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2021 Workers' Compensation Fee Schedule

Table C: Skilled Nursing Facilities

NPI or Provider # Provider # In-Patient Allowance Out-Patient Allowance
  Implied Decimal 2 (in dollars)
1306844295 395001 50232 91
1679575989 395003 44536 100
1376533109 395006 57225 100
1265474753 395010 36506 100
1295165223 395011 76126 60
1023015138 395012 28739 100
1659875789 395013 34180 80
1871916874 395015 47448 71
1154321008 395016 37543 40
1629015078 395018 63955 80
1477565216 395020 31589 80
1245238724 395023 43629 92
1558702381 395028 74313 88
1487175816 395031 48418 63
1285619601 395032 59033 70
1629074935 395034 33661 100
1215984935 395037 37543 100
1770072175 395041 44165 71
1063418150 395042 25892 70
1396166617 395044 19936 80
1447245337 395045 39101 69
1922005271 395047 41429 70
1497750053 395050 40134 100
1629063250 395052 41429 94
1346238672 395058 35729 100
1467400960 395066 55408 90
1194015784 395067 29256 100
1194064683 395075 57482 65
1477735785 395077 61106 65
1245327428 395078 55149 60
1982602447 395080 47646 91
1902806854 395090 25117 80
1649228149 395092 15017 80
1053318501 395094 25636 80
1376664839 395095 46607 77
1033115514 395101 26153 100
1285744474 395102 28484 100
1235137472 395103 29516 100
1104829571 395104 33401 80
1356323109 395105 47385 94
1225034440 395108 42727 100
1134177637 395109 34697 80
1770562688 395110 63437 100
1316002355 395117 35474 100
1003809526 395118 47901 91
1437146917 395121 37803 100
1124079587 395123 11651 100
1205062585 395124 26926 80
1376530469 395134 48937 100
1851573166 395135 25117 100
1063694370 395138 47901 75
1538119573 395142 41996 71
1477657955 395146 57740 100
1518049899 395148 34951 100
1811208077 395155 59033 24
1225017130 395156 54372 80
1710348305 395158 44019 60
1326046061 395160 37027 70
1801894712 395164 68098 88
1053746222 395166 37027 71
1124535174 395167 50137 71
1255320032 395168 48418 45
1518951763 395171 39101 64
1205841632 395172 40134 70
1760622161 395173 61366 50
1093219040 395174 40391 83
1063711786 395176 41555 83
1932150349 395177 43319 71
1508857897 395180 32627 80
1205903630 395182 42727 67
1699738732 395188 74568 95
1093766305 395193 46727 71
1528429107 395197 38062 61
1518913136 395199 33661 100
1275086050 395200 13196 100
1821261710 395202 49194 50
1134113293 395203 42854 84
1295735157 395205 45055 60
1386616068 395206 37027 80
1306340435 395208 44277 73
1396708467 395217 62142 95
1477665198 395218 30554 80
1669423992 395223 41996 71
1386826691 395224 42982 88
1851396972 395227 60592 55
1992729305 395228 34951 80
1184869877 395231 40134 100
1710982392 395232 42463 100
1730182189 395235 40912 78
1730540428 395237 49194 100
1679028088 395241 13725 80
1750563060 395243 38062 70
1649277625 395244 32104 100
1619928074 395247 10875 100
1255323986 395248 40391 65
1780639872 395249 46784 71
1255338976 395250 41949 85
1386695617 395252 40628 71
1558312959 395256 46727 71
1992709414 395258 56449 75
1013417328 395259 55889 71
1528068012 395260 28484 100
1033529490 395261 40391 75
1295281665 395262 15537 80
1518461565 395266 47279 71
1629110754 395270 44536 82
1902857212 395273 40628 71
1326033556 395276 53598 51
1033160494 395277 46727 71
1649279142 395278 42463 75
1619951993 395282 37938 100
1053317446 395283 38323 63
1841241254 395284 46727 71
1083632202 395285 32104 58
1356414759 395286 43201 86
1992756225 395288 40628 71
1932642287 395289 56877 100
1619459351 395290 38062 66
1518919778 395292 36506 86
1942743299 395295 14240 80
1093181752 395296 54428 71
1275581779 395298 38838 65
1407832843 395300 74568 53
1538103270 395305 47901 99
1023005766 395306 28222 41
1255312138 395307 46607 100
1073518213 395308 73272 80
1679520266 395309 44019 100
1801195524 395311 54372 35
1730137233 395313 31851 75
1497837470 395316 48937 40
1750622601 395317 38062 36
1699772327 395318 46090 100
1518915792 395319 59554 95
1184619736 395321 40656 100
1477540524 395324 51527 86
1831184506 395325 38838 100
1417937624 395326 33401 55
1013912500 395328 37543 75
1548268840 395329 36119 100
1598749558 395330 41555 100
1992209027 395331 61109 86
1093973158 395332 58259 55
1992758205 395333 46349 57
1386157485 395334 54428 71
1548716913 395335 41996 71
1699773655 395336 33143 39
1780751115 395338 39357 75
1104867902 395342 77678 60
1508813460 395344 36252 100
1194200873 395345 49194 60
1851395396 395346 44793 45
1578520011 395347 50494 65
1851346704 395348 42727 100
1891806980 395349 39357 100
1265448690 395350 25892 85
1720034002 395351 38838 100
1528139078 395352 45454 71
1760479893 395353 22339 80
1871775197 395354 38969 84
1124014691 395355 48678 80
1740287499 395356 19418 80
1366446288 395357 34951 100
1992750921 395359 36252 100
1376651513 395360 45313 75
1376659748 395361 40912 45
1720531502 395363 40628 71
1023064193 395364 33661 100
1326035577 395365 32104 100
1194724153 395366 37284 56
1598759748 395367 45055 100
1568827921 395370 46607 70
1700875382 395371 31329 90
1952493272 395372 41949 100
1154388684 395373 46090 80
1154378941 395374 44019 100
1548254790 395375 33401 100
1437383353 395376 36767 87
1366434284 395378 33661 100
1912315649 395379 43498 89
1033114707 395380 59814 61
1134118631 395381 60848 81
1720449374 395382 53080 41
1992704589 395384 34697 80
1538133053 395386 36252 100
1700834314 395387 53598 80
1174504062 395388 42463 85
1619062858 395390 45828 81
1972509966 395391 40912 80
1750691267 395393 39876 100
1649225590 395394 41429 34
1225036478 395395 38838 100
1861431199 395396 34951 100
1952357659 395397 40134 100
1588641757 395398 28222 100
1689633943 395400 37284 75
1891786604 395401 34951 80
1245287341 395402 40134 100
1932384963 395403 52565 65
1831201946 395404 63179 70
1801830195 395405 58259 70
1174510325 395406 43759 79
1356523666 395408 51786 50
1639176977 395409 49715 75
1386637809 395410 34951 83
1043207152 395413 44019 40
1548431547 395414 35729 58
1295118396 395416 51786 66
1043268543 395418 53340 61
1417928185 395421 27711 41