Table calendar_year_2021_cohs_rates

Table: calendar_year_2021_cohs_rates

rating_period calendar_year model county health_plan category_of_aid lower_bound midpoint upper_bound

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Del Norte Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Del Norte Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Del Norte Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Del Norte Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Del Norte Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Del Norte Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Humboldt Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Humboldt Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Humboldt Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Humboldt Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Humboldt Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Humboldt Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Lake Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Lake Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Lake Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Lake Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Lake Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Lake Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Lake Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Lake Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Lake Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Lake Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Lake Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Lake Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Lake Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Lassen Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Lassen Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Lassen Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Lassen Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Lassen Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Lassen Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Lassen Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Lassen Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Lassen Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Lassen Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Lassen Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Lassen Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Lassen Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Marin Partnership Health Plan Adult Expansion 459.61 471.73 484.32

1/21-12/21 2021 COHS Marin Partnership Health Plan Adult 350.69 360.37 370.45

1/21-12/21 2021 COHS Marin Partnership Health Plan Child 96.56 100.05 103.7

1/21-12/21 2021 COHS Marin Partnership Health Plan LTC 8846.39 8960.19 9076.92

1/21-12/21 2021 COHS Marin Partnership Health Plan LTC Dual 7320.52 7403.44 7488.28

1/21-12/21 2021 COHS Marin Partnership Health Plan Maternity 11230.67 11547.95 11875.83

1/21-12/21 2021 COHS Marin Partnership Health Plan SPD 1280.06 1309.82 1340.64

1/21-12/21 2021 COHS Marin Partnership Health Plan SPD Dual 310.56 317.2 324.09

1/21-12/21 2021 COHS Marin Partnership Health Plan WCM 2281.81 2340.75 2401.85

1/21-12/21 2021 COHS Marin Partnership Health Plan Behavioral Health Treatment 0-6 3122.8 3203.14 3286.03

1/21-12/21 2021 COHS Marin Partnership Health Plan Behavioral Health Treatment 7-20 2203.8 2260.5 2319

1/21-12/21 2021 COHS Marin Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Marin Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Mendocino Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Mendocino Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Mendocino Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Mendocino Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Mendocino Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Mendocino Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Adult Expansion 365.16 374.7 384.62

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Adult 369.4 379.5 390

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Child 77.17 79.96 82.88

1/21-12/21 2021 COHS Merced Central CA Alliance for Health LTC 10849.37 10993.42 11141.3

1/21-12/21 2021 COHS Merced Central CA Alliance for Health LTC Dual 6878.26 6957.06 7037.71

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Maternity 9043.76 9301.5 9567.97

1/21-12/21 2021 COHS Merced Central CA Alliance for Health SPD 1209.77 1238.25 1267.77

1/21-12/21 2021 COHS Merced Central CA Alliance for Health SPD Dual 237.94 243.7 249.69

1/21-12/21 2021 COHS Merced Central CA Alliance for Health WCM 1687.38 1726.57 1767.15

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Behavioral Health Treatment 0-6 3101.7 3182.27 3265.41

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Behavioral Health Treatment 7-20 2470.32 2534.48 2600.7

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Merced Central CA Alliance for Health Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Modoc Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Modoc Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Modoc Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Modoc Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Modoc Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Modoc Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Modoc Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Modoc Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Modoc Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Modoc Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Modoc Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Modoc Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Modoc Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Adult Expansion 421.91 432.73 443.97

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Adult 345.06 354.39 364.09

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Child 82.53 85.46 88.52

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health LTC 11969.84 12126.83 12287.94

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health LTC Dual 8479.38 8575.18 8673.19

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Maternity 9835.33 10115.6 10405.37

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health SPD 1239.52 1267.54 1296.59

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health SPD Dual 248.68 254.34 260.21

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health WCM 2004.66 2053.38 2103.83

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Behavioral Health Treatment 0-6 3817.42 3916.57 4018.9

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Behavioral Health Treatment 7-20 2256.09 2314.68 2375.16

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Monterey Central CA Alliance for Health Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Napa Partnership Health Plan Adult Expansion 459.61 471.73 484.32

1/21-12/21 2021 COHS Napa Partnership Health Plan Adult 350.69 360.37 370.45

1/21-12/21 2021 COHS Napa Partnership Health Plan Child 96.56 100.05 103.7

1/21-12/21 2021 COHS Napa Partnership Health Plan LTC 8846.39 8960.19 9076.92

1/21-12/21 2021 COHS Napa Partnership Health Plan LTC Dual 7320.52 7403.44 7488.28

1/21-12/21 2021 COHS Napa Partnership Health Plan Maternity 11230.67 11547.95 11875.83

1/21-12/21 2021 COHS Napa Partnership Health Plan OBRA 392.08 403.06 414.47

1/21-12/21 2021 COHS Napa Partnership Health Plan SPD 1280.06 1309.82 1340.64

1/21-12/21 2021 COHS Napa Partnership Health Plan SPD Dual 310.56 317.2 324.09

1/21-12/21 2021 COHS Napa Partnership Health Plan WCM 2281.81 2340.75 2401.85

1/21-12/21 2021 COHS Napa Partnership Health Plan Behavioral Health Treatment 0-6 3122.8 3203.14 3286.03

1/21-12/21 2021 COHS Napa Partnership Health Plan Behavioral Health Treatment 7-20 2203.8 2260.5 2319

1/21-12/21 2021 COHS Napa Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Napa Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Orange CalOptima Adult Expansion 413.87 423.41 433.32

1/21-12/21 2021 COHS Orange CalOptima Adult 276.61 283.17 289.99

1/21-12/21 2021 COHS Orange CalOptima Behavioral Health Treatment 0-6 2276.53 2335.04 2395.41

1/21-12/21 2021 COHS Orange CalOptima Behavioral Health Treatment 7-20 1699.87 1743.56 1788.64

1/21-12/21 2021 COHS Orange CalOptima Child 87.45 90.34 93.36

1/21-12/21 2021 COHS Orange CalOptima Health Homes Dual 134.7 141.33 148.66

1/21-12/21 2021 COHS Orange CalOptima Health Homes Non-Dual 550.8 583.66 616.32

1/21-12/21 2021 COHS Orange CalOptima Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Orange CalOptima Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Orange CalOptima LTC 12611.54 12772.22 12937.05

1/21-12/21 2021 COHS Orange CalOptima LTC Dual 7859.49 7947.18 8036.87

1/21-12/21 2021 COHS Orange CalOptima Maternity 6345.86 6524.99 6710.1

1/21-12/21 2021 COHS Orange CalOptima SPD 829.06 846.09 863.73

1/21-12/21 2021 COHS Orange CalOptima SPD Dual 211.97 216.86 221.94

1/21-12/21 2021 COHS Orange CalOptima WCM 1983.35 2026.08 2070.33

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Adult Expansion 379.6 388.27 397.28

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Adult 307.88 315.13 322.66

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Behavioral Health Treatment 0-6 2834.83 2908.15 2983.81

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Behavioral Health Treatment 7-20 1918.44 1968.06 2019.26

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Child 83.27 86.02 88.89

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS San Luis Obispo CenCal Health LTC 8151.24 8259.03 8369.67

1/21-12/21 2021 COHS San Luis Obispo CenCal Health LTC Dual 6733.32 6809.77 6887.99

1/21-12/21 2021 COHS San Luis Obispo CenCal Health Maternity 6468.24 6651.91 6841.77

1/21-12/21 2021 COHS San Luis Obispo CenCal Health SPD 954.64 972.96 991.95

1/21-12/21 2021 COHS San Luis Obispo CenCal Health SPD Dual 236.51 241.89 247.47

1/21-12/21 2021 COHS San Luis Obispo CenCal Health WCM 1970.19 2010.34 2051.83

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Behavioral Health Treatment 0-6 2717.4 2787.8 2860.44

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Behavioral Health Treatment 7-20 2024.63 2077.08 2131.2

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Adult Expansion 392.3 401.08 410.21

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Adult 320.8 328.77 337.08

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Child 89.12 92.21 95.45

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo LTC 16244.82 16444.89 16649.98

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo LTC Dual 9376.13 9480.14 9586.5

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo Maternity 9680.41 9955.63 10240.13

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo SPD 1027.57 1049.09 1071.4

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo SPD Dual 311.4 317.88 324.61

1/21-12/21 2021 COHS San Mateo Health Plan of San Mateo WCM 2063.99 2106.05 2149.52

1/21-12/21 2021 COHS Santa Barbara CenCal Health Adult Expansion 403.61 413.09 422.94

1/21-12/21 2021 COHS Santa Barbara CenCal Health Adult 336.3 344.87 353.78

1/21-12/21 2021 COHS Santa Barbara CenCal Health Behavioral Health Treatment 0-6 2261.42 2319.9 2380.26

1/21-12/21 2021 COHS Santa Barbara CenCal Health Behavioral Health Treatment 7-20 1766.23 1811.91 1859.05

1/21-12/21 2021 COHS Santa Barbara CenCal Health Child 90.81 93.85 97.04

1/21-12/21 2021 COHS Santa Barbara CenCal Health Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Santa Barbara CenCal Health Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Santa Barbara CenCal Health LTC 11431.32 11568.05 11708.15

1/21-12/21 2021 COHS Santa Barbara CenCal Health LTC Dual 8548.07 8643.58 8741.26

1/21-12/21 2021 COHS Santa Barbara CenCal Health Maternity 7128.2 7330.61 7539.83

1/21-12/21 2021 COHS Santa Barbara CenCal Health SPD 1102.53 1124.7 1147.67

1/21-12/21 2021 COHS Santa Barbara CenCal Health SPD Dual 245.94 251.47 257.21

1/21-12/21 2021 COHS Santa Barbara CenCal Health WCM 2141.47 2186.66 2233.38

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Adult Expansion 427.8 438.74 450.11

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Adult 393.29 403.62 414.36

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Child 88.87 92.11 95.52

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health LTC 8472.13 8584.45 8699.76

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health LTC Dual 7517.36 7602.99 7690.63

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Maternity 8868.41 9121.16 9382.47

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health SPD 1388.17 1419.72 1452.42

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health SPD Dual 262.05 268.2 274.6

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health WCM 1965.44 2009.6 2055.32

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Behavioral Health Treatment 0-6 3119.95 3200.99 3284.62

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Behavioral Health Treatment 7-20 2214.86 2272.39 2331.76

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Santa Cruz Central CA Alliance for Health Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Shasta Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Shasta Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Shasta Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Shasta Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Shasta Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Shasta Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Shasta Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Shasta Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Shasta Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Shasta Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Shasta Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Shasta Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Shasta Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Siskiyou Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Solano Partnership Health Plan Adult Expansion 459.61 471.73 484.32

1/21-12/21 2021 COHS Solano Partnership Health Plan Adult 350.69 360.37 370.45

1/21-12/21 2021 COHS Solano Partnership Health Plan Child 96.56 100.05 103.7

1/21-12/21 2021 COHS Solano Partnership Health Plan LTC 8846.39 8960.19 9076.92

1/21-12/21 2021 COHS Solano Partnership Health Plan LTC Dual 7320.52 7403.44 7488.28

1/21-12/21 2021 COHS Solano Partnership Health Plan Maternity 11230.67 11547.95 11875.83

1/21-12/21 2021 COHS Solano Partnership Health Plan OBRA 392.08 403.06 414.47

1/21-12/21 2021 COHS Solano Partnership Health Plan SPD 1280.06 1309.82 1340.64

1/21-12/21 2021 COHS Solano Partnership Health Plan SPD Dual 310.56 317.2 324.09

1/21-12/21 2021 COHS Solano Partnership Health Plan WCM 2281.81 2340.75 2401.85

1/21-12/21 2021 COHS Solano Partnership Health Plan Behavioral Health Treatment 0-6 3122.8 3203.14 3286.03

1/21-12/21 2021 COHS Solano Partnership Health Plan Behavioral Health Treatment 7-20 2203.8 2260.5 2319

1/21-12/21 2021 COHS Solano Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Solano Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Sonoma Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Sonoma Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Sonoma Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Sonoma Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Sonoma Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Sonoma Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Trinity Partnership Health Plan Adult Expansion 448.05 459.91 472.23

1/21-12/21 2021 COHS Trinity Partnership Health Plan Adult 362.55 372.56 382.96

1/21-12/21 2021 COHS Trinity Partnership Health Plan Child 86.56 89.76 93.11

1/21-12/21 2021 COHS Trinity Partnership Health Plan LTC 10007.06 10135.2 10266.62

1/21-12/21 2021 COHS Trinity Partnership Health Plan LTC Dual 7663.16 7748.84 7836.47

1/21-12/21 2021 COHS Trinity Partnership Health Plan Maternity 11749.55 12081.47 12424.49

1/21-12/21 2021 COHS Trinity Partnership Health Plan SPD 1238.1 1266.89 1296.71

1/21-12/21 2021 COHS Trinity Partnership Health Plan SPD Dual 277.98 284.47 291.2

1/21-12/21 2021 COHS Trinity Partnership Health Plan WCM 2219.1 2272.03 2326.86

1/21-12/21 2021 COHS Trinity Partnership Health Plan Behavioral Health Treatment 0-6 2622.72 2690.2 2759.81

1/21-12/21 2021 COHS Trinity Partnership Health Plan Behavioral Health Treatment 7-20 2333.11 2393.14 2455.06

1/21-12/21 2021 COHS Trinity Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Trinity Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Ventura Gold Coast Behavioral Health Treatment 0-6 2509.11 2574.3 2641.59

1/21-12/21 2021 COHS Ventura Gold Coast Behavioral Health Treatment 7-20 1816.98 1864.2 1912.92

1/21-12/21 2021 COHS Ventura Gold Coast Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Ventura Gold Coast Hep C Non-340B 2184.11 2184.11 2285.16

1/21-12/21 2021 COHS Ventura Gold Coast Adult Expansion 446.48 457.03 467.99

1/21-12/21 2021 COHS Ventura Gold Coast Adult 360.77 369.55 378.68

1/21-12/21 2021 COHS Ventura Gold Coast Child 90.18 93.28 96.52

1/21-12/21 2021 COHS Ventura Gold Coast LTC 13001.3 13166.61 13336.18

1/21-12/21 2021 COHS Ventura Gold Coast LTC Dual 9377.25 9481.06 9587.23

1/21-12/21 2021 COHS Ventura Gold Coast Maternity 7516.68 7730.96 7952.51

1/21-12/21 2021 COHS Ventura Gold Coast SPD 1296.53 1324.06 1352.59

1/21-12/21 2021 COHS Ventura Gold Coast SPD Dual 266.38 272.69 279.25

1/21-12/21 2021 COHS Yolo Partnership Health Plan Adult Expansion 459.61 471.73 484.32

1/21-12/21 2021 COHS Yolo Partnership Health Plan Adult 350.69 360.37 370.45

1/21-12/21 2021 COHS Yolo Partnership Health Plan Child 96.56 100.05 103.7

1/21-12/21 2021 COHS Yolo Partnership Health Plan LTC 8846.39 8960.19 9076.92

1/21-12/21 2021 COHS Yolo Partnership Health Plan LTC Dual 7320.52 7403.44 7488.28

1/21-12/21 2021 COHS Yolo Partnership Health Plan Maternity 11230.67 11547.95 11875.83

1/21-12/21 2021 COHS Yolo Partnership Health Plan OBRA 392.08 403.06 414.47

1/21-12/21 2021 COHS Yolo Partnership Health Plan SPD 1280.06 1309.82 1340.64

1/21-12/21 2021 COHS Yolo Partnership Health Plan SPD Dual 310.56 317.2 324.09

1/21-12/21 2021 COHS Yolo Partnership Health Plan WCM 2281.81 2340.75 2401.85

1/21-12/21 2021 COHS Yolo Partnership Health Plan Behavioral Health Treatment 0-6 3122.8 3203.14 3286.03

1/21-12/21 2021 COHS Yolo Partnership Health Plan Behavioral Health Treatment 7-20 2203.8 2260.5 2319

1/21-12/21 2021 COHS Yolo Partnership Health Plan Hep C 340B 1722.85 1722.85 1759.31

1/21-12/21 2021 COHS Yolo Partnership Health Plan Hep C Non-340B 2184.11 2184.11 2285.16