| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Adult |
$300.08 |
$308.68 |
$317.60 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
BCCTP |
$1,227.36 |
$1,262.33 |
$1,298.60 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Behavioral Health Treatment 0-6 |
$2,772.83 |
$2,843.59 |
$2,916.80 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Behavioral Health Treatment 7-20 |
$2,077.02 |
$2,130.04 |
$2,184.89 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Child |
$86.06 |
$88.59 |
$91.21 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
LTC |
$10,542.42 |
$10,733.55 |
$10,931.02 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
LTC Full-Dual |
$6,073.27 |
$6,171.70 |
$6,273.28 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
Optional Expansion |
$442.82 |
$457.65 |
$473.18 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
SPD |
$743.19 |
$764.12 |
$785.81 |
| 07/18-06/19 |
2018-19 |
COHS |
Orange |
Cal Optima |
SPD/Full-Dual |
$219.85 |
$224.91 |
$230.15 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Adult |
$292.37 |
$300.73 |
$309.40 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Adult |
$325.25 |
$334.57 |
$344.23 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
BCCTP |
$1,136.61 |
$1,168.95 |
$1,202.50 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
BCCTP |
$1,555.70 |
$1,600.05 |
$1,646.04 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Behavioral Health Treatment 0-6 |
$2,890.47 |
$2,964.22 |
$3,040.51 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Behavioral Health Treatment 0-6 |
$2,511.79 |
$2,575.88 |
$2,642.17 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Behavioral Health Treatment 7-20 |
$1,892.77 |
$1,941.07 |
$1,991.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Behavioral Health Treatment 7-20 |
$1,975.10 |
$2,025.51 |
$2,077.66 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Child |
$78.91 |
$81.23 |
$83.64 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Child |
$86.09 |
$88.62 |
$91.25 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
LTC |
$5,840.66 |
$5,944.15 |
$6,051.06 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
LTC |
$9,896.35 |
$10,069.20 |
$10,247.75 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
LTC Full-Dual |
$5,531.03 |
$5,620.15 |
$5,712.12 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
LTC Full-Dual |
$7,207.14 |
$7,321.56 |
$7,439.62 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
Optional Expansion |
$349.56 |
$361.17 |
$373.32 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
Optional Expansion |
$397.88 |
$411.07 |
$424.87 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
SPD |
$875.20 |
$898.47 |
$922.59 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
SPD |
$951.58 |
$976.87 |
$1,003.09 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
SPD/Full-Dual |
$208.57 |
$213.29 |
$218.18 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
SPD/Full-Dual |
$250.27 |
$255.81 |
$261.54 |
| 07/18-06/19 |
2018-19 |
COHS |
San Luis Obispo |
CenCal Health |
WCM |
$1,576.57 |
$1,633.29 |
$1,692.56 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Barbara |
CenCal Health |
WCM |
$1,521.66 |
$1,574.92 |
$1,630.51 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Adult |
$330.39 |
$340.10 |
$350.19 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Adult |
$335.05 |
$344.88 |
$355.10 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Adult |
$365.85 |
$376.56 |
$387.68 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
BCCTP |
$941.66 |
$968.96 |
$997.30 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
BCCTP |
$1,364.33 |
$1,403.88 |
$1,444.92 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
BCCTP |
$1,087.70 |
$1,118.65 |
$1,150.78 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Behavioral Health Treatment 0-6 |
$3,421.26 |
$3,508.56 |
$3,598.87 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Behavioral Health Treatment 0-6 |
$3,145.60 |
$3,225.86 |
$3,308.90 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Behavioral Health Treatment 0-6 |
$3,160.51 |
$3,241.15 |
$3,324.58 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Behavioral Health Treatment 7-20 |
$2,558.24 |
$2,623.52 |
$2,691.05 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Behavioral Health Treatment 7-20 |
$2,190.99 |
$2,246.91 |
$2,304.75 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Behavioral Health Treatment 7-20 |
$2,127.85 |
$2,182.16 |
$2,238.33 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Child |
$73.61 |
$75.92 |
$78.33 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Child |
$76.36 |
$78.73 |
$81.21 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Child |
$81.18 |
$83.73 |
$86.38 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
LTC |
$9,611.34 |
$9,788.77 |
$9,972.14 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
LTC |
$10,987.02 |
$11,191.00 |
$11,401.84 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
LTC |
$8,373.21 |
$8,527.18 |
$8,686.32 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
LTC Full-Dual |
$5,654.11 |
$5,746.05 |
$5,840.95 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
LTC Full-Dual |
$7,094.42 |
$7,208.54 |
$7,326.33 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
LTC Full-Dual |
$6,093.24 |
$6,192.44 |
$6,294.82 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
Optional Expansion |
$304.04 |
$314.20 |
$324.84 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
Optional Expansion |
$346.02 |
$357.55 |
$369.62 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
Optional Expansion |
$340.89 |
$352.11 |
$363.84 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
SPD |
$1,065.87 |
$1,095.66 |
$1,126.56 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
SPD |
$1,078.76 |
$1,109.03 |
$1,140.44 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
SPD |
$1,032.64 |
$1,060.63 |
$1,089.67 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
SPD/Full-Dual |
$194.77 |
$199.43 |
$204.27 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
SPD/Full-Dual |
$212.52 |
$217.18 |
$222.02 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
SPD/Full-Dual |
$219.85 |
$224.79 |
$229.92 |
| 07/18-06/19 |
2018-19 |
COHS |
Merced |
Central California Alliance for Health |
WCM |
$1,399.98 |
$1,448.65 |
$1,499.43 |
| 07/18-06/19 |
2018-19 |
COHS |
Monterey |
Central California Alliance for Health |
WCM |
$1,635.56 |
$1,691.72 |
$1,750.31 |
| 07/18-06/19 |
2018-19 |
COHS |
Santa Cruz |
Central California Alliance for Health |
WCM |
$1,588.20 |
$1,643.47 |
$1,701.16 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Adult |
$312.97 |
$322.09 |
$331.57 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
BCCTP |
$1,319.75 |
$1,357.77 |
$1,397.23 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Behavioral Health Treatment 0-6 |
$2,671.01 |
$2,739.17 |
$2,809.68 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Behavioral Health Treatment 7-20 |
$1,944.66 |
$1,994.29 |
$2,045.63 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Child |
$80.59 |
$83.09 |
$85.69 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
LTC |
$12,817.43 |
$13,040.84 |
$13,271.60 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
LTC Full-Dual |
$7,057.73 |
$7,170.28 |
$7,286.43 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
Optional Expansion |
$373.21 |
$385.52 |
$398.40 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
SPD |
$1,052.37 |
$1,080.09 |
$1,108.83 |
| 07/18-06/19 |
2018-19 |
COHS |
Ventura |
Gold Coast |
SPD/Full-Dual |
$234.65 |
$239.72 |
$244.99 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Adult |
$326.28 |
$335.73 |
$345.53 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
BCCTP |
$1,249.36 |
$1,285.41 |
$1,322.82 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Behavioral Health Treatment 0-6 |
$3,146.34 |
$3,226.62 |
$3,309.67 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Behavioral Health Treatment 7-20 |
$2,371.47 |
$2,431.99 |
$2,494.59 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Child |
$89.54 |
$92.22 |
$95.02 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
LTC |
$12,221.36 |
$12,445.42 |
$12,676.97 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
LTC Full-Dual |
$5,840.79 |
$5,935.79 |
$6,033.84 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
OBRA |
$- |
$- |
$- |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
Optional Expansion |
$412.30 |
$426.02 |
$440.38 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
SPD |
$850.49 |
$874.72 |
$899.86 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
SPD/Full-Dual |
$222.75 |
$228.08 |
$233.60 |
| 07/18-06/19 |
2018-19 |
COHS |
San Mateo |
Health Plan of San Mateo |
WCM |
$1,654.30 |
$1,712.09 |
$1,772.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Adult |
$364.77 |
$375.62 |
$386.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Adult |
$362.09 |
$371.98 |
$382.23 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Adult |
$364.77 |
$375.62 |
$386.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Adult |
$362.09 |
$371.98 |
$382.23 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Adult |
$364.77 |
$375.62 |
$386.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Adult |
$362.09 |
$371.98 |
$382.23 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Adult |
$355.29 |
$365.40 |
$375.89 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Adult |
$364.77 |
$375.62 |
$386.89 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Adult |
$362.09 |
$371.98 |
$382.23 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
BCCTP |
$2,010.07 |
$2,069.94 |
$2,132.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
BCCTP |
$1,970.67 |
$2,024.41 |
$2,080.11 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
BCCTP |
$2,010.07 |
$2,069.94 |
$2,132.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
BCCTP |
$1,970.67 |
$2,024.41 |
$2,080.11 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
BCCTP |
$2,010.07 |
$2,069.94 |
$2,132.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
BCCTP |
$1,970.67 |
$2,024.41 |
$2,080.11 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
BCCTP |
$1,588.47 |
$1,633.75 |
$1,680.72 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
BCCTP |
$2,010.07 |
$2,069.94 |
$2,132.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
BCCTP |
$1,970.67 |
$2,024.41 |
$2,080.11 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,470.32 |
$2,533.35 |
$2,598.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Behavioral Health Treatment 0-6 |
$2,899.65 |
$2,973.64 |
$3,050.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,055.02 |
$2,107.46 |
$2,161.70 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Behavioral Health Treatment 7-20 |
$2,264.01 |
$2,321.79 |
$2,381.56 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Child |
$108.78 |
$112.10 |
$115.54 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Child |
$135.81 |
$139.61 |
$143.55 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Child |
$108.78 |
$112.10 |
$115.54 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Child |
$135.81 |
$139.61 |
$143.55 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Child |
$108.78 |
$112.10 |
$115.54 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Child |
$135.81 |
$139.61 |
$143.55 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Child |
$92.81 |
$95.51 |
$98.32 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Child |
$108.78 |
$112.10 |
$115.54 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Child |
$135.81 |
$139.61 |
$143.55 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Hepatitis C 340B |
$2,938.18 |
$3,037.18 |
$3,147.04 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Hepatitis C Non-340B |
$3,784.81 |
$3,910.44 |
$4,050.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
LTC |
$6,512.85 |
$6,631.08 |
$6,753.21 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
LTC |
$6,573.87 |
$6,696.89 |
$6,824.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
LTC |
$6,573.87 |
$6,696.89 |
$6,824.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
LTC |
$6,512.85 |
$6,631.08 |
$6,753.21 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
LTC |
$6,573.87 |
$6,696.89 |
$6,824.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
LTC |
$6,512.85 |
$6,631.08 |
$6,753.21 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
LTC |
$6,471.47 |
$6,585.01 |
$6,702.29 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
LTC |
$6,573.87 |
$6,696.89 |
$6,824.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
LTC |
$6,512.85 |
$6,631.08 |
$6,753.21 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
LTC/Full-Dual |
$5,999.22 |
$6,097.13 |
$6,198.19 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
LTC/Full-Dual |
$6,045.82 |
$6,145.37 |
$6,248.13 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
LTC/Full-Dual |
$6,045.82 |
$6,145.37 |
$6,248.13 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
LTC/Full-Dual |
$5,999.22 |
$6,097.13 |
$6,198.19 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
LTC/Full-Dual |
$6,045.82 |
$6,145.37 |
$6,248.13 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
LTC/Full-Dual |
$5,999.22 |
$6,097.13 |
$6,198.19 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
LTC/Full-Dual |
$5,721.07 |
$5,814.07 |
$5,910.06 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
LTC/Full-Dual |
$6,045.82 |
$6,145.37 |
$6,248.13 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
LTC/Full-Dual |
$5,999.22 |
$6,097.13 |
$6,198.19 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
OBRA |
$243.83 |
$250.61 |
$257.65 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
OBRA |
$247.44 |
$254.94 |
$262.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
OBRA |
$243.83 |
$250.61 |
$257.65 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
OBRA |
$247.44 |
$254.94 |
$262.73 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
OBRA |
$247.44 |
$254.94 |
$262.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
OBRA |
$243.83 |
$250.61 |
$257.65 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
OBRA |
$- |
$- |
$- |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
OBRA |
$247.44 |
$254.94 |
$262.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
OBRA |
$243.83 |
$250.61 |
$257.65 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
Optional Expansion |
$428.66 |
$442.88 |
$457.77 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
Optional Expansion |
$446.74 |
$461.56 |
$477.08 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
SPD |
$1,168.07 |
$1,198.47 |
$1,229.96 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
SPD |
$1,083.76 |
$1,114.17 |
$1,145.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
SPD |
$1,168.07 |
$1,198.47 |
$1,229.96 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
SPD |
$1,083.76 |
$1,114.17 |
$1,145.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
SPD |
$1,168.07 |
$1,198.47 |
$1,229.96 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
SPD |
$1,083.76 |
$1,114.17 |
$1,145.73 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
SPD |
$1,103.08 |
$1,133.42 |
$1,164.88 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
SPD |
$1,083.76 |
$1,114.17 |
$1,145.73 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
SPD |
$1,168.07 |
$1,198.47 |
$1,229.96 |
| 07/18-12/18 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
SPD/Full-Dual |
$335.21 |
$342.45 |
$349.95 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
SPD/Full-Dual |
$337.69 |
$345.39 |
$353.37 |
| 07/18-12/18 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
SPD/Full-Dual |
$335.21 |
$342.45 |
$349.95 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
SPD/Full-Dual |
$337.69 |
$345.39 |
$353.37 |
| 07/18-12/18 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
SPD/Full-Dual |
$335.21 |
$342.45 |
$349.95 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
SPD/Full-Dual |
$337.69 |
$345.39 |
$353.37 |
| 07/18-12/18 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 07/18-12/18 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
SPD/Full-Dual |
$225.06 |
$230.17 |
$235.46 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
SPD/Full-Dual |
$337.69 |
$345.39 |
$353.37 |
| 07/18-12/18 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
SPD/Full-Dual |
$335.21 |
$342.45 |
$349.95 |
| 01/19-06/19 |
2018-19 |
COHS |
Del Norte |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Humboldt |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Lake |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Lassen |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Marin |
Partnership Health Plan |
WCM |
$1,993.17 |
$2,064.94 |
$2,139.90 |
| 01/19-06/19 |
2018-19 |
COHS |
Mendocino |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Modoc |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Napa |
Partnership Health Plan |
WCM |
$1,993.17 |
$2,064.94 |
$2,139.90 |
| 01/19-06/19 |
2018-19 |
COHS |
Shasta |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Siskiyou |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Solano |
Partnership Health Plan |
WCM |
$1,993.17 |
$2,064.94 |
$2,139.90 |
| 01/19-06/19 |
2018-19 |
COHS |
Sonoma |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Trinity |
Partnership Health Plan |
WCM |
$1,970.71 |
$2,041.58 |
$2,115.61 |
| 01/19-06/19 |
2018-19 |
COHS |
Yolo |
Partnership Health Plan |
WCM |
$1,993.17 |
$2,064.94 |
$2,139.90 |