INPATIENT APRDRG 7114: POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE
|
Facility
IP
|
$59,370.43
|
|
Service Code
|
APR-DRG 7114
|
Hospital Charge Code |
APRDRG 7114
|
Min. Negotiated Rate |
$15,448.40 |
Max. Negotiated Rate |
$59,370.43 |
Rate for Payer: Buckeye Health Medicaid OOS |
$15,448.40
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$59,370.43
|
Rate for Payer: Managed Health Services Medicaid |
$59,370.43
|
Rate for Payer: MDWise Medicaid |
$59,370.43
|
Rate for Payer: Molina Healthcare of OH Medicare |
$15,448.40
|
|
INPATIENT APRDRG 7201: SEPTICEMIA & DISSEMINATED INFECTIONS
|
Facility
IP
|
$8,541.92
|
|
Service Code
|
APR-DRG 7201
|
Hospital Charge Code |
APRDRG 7201
|
Min. Negotiated Rate |
$1,817.85 |
Max. Negotiated Rate |
$8,541.92 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,817.85
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$8,541.92
|
Rate for Payer: Managed Health Services Medicaid |
$8,541.92
|
Rate for Payer: MDWise Medicaid |
$8,541.92
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,817.85
|
|
INPATIENT APRDRG 7202: SEPTICEMIA & DISSEMINATED INFECTIONS
|
Facility
IP
|
$10,888.92
|
|
Service Code
|
APR-DRG 7202
|
Hospital Charge Code |
APRDRG 7202
|
Min. Negotiated Rate |
$2,306.82 |
Max. Negotiated Rate |
$10,888.92 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,306.82
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$10,888.92
|
Rate for Payer: Managed Health Services Medicaid |
$10,888.92
|
Rate for Payer: MDWise Medicaid |
$10,888.92
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,306.82
|
|
INPATIENT APRDRG 7203: SEPTICEMIA & DISSEMINATED INFECTIONS
|
Facility
IP
|
$16,243.96
|
|
Service Code
|
APR-DRG 7203
|
Hospital Charge Code |
APRDRG 7203
|
Min. Negotiated Rate |
$3,652.36 |
Max. Negotiated Rate |
$16,243.96 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,652.36
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$16,243.96
|
Rate for Payer: Managed Health Services Medicaid |
$16,243.96
|
Rate for Payer: MDWise Medicaid |
$16,243.96
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,652.36
|
|
INPATIENT APRDRG 7204: SEPTICEMIA & DISSEMINATED INFECTIONS
|
Facility
IP
|
$37,412.53
|
|
Service Code
|
APR-DRG 7204
|
Hospital Charge Code |
APRDRG 7204
|
Min. Negotiated Rate |
$7,909.61 |
Max. Negotiated Rate |
$37,412.53 |
Rate for Payer: Buckeye Health Medicaid OOS |
$7,909.61
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$37,412.53
|
Rate for Payer: Managed Health Services Medicaid |
$37,412.53
|
Rate for Payer: MDWise Medicaid |
$37,412.53
|
Rate for Payer: Molina Healthcare of OH Medicare |
$7,909.61
|
|
INPATIENT APRDRG 7211: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$9,043.88
|
|
Service Code
|
APR-DRG 7211
|
Hospital Charge Code |
APRDRG 7211
|
Min. Negotiated Rate |
$2,071.78 |
Max. Negotiated Rate |
$9,043.88 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,071.78
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$9,043.88
|
Rate for Payer: Managed Health Services Medicaid |
$9,043.88
|
Rate for Payer: MDWise Medicaid |
$9,043.88
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,071.78
|
|
INPATIENT APRDRG 7212: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$12,079.06
|
|
Service Code
|
APR-DRG 7212
|
Hospital Charge Code |
APRDRG 7212
|
Min. Negotiated Rate |
$2,555.31 |
Max. Negotiated Rate |
$12,079.06 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,555.31
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$12,079.06
|
Rate for Payer: Managed Health Services Medicaid |
$12,079.06
|
Rate for Payer: MDWise Medicaid |
$12,079.06
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,555.31
|
|
INPATIENT APRDRG 7213: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$20,053.66
|
|
Service Code
|
APR-DRG 7213
|
Hospital Charge Code |
APRDRG 7213
|
Min. Negotiated Rate |
$4,806.73 |
Max. Negotiated Rate |
$20,053.66 |
Rate for Payer: Buckeye Health Medicaid OOS |
$4,806.73
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$20,053.66
|
Rate for Payer: Managed Health Services Medicaid |
$20,053.66
|
Rate for Payer: MDWise Medicaid |
$20,053.66
|
Rate for Payer: Molina Healthcare of OH Medicare |
$4,806.73
|
|
INPATIENT APRDRG 7214: POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$34,408.19
|
|
Service Code
|
APR-DRG 7214
|
Hospital Charge Code |
APRDRG 7214
|
Min. Negotiated Rate |
$8,145.60 |
Max. Negotiated Rate |
$34,408.19 |
Rate for Payer: Buckeye Health Medicaid OOS |
$8,145.60
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$34,408.19
|
Rate for Payer: Managed Health Services Medicaid |
$34,408.19
|
Rate for Payer: MDWise Medicaid |
$34,408.19
|
Rate for Payer: Molina Healthcare of OH Medicare |
$8,145.60
|
|
INPATIENT APRDRG 7221: FEVER
|
Facility
IP
|
$5,495.64
|
|
Service Code
|
APR-DRG 7221
|
Hospital Charge Code |
APRDRG 7221
|
Min. Negotiated Rate |
$1,861.08 |
Max. Negotiated Rate |
$5,495.64 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,861.08
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$5,495.64
|
Rate for Payer: Managed Health Services Medicaid |
$5,495.64
|
Rate for Payer: MDWise Medicaid |
$5,495.64
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,861.08
|
|
INPATIENT APRDRG 7222: FEVER
|
Facility
IP
|
$8,069.56
|
|
Service Code
|
APR-DRG 7222
|
Hospital Charge Code |
APRDRG 7222
|
Min. Negotiated Rate |
$1,990.45 |
Max. Negotiated Rate |
$8,069.56 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,990.45
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$8,069.56
|
Rate for Payer: Managed Health Services Medicaid |
$8,069.56
|
Rate for Payer: MDWise Medicaid |
$8,069.56
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,990.45
|
|
INPATIENT APRDRG 7223: FEVER
|
Facility
IP
|
$9,009.35
|
|
Service Code
|
APR-DRG 7223
|
Hospital Charge Code |
APRDRG 7223
|
Min. Negotiated Rate |
$3,050.04 |
Max. Negotiated Rate |
$9,009.35 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,050.04
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$9,009.35
|
Rate for Payer: Managed Health Services Medicaid |
$9,009.35
|
Rate for Payer: MDWise Medicaid |
$9,009.35
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,050.04
|
|
INPATIENT APRDRG 7224: FEVER
|
Facility
IP
|
$13,102.71
|
|
Service Code
|
APR-DRG 7224
|
Hospital Charge Code |
APRDRG 7224
|
Min. Negotiated Rate |
$3,872.35 |
Max. Negotiated Rate |
$13,102.71 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,872.35
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$13,102.71
|
Rate for Payer: Managed Health Services Medicaid |
$13,102.71
|
Rate for Payer: MDWise Medicaid |
$13,102.71
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,872.35
|
|
INPATIENT APRDRG 7231: VIRAL ILLNESS
|
Facility
IP
|
$4,566.96
|
|
Service Code
|
APR-DRG 7231
|
Hospital Charge Code |
APRDRG 7231
|
Min. Negotiated Rate |
$1,771.10 |
Max. Negotiated Rate |
$4,566.96 |
Rate for Payer: Buckeye Health Medicaid OOS |
$1,771.10
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$4,566.96
|
Rate for Payer: Managed Health Services Medicaid |
$4,566.96
|
Rate for Payer: MDWise Medicaid |
$4,566.96
|
Rate for Payer: Molina Healthcare of OH Medicare |
$1,771.10
|
|
INPATIENT APRDRG 7232: VIRAL ILLNESS
|
Facility
IP
|
$6,573.56
|
|
Service Code
|
APR-DRG 7232
|
Hospital Charge Code |
APRDRG 7232
|
Min. Negotiated Rate |
$2,286.97 |
Max. Negotiated Rate |
$6,573.56 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,286.97
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$6,573.56
|
Rate for Payer: Managed Health Services Medicaid |
$6,573.56
|
Rate for Payer: MDWise Medicaid |
$6,573.56
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,286.97
|
|
INPATIENT APRDRG 7233: VIRAL ILLNESS
|
Facility
IP
|
$11,615.34
|
|
Service Code
|
APR-DRG 7233
|
Hospital Charge Code |
APRDRG 7233
|
Min. Negotiated Rate |
$3,583.51 |
Max. Negotiated Rate |
$11,615.34 |
Rate for Payer: Buckeye Health Medicaid OOS |
$3,583.51
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$11,615.34
|
Rate for Payer: Managed Health Services Medicaid |
$11,615.34
|
Rate for Payer: MDWise Medicaid |
$11,615.34
|
Rate for Payer: Molina Healthcare of OH Medicare |
$3,583.51
|
|
INPATIENT APRDRG 7234: VIRAL ILLNESS
|
Facility
IP
|
$21,918.43
|
|
Service Code
|
APR-DRG 7234
|
Hospital Charge Code |
APRDRG 7234
|
Min. Negotiated Rate |
$6,471.52 |
Max. Negotiated Rate |
$21,918.43 |
Rate for Payer: Buckeye Health Medicaid OOS |
$6,471.52
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$21,918.43
|
Rate for Payer: Managed Health Services Medicaid |
$21,918.43
|
Rate for Payer: MDWise Medicaid |
$21,918.43
|
Rate for Payer: Molina Healthcare of OH Medicare |
$6,471.52
|
|
INPATIENT APRDRG 7241: OTHER INFECTIOUS & PARASITIC DISEASES
|
Facility
IP
|
$9,820.87
|
|
Service Code
|
APR-DRG 7241
|
Hospital Charge Code |
APRDRG 7241
|
Min. Negotiated Rate |
$2,149.28 |
Max. Negotiated Rate |
$9,820.87 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,149.28
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$9,820.87
|
Rate for Payer: Managed Health Services Medicaid |
$9,820.87
|
Rate for Payer: MDWise Medicaid |
$9,820.87
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,149.28
|
|
INPATIENT APRDRG 7242: OTHER INFECTIOUS & PARASITIC DISEASES
|
Facility
IP
|
$11,066.51
|
|
Service Code
|
APR-DRG 7242
|
Hospital Charge Code |
APRDRG 7242
|
Min. Negotiated Rate |
$2,904.98 |
Max. Negotiated Rate |
$11,066.51 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,904.98
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$11,066.51
|
Rate for Payer: Managed Health Services Medicaid |
$11,066.51
|
Rate for Payer: MDWise Medicaid |
$11,066.51
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,904.98
|
|
INPATIENT APRDRG 7243: OTHER INFECTIOUS & PARASITIC DISEASES
|
Facility
IP
|
$22,935.91
|
|
Service Code
|
APR-DRG 7243
|
Hospital Charge Code |
APRDRG 7243
|
Min. Negotiated Rate |
$5,236.78 |
Max. Negotiated Rate |
$22,935.91 |
Rate for Payer: Buckeye Health Medicaid OOS |
$5,236.78
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$22,935.91
|
Rate for Payer: Managed Health Services Medicaid |
$22,935.91
|
Rate for Payer: MDWise Medicaid |
$22,935.91
|
Rate for Payer: Molina Healthcare of OH Medicare |
$5,236.78
|
|
INPATIENT APRDRG 7244: OTHER INFECTIOUS & PARASITIC DISEASES
|
Facility
IP
|
$28,966.81
|
|
Service Code
|
APR-DRG 7244
|
Hospital Charge Code |
APRDRG 7244
|
Min. Negotiated Rate |
$13,072.42 |
Max. Negotiated Rate |
$28,966.81 |
Rate for Payer: Buckeye Health Medicaid OOS |
$13,072.42
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$28,966.81
|
Rate for Payer: Managed Health Services Medicaid |
$28,966.81
|
Rate for Payer: MDWise Medicaid |
$28,966.81
|
Rate for Payer: Molina Healthcare of OH Medicare |
$13,072.42
|
|
INPATIENT APRDRG 7401: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE
|
Facility
IP
|
$2,140.31
|
|
Service Code
|
APR-DRG 7401
|
Hospital Charge Code |
APRDRG 7401
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$2,140.31 |
Rate for Payer: Buckeye Health Medicaid OOS |
$2,140.31
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$2,140.31
|
|
INPATIENT APRDRG 7402: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE
|
Facility
IP
|
$4,083.05
|
|
Service Code
|
APR-DRG 7402
|
Hospital Charge Code |
APRDRG 7402
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$4,083.05 |
Rate for Payer: Buckeye Health Medicaid OOS |
$4,083.05
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$4,083.05
|
|
INPATIENT APRDRG 7403: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE
|
Facility
IP
|
$4,083.05
|
|
Service Code
|
APR-DRG 7403
|
Hospital Charge Code |
APRDRG 7403
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$4,083.05 |
Rate for Payer: Buckeye Health Medicaid OOS |
$4,083.05
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$4,083.05
|
|
INPATIENT APRDRG 7404: MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE
|
Facility
IP
|
$4,083.05
|
|
Service Code
|
APR-DRG 7404
|
Hospital Charge Code |
APRDRG 7404
|
Min. Negotiated Rate |
$1,307.20 |
Max. Negotiated Rate |
$4,083.05 |
Rate for Payer: Buckeye Health Medicaid OOS |
$4,083.05
|
Rate for Payer: CareSource Indiana of IN Hoosier Healthwise |
$1,307.20
|
Rate for Payer: Managed Health Services Medicaid |
$1,307.20
|
Rate for Payer: MDWise Medicaid |
$1,307.20
|
Rate for Payer: Molina Healthcare of OH Medicare |
$4,083.05
|
|