | |||||
| 3202272 | 611103898 | 3230860 | 1780667923 | HUMANA MEDICAID RECOVERY | PO BOX 934604 | ATLANTA | GA | 31193 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 2 | 1 | $2,610.00 | Non-Par | Non-Par | YES | NPI | N | ||
| 3202272 | 953372911 | 9531620 | KENDALL KIDNEY CENTER | 8364 MILLS DR 1740 | MIAMI | FL | 33183 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 13 | 61 | 112 | $388,071.65 | YES | CPF | N | |||||
| 3202272 | 203264203 | 9929542 | 1033235155 | CAMPBELL URGENT CARE | 1855 NE 8TH ST | HOMESTEAD | FL | 33033 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 2 | $370.00 | YES | CPF | N | ||||
| 3202272 | 201041151 | 3222578 | 1700066586 | RITECARE MEDICAL CENTER | 55 PACIFIC AVE | SAN FRANCISCO | CA | 94111 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $-130.00 | YES | NAME+STATE | N | ||||
| 3202272 | 845172222 | 2429851 | 1346769593 | GLOBAL DIAGNOSTIC LABS LLC | 4960 PEACHTREE IND BLVD 220 | BERKELEY LAKE | GA | 30071 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 5 | $523.44 | Non-Par | Non-Par | Non-Par | No Disruption from incumbent | N | ||
| 3202272 | 840611484 | 6117165 | 1962489237 | LABORATORY CORPORATION OF AMERICA | 3162 MOMENTUM PLACE | CHICAGO | IL | 60689 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 5 | 5 | 5 | 7 | $721.35 | YES | CPF | N | ||||
| 3202272 | 650825319 | 7480037 | 1376589002 | ER STAT INC | 5000 UNIVERSITY DR | MIAMI | FL | 33146 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $930.00 | Non-Par | Non-Par | YES | Hospital-Based | N | ||
| 3202272 | 262556798 | 2184099 | 1164187977 | BEEPERMD URGENT CARE | 10970 CROSS CREEK BLVD | TAMPA | FL | 33647 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 1 | 3 | $1,515.00 | YES | CPF | N | ||||
| 3202272 | 846002707 | 0975828 | MONTROSE MEMORIAL HOSPITAL | 800 S 3RD ST | MONTROSE | CO | 81401 | CO807 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 2 | 2 | -10 | $-1,403.00 | YES | CPF | N | |||||
| 3202272 | 582095884 | 0617358 | WELLSTAR PAULDING HOSPITAL | 2518 JIMMY LEE SMITH PKWY | HIRAM | GA | 30141 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 2 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 521245746 | 0564774 | RIVERSIDE REGIONAL MEDICAL CENTER | 500 J CLYDE MORRIS BLVD | NEWPORT NEWS | VA | 23601 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 8 | 8 | 19 | $5,149.01 | YES | CPF | N | |||||
| 3202272 | 161469571 | 0463260 | UNIVERSITY HOSPITAL SUNY HEALTH SCIENCE CENTER | 750 E ADAMS ST | SYRACUSE | NY | 13210 | FL851 | NONPAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 0 | $0.00 | Non-Par | Non-Par | YES | CPF | N | |||
| 3202272 | 331216751 | 0617001 | PIEDMONT COLUMBUS REGIONAL NORTHSIDE | 100 FRIST CT | COLUMBUS | GA | 31909 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 2 | 2 | 2 | 3 | $775.42 | YES | CPF | N | |||||
| 3202272 | 010790511 | 7678739 | 1386969145 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 11 | 15 | 11 | 12 | $5,083.64 | YES | CPF | N | ||||
| 3202272 | 581954432 | 5095403 | NORTHSIDE HOSPITAL FORSYTH | 1200 NORTHSIDE FORSYTH DR | CUMMING | GA | 30041 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 2 | 3 | 2 | 0 | $0.00 | YES | CPF | N | |||||
| 3202272 | 452948358 | 8133999 | 1538679535 | URGENT CARE OF THE PALM BEACHES | 5818 S DIXIE HWY | WEST PALM BEACH | FL | 33405 | FL851 | PAR | DPP4 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $680.00 | YES | CPF | N | ||||
| 3202272 | 010790511 | 7678739 | 1518596964 | MD NOW | 7007 W BROWARD BLVD UNIT 5 | PLANTATION | FL | 33317 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 11 | 12 | 12 | 12 | $4,685.79 | YES | CPF | N | ||||
| 3202272 | 741152597 | 0919275 | MEMORIAL HERMANN HOSPITAL | 1300 BAY AREA BLVD B145 | HOUSTON | TX | 77058 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 11 | $11,196.75 | YES | CPF | N | |||||
| 3202272 | 934104475 | 1624255 | 1629841788 | NC HEALTH CARE SERVICES | 160 HENDERSONVILLE RD | ASHEVILLE | NC | 28803 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 1 | 1 | 1 | $300.00 | YES | CPF | N | ||||
| 3202272 | 650933685 | 7343261 | SURGERY CENTER OF WESTON | 2300 N COMMERCE PKWY 206 | WESTON | FL | 33326 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS IN-NETWORK | 1 | 4 | 4 | 10 | $22,900.00 | YES | CPF | N | |||||
| 3202272 | 590747311 | 0633465 | BAPTIST MEDICAL CENTER | 461 OUTLET MALL BLVD | SAINT AUGUSTINE | FL | 32084 | OA001 | PAR | OAP1 | OTHER | FACILITY OUTPATIENT | CLAIMS PAID AS OUT-OF-NETWORK | 1 | 1 | 1 | 0 | $0.00 | YES | CPF | N |
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File details come from the government source that posted it. Updated .