FPL Range: 201%-260%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 75% of Medicare Allowable

FPL Range: 261%-320%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 50% of Medicare Allowable

FPL Range: 321%-350%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 25% of Medicare Allowable