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FQHC RHC CURRENT RATES (WEB 12-19-18).Xlsx Prvdr Current Rev Rate Revenue Provider Owner Service Current Revenue Special Zip Type County Provider Legal Name Rate Begin Procedure Status Physical Street Address City Type Number Num Location Rate Code Processing State Code Code Code Date Code Code Type Code 1396067500 AAA COMPREHENSIVE HEALTHCARE 01 001 10/1/2018 $158.18 0521 T1015 1 F 7451 N LANKERSHIM BLVD NORTH HOLLYWOOD CA 91605 FQ 035 19 1215383047 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 900 KING STREET ARBUCKLE CA 95912 RH 035 06 1316937121 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $201.19 0521 T1015 1 U 15230 LAKESHORE DR CLEARLAKE CA 95422 RH 035 17 1508212424 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 151 E WEBSTER COLUSA CA 95932 RH 035 06 1558737486 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $ 81.32 0521 T1015 1 U 18990 COYOTE VALLEY RD HIDDEN VALLEY CA 95467 RH 035 17 1609222512 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 501 E STREET WILLIAMS CA 95987 RH 035 06 1841626587 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $ 81.32 0521 T1015 1 U 9430 LAKE STREET LOWER LAKE CA 95457 RH 035 17 1962492876 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $150.94 0521 T1015 1 U 5290 STATE ST KELSEYVILLE CA 95451 RH 035 17 1972593788 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $146.41 0521 T1015 1 U 21337 BUSH ST MIDDLETOWN CA 95461 RH 035 17 1275841629 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $278.89 0521 T1015 1 U 105 WEST E STREET TEHACHAPI CA 93561 RH 035 15 1508175431 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $237.83 0521 T1015 1 U 2041 BELSHAW STREET MOJAVE CA 93501 RH 035 15 1699084525 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $237.83 0521 T1015 1 U 9350 NORTH LOOP BLVD CALIFORNIA CITY CA 93505 RH 035 15 1922490960 AGHABY COMPREHENSIVE 01 001 10/1/2018 $180.80 0521 T1015 1 F 349 W COMPTON BLVD COMPTON CA 90220 FQ 035 19 1881632867 ALAMEDA COUNTY HEALTH 01 001 10/1/2018 $229.01 0521 T1015 1 F 1900 FRUITVALE AVE OAKLAND CA 94601 FQ 035 01 1104959089 ALAMEDA COUNTY MED CTR 01 001 10/1/2018 $311.98 0521 T1015 1 F 6955 FOOTHILL BLVD OAKLAND CA 94605 FQ 035 01 1922131804 ALAMEDA COUNTY MED CTR 01 001 10/1/2018 $289.79 0521 T1015 1 F 6066 CIVIC TERRACE AVE NEWARK CA 94560 FQ 035 01 1548551997 ALAMEDA COUNTY MEDICAL 01 001 10/1/2018 $205.69 0521 T1015 1 F 1411 E 31ST STREET OAKLAND CA 94602 FQ 035 01 1033241633 ALAMEDA HEALTH SYSTEM 01 001 10/1/2018 $257.34 0521 T1015 1 F 664 SOUTHLAND MALL HAYWARD CA 94545 FQ 035 01 1306128822 ALL FOR HEALTH HEALTH 01 001 10/1/2018 $182.55 0521 T1015 1 F 437 S PACIFIC AVE GLENDALE CA 91204 FQ 035 19 1457633364 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $142.65 0521 T1015 1 F 520 EAST BROADWAY BLVD GLENDALE CA 91205 FQ 035 19 1568567220 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $119.91 0521 T1015 1 F 519 E BROADWAY GLENDALE CA 91205 FQ 035 19 1700131679 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $182.55 0521 T1015 1 F 401 S GLENOAKS BLVD BURBANK CA 91502 FQ 035 19 1073907689 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 800 S CENTRAL AVE GLENDALE CA 91204 FQ 035 19 1518398031 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 1030 SOUTH GLENDALE AVE GLENDALE CA 91205 FQ 035 19 1710318878 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 8134 FOOTHILL BLVD SUNLAND CA 91040 FQ 035 19 1467971747 ALL FOR HEALTH, HEALTH FOR 01 001 5/1/2018 $166.60 0521 T1015 1 F 710 S CENTRAL AVE GLENDALE CA 91204 FQ 035 19 1760900922 ALL FOR HEALTH, HEALTH FOR 01 001 5/12/2018 $166.60 0521 T1015 1 F 2048 MONTROSE AVE MONTROSE CA 91020 FQ 035 19 1831617018 ALL FOR HEALTH, HEALTH FOR 01 001 5/12/2018 $166.60 0521 T1015 1 F 115 GIBSON ROAD TEMPLETON CA 93465 FQ 035 40 1902263015 ALL FOR HEALTH, HEALTH FOR 01 001 10/1/2018 $175.65 0521 T1015 1 F 5855 CAPISTRANO AVE ATASCADERO CA 93422 FQ 035 40 1710218409 ALLIANCE MEDICAL CENTER 01 001 10/1/2018 $186.64 0521 T1015 1 F 8465 OLD REDWOOD HWY WINDSOR CA 95492 FQ 035 49 1750399796 ALLIANCE MEDICAL CENTER 01 001 10/1/2018 $202.12 0521 T1015 1 F 1381 UNIVERSITY ST HEALDSBURG CA 95448 FQ 035 49 1518418862 ALLIANCE MEDICAL CENTER INC 01 001 10/1/2017 $196.97 0521 T1015 1 F 8499 OLD REDWOOD HIGHWAY WINDSOR CA 95492 FQ 035 49 1174996177 ALL-INCLUSIVE COMMUNITY 01 001 10/1/2018 $195.60 0521 T1015 1 F 3920 EAGLE ROCK BLVD LOS ANGELES CA 90065 FQ 035 19 1093019051 ALL INCLUSIVE COMMUNITY HLTH 01 001 10/1/2018 $147.91 0521 T1015 1 F 1311 N SAN FERNANDO BLVD BURBANK CA 91504 FQ 035 19 1528108610 ALTA FAMILY HEALTH CLIN 01 001 10/1/2018 $161.71 0521 T1015 1 F 888 N ALTA AVE DINUBA CA 93618 FQ 035 54 1982814745 ALTAMED COMM HEALTH CLIN 01 001 10/1/2018 $221.84 0521 T1015 1 F 10418 VALLEY BLVD EL MONTE CA 91731 FQ 035 19 1982814745 ALTAMED COMM HEALTH CLIN 01 002 10/1/2017 $177.95 0521 T1015 1 F 910 S SUNSET AVE WEST COVINA CA 91790 FQ 035 19 1346450103 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $157.87 0521 T1015 1 F 1701 ZONAL AVE LOS ANGELES CA 90033 FQ 035 19 1366834400 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $248.35 0521 T1015 1 F 1155 W CENTRAL AVE SANTA ANA CA 92707 FQ 035 30 1629283197 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $454.36 0521 T1015 1 F 4650 SUNSET BLVD LOS ANGELES CA 90027 FQ 035 19 1629283197 ALTAMED HEALTH SERVICES 01 002 10/1/2017 $431.03 0521 T1015 1 F 2100 W 3RD STREET LOS ANGELES CA 90057 FQ 035 19 1710191283 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $250.90 0521 T1015 1 F 9436 SLAUSON AVE PICO RIVERA CA 90660 FQ 035 19 1730481318 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $248.34 0521 T1015 1 F 1300 S SUNSET AVE WEST COVINA CA 91790 FQ 035 19 1760651814 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $243.89 0521 T1015 1 F 2720 S BRISTOL STREET SANTA ANA CA 92704 FQ 035 30 1760651814 ALTAMED HEALTH SERVICES 01 002 10/1/2017 $228.15 0521 T1015 1 F 1515 S BROADWAY SANTA ANA CA 92707 FQ 035 30 1770006728 ALTAMED HEALTH SERVICES 01 001 4/16/2018 $216.51 0521 T1015 1 F 972 GOODRICH BLVD COMMERCE CA 90022 FQ 035 19 1790177582 ALTAMED HEALTH SERVICES 01 001 10/1/2017 $224.02 0521 T1015 1 F 1900 E SLAUSON AVE HUNTINGTON PARK CA 90255 FQ 035 19 1902267479 ALTAMED HEALTH SERVICES 01 002 4/26/2018 $236.42 0521 T1015 1 F 8627 ATLANTIC AVENUE SOUTH GATE CA 90280 FQ 035 19 1902267479 ALTAMED HEALTH SERVICES 01 001 10/15/2017 $236.42 0521 T1015 1 F 8627 ATLANTIC AVENUE SOUTH GATE CA 90280 FQ 035 19 1063659985 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $241.75 0521 T1015 1 F 1814 W LINCOLN AVE ANAHEIM CA 92801 FQ 035 30 1083851992 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 12751 HARBOR BLVD GARDEN GROVE CA 92840 FQ 035 30 1134492937 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $228.39 0521 T1015 1 F 2219 E 1ST STREET LOS ANGELES CA 90033 FQ 035 19 1235376047 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 1820 W LINCOLN AVENUE ANAHEIM CA 92801 FQ 035 30 1306015425 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $230.45 0521 T1015 1 F 8041 NEWMAN AVE HUNTINGTON BEACH CA 92647 FQ 035 30 1316116221 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $223.03 0521 T1015 1 F 4010 E CHAPMAN AVE ORANGE CA 92869 FQ 035 30 1356775878 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $245.51 0521 T1015 1 F 6336 PASSONS BLVD PICO RIVERA CA 90660 FQ 035 19 1437414190 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $249.85 0521 T1015 1 F 1300 N VERMONT AVE LOS ANGELES CA 90027 FQ 035 19 1538303516 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $164.43 0521 T1015 1 F 1814 W LINCOLN AVE ANAHEIM CA 92801 FQ 035 30 1740427657 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 1400 N MAIN ST SANTA ANA CA 92701 FQ 035 30 1740427657 ALTAMED HEALTH SERVICES CORP 01 002 4/26/2018 $240.52 0521 T1015 1 F 1400 N MAIN STREET SANTA ANA CA 92701 FQ 035 30 1255542601 ALTAMED MEDICAL & DENTAL 01 001 10/1/2018 $228.97 0521 T1015 1 F 3945 WHITTIER BLVD LOS ANGELES CA 90023 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 002 10/1/2017 $214.20 0521 T1015 1 F 268 E BLOOM STREET LOS ANGELES CA 90012 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 003 10/1/2017 $214.20 0521 T1015 1 F 1305 S CONCORD STREET LOS ANGELES CA 90023 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 005 10/1/2017 $214.20 0521 T1015 1 F 1424 CRUSADO LANE LOS ANGELES CA 90033 FQ 035 19 1083800098 ALTAMED MEDICAL GROUP 01 001 10/1/2018 $215.60 0521 T1015 1 F 5425 POMONA BLVD LOS ANGELES CA 90022 FQ 035 19 1396959060 ALTAMED MEDICAL GROUP- 01 001 10/1/2018 $250.27 0521 T1015 1 F 5427 WHITTIER BLVD LOS ANGELES CA 90022 FQ 035 19 1023011632 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $135.67 0521 T1015 1 F 1101 N CHERRY ST TULARE CA 93274 FQ 035 54 1346486511 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $144.86 0521 T1015 1 F 737 W BARDSLEY AVE TULARE CA 93274 FQ 035 54 1568827210 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $165.20 0521 T1015 1 F 1500 W TULARE DRIVE TULARE CA 93274 FQ 035 54 1689011637 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $149.81 0521 T1015 1 F 3035 E BARDSLEY AVE TULARE CA 93274 FQ 035 54 1790105559 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $159.01 0521 T1015 1 F 600 N CHERRY ST TULARE CA 93274 FQ 035 54 Prvdr Current Rev Rate Revenue Provider Owner Service Revenue Special Type County Provider Legal Name Rate Begin Current Procedure Status Physical Street Address City Zip Type Number Num Location Rate Code Processing State Code Code Code Date Code Code Type Code 1811174725 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $124.20 0521 T1015 1 F 1186 LELAND AVE TULARE CA 93274 FQ 035 54 1932529831 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $161.37 0521 T1015 1 F 16686 ROAD 168 WOODVILLE CA 93257 FQ 035 54 1942506605
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