OUTPATIENT EAPG 00532: HEAD TRAUMA
|
Facility
OP
|
$71.03
|
|
Service Code
|
EAPG 00532
|
Hospital Charge Code |
EAPG 00532
|
Min. Negotiated Rate |
$71.03 |
Max. Negotiated Rate |
$71.03 |
Rate for Payer: Buckeye Health Medicaid OOS |
$71.03
|
Rate for Payer: Molina Healthcare of OH Medicare |
$71.03
|
|
OUTPATIENT EAPG 00533: AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT
|
Facility
OP
|
$53.52
|
|
Service Code
|
EAPG 00533
|
Hospital Charge Code |
EAPG 00533
|
Min. Negotiated Rate |
$53.52 |
Max. Negotiated Rate |
$53.52 |
Rate for Payer: Buckeye Health Medicaid OOS |
$53.52
|
Rate for Payer: Molina Healthcare of OH Medicare |
$53.52
|
|
OUTPATIENT EAPG 00534: NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARC
|
Facility
OP
|
$35.05
|
|
Service Code
|
EAPG 00534
|
Hospital Charge Code |
EAPG 00534
|
Min. Negotiated Rate |
$35.05 |
Max. Negotiated Rate |
$35.05 |
Rate for Payer: Buckeye Health Medicaid OOS |
$35.05
|
Rate for Payer: Molina Healthcare of OH Medicare |
$35.05
|
|
OUTPATIENT EAPG 00535: CVA & PRECEREBRAL OCCLUSION W INFARCT
|
Facility
OP
|
$34.92
|
|
Service Code
|
EAPG 00535
|
Hospital Charge Code |
EAPG 00535
|
Min. Negotiated Rate |
$34.92 |
Max. Negotiated Rate |
$34.92 |
Rate for Payer: Buckeye Health Medicaid OOS |
$34.92
|
Rate for Payer: Molina Healthcare of OH Medicare |
$34.92
|
|
OUTPATIENT EAPG 00536: CEREBRAL PALSY
|
Facility
OP
|
$77.84
|
|
Service Code
|
EAPG 00536
|
Hospital Charge Code |
EAPG 00536
|
Min. Negotiated Rate |
$77.84 |
Max. Negotiated Rate |
$77.84 |
Rate for Payer: Buckeye Health Medicaid OOS |
$77.84
|
Rate for Payer: Molina Healthcare of OH Medicare |
$77.84
|
|
OUTPATIENT EAPG 00550: ACUTE MAJOR EYE INFECTIONS
|
Facility
OP
|
$51.86
|
|
Service Code
|
EAPG 00550
|
Hospital Charge Code |
EAPG 00550
|
Min. Negotiated Rate |
$51.86 |
Max. Negotiated Rate |
$51.86 |
Rate for Payer: Buckeye Health Medicaid OOS |
$51.86
|
Rate for Payer: Molina Healthcare of OH Medicare |
$51.86
|
|
OUTPATIENT EAPG 00551: CATARACTS
|
Facility
OP
|
$37.24
|
|
Service Code
|
EAPG 00551
|
Hospital Charge Code |
EAPG 00551
|
Min. Negotiated Rate |
$37.24 |
Max. Negotiated Rate |
$37.24 |
Rate for Payer: Buckeye Health Medicaid OOS |
$37.24
|
Rate for Payer: Molina Healthcare of OH Medicare |
$37.24
|
|
OUTPATIENT EAPG 00552: GLAUCOMA
|
Facility
OP
|
$36.75
|
|
Service Code
|
EAPG 00552
|
Hospital Charge Code |
EAPG 00552
|
Min. Negotiated Rate |
$36.75 |
Max. Negotiated Rate |
$36.75 |
Rate for Payer: Buckeye Health Medicaid OOS |
$36.75
|
Rate for Payer: Molina Healthcare of OH Medicare |
$36.75
|
|
OUTPATIENT EAPG 00553: LEVEL I OTHER OPHTHALMIC DIAGNOSES
|
Facility
OP
|
$54.64
|
|
Service Code
|
EAPG 00553
|
Hospital Charge Code |
EAPG 00553
|
Min. Negotiated Rate |
$54.64 |
Max. Negotiated Rate |
$54.64 |
Rate for Payer: Buckeye Health Medicaid OOS |
$54.64
|
Rate for Payer: Molina Healthcare of OH Medicare |
$54.64
|
|
OUTPATIENT EAPG 00554: LEVEL II OTHER OPHTHALMIC DIAGNOSES
|
Facility
OP
|
$64.02
|
|
Service Code
|
EAPG 00554
|
Hospital Charge Code |
EAPG 00554
|
Min. Negotiated Rate |
$64.02 |
Max. Negotiated Rate |
$64.02 |
Rate for Payer: Buckeye Health Medicaid OOS |
$64.02
|
Rate for Payer: Molina Healthcare of OH Medicare |
$64.02
|
|
OUTPATIENT EAPG 00555: CONJUNCTIVITIS
|
Facility
OP
|
$51.76
|
|
Service Code
|
EAPG 00555
|
Hospital Charge Code |
EAPG 00555
|
Min. Negotiated Rate |
$51.76 |
Max. Negotiated Rate |
$51.76 |
Rate for Payer: Buckeye Health Medicaid OOS |
$51.76
|
Rate for Payer: Molina Healthcare of OH Medicare |
$51.76
|
|
OUTPATIENT EAPG 00560: EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES
|
Facility
OP
|
$37.91
|
|
Service Code
|
EAPG 00560
|
Hospital Charge Code |
EAPG 00560
|
Min. Negotiated Rate |
$37.91 |
Max. Negotiated Rate |
$37.91 |
Rate for Payer: Buckeye Health Medicaid OOS |
$37.91
|
Rate for Payer: Molina Healthcare of OH Medicare |
$37.91
|
|
OUTPATIENT EAPG 00561: VERTIGINOUS DIAGNOSES EXCEPT FOR BENIGN VERTIGO
|
Facility
OP
|
$94.65
|
|
Service Code
|
EAPG 00561
|
Hospital Charge Code |
EAPG 00561
|
Min. Negotiated Rate |
$94.65 |
Max. Negotiated Rate |
$94.65 |
Rate for Payer: Buckeye Health Medicaid OOS |
$94.65
|
Rate for Payer: Molina Healthcare of OH Medicare |
$94.65
|
|
OUTPATIENT EAPG 00562: INFECTIONS OF UPPER RESPIRATORY TRACT & OTITIS MEDIA
|
Facility
OP
|
$58.58
|
|
Service Code
|
EAPG 00562
|
Hospital Charge Code |
EAPG 00562
|
Min. Negotiated Rate |
$58.58 |
Max. Negotiated Rate |
$58.58 |
Rate for Payer: Buckeye Health Medicaid OOS |
$58.58
|
Rate for Payer: Molina Healthcare of OH Medicare |
$58.58
|
|
OUTPATIENT EAPG 00563: DENTAL & ORAL DIAGNOSES & INJURIES
|
Facility
OP
|
$52.67
|
|
Service Code
|
EAPG 00563
|
Hospital Charge Code |
EAPG 00563
|
Min. Negotiated Rate |
$52.67 |
Max. Negotiated Rate |
$52.67 |
Rate for Payer: Buckeye Health Medicaid OOS |
$52.67
|
Rate for Payer: Molina Healthcare of OH Medicare |
$52.67
|
|
OUTPATIENT EAPG 00564: LEVEL I OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES
|
Facility
OP
|
$55.90
|
|
Service Code
|
EAPG 00564
|
Hospital Charge Code |
EAPG 00564
|
Min. Negotiated Rate |
$55.90 |
Max. Negotiated Rate |
$55.90 |
Rate for Payer: Buckeye Health Medicaid OOS |
$55.90
|
Rate for Payer: Molina Healthcare of OH Medicare |
$55.90
|
|
OUTPATIENT EAPG 00565: LEVEL II OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES
|
Facility
OP
|
$71.93
|
|
Service Code
|
EAPG 00565
|
Hospital Charge Code |
EAPG 00565
|
Min. Negotiated Rate |
$71.93 |
Max. Negotiated Rate |
$71.93 |
Rate for Payer: Buckeye Health Medicaid OOS |
$71.93
|
Rate for Payer: Molina Healthcare of OH Medicare |
$71.93
|
|
OUTPATIENT EAPG 00570: CYSTIC FIBROSIS - PULMONARY DISEASE
|
Facility
OP
|
$213.91
|
|
Service Code
|
EAPG 00570
|
Hospital Charge Code |
EAPG 00570
|
Min. Negotiated Rate |
$213.91 |
Max. Negotiated Rate |
$213.91 |
Rate for Payer: Buckeye Health Medicaid OOS |
$213.91
|
Rate for Payer: Molina Healthcare of OH Medicare |
$213.91
|
|
OUTPATIENT EAPG 00571: RESPIRATORY MALIGNANCY
|
Facility
OP
|
$45.92
|
|
Service Code
|
EAPG 00571
|
Hospital Charge Code |
EAPG 00571
|
Min. Negotiated Rate |
$45.92 |
Max. Negotiated Rate |
$45.92 |
Rate for Payer: Buckeye Health Medicaid OOS |
$45.92
|
Rate for Payer: Molina Healthcare of OH Medicare |
$45.92
|
|
OUTPATIENT EAPG 00572: BRONCHIOLITIS & RSV PNEUMONIA
|
Facility
OP
|
$93.83
|
|
Service Code
|
EAPG 00572
|
Hospital Charge Code |
EAPG 00572
|
Min. Negotiated Rate |
$93.83 |
Max. Negotiated Rate |
$93.83 |
Rate for Payer: Buckeye Health Medicaid OOS |
$93.83
|
Rate for Payer: Molina Healthcare of OH Medicare |
$93.83
|
|
OUTPATIENT EAPG 00573: COMMUNITY ACQUIRED PNUEMONIA
|
Facility
OP
|
$105.76
|
|
Service Code
|
EAPG 00573
|
Hospital Charge Code |
EAPG 00573
|
Min. Negotiated Rate |
$105.76 |
Max. Negotiated Rate |
$105.76 |
Rate for Payer: Buckeye Health Medicaid OOS |
$105.76
|
Rate for Payer: Molina Healthcare of OH Medicare |
$105.76
|
|
OUTPATIENT EAPG 00574: CHRONIC OBSTRUCTIVE PULMONARY DISEASE
|
Facility
OP
|
$54.18
|
|
Service Code
|
EAPG 00574
|
Hospital Charge Code |
EAPG 00574
|
Min. Negotiated Rate |
$54.18 |
Max. Negotiated Rate |
$54.18 |
Rate for Payer: Buckeye Health Medicaid OOS |
$54.18
|
Rate for Payer: Molina Healthcare of OH Medicare |
$54.18
|
|
OUTPATIENT EAPG 00575: ASTHMA
|
Facility
OP
|
$74.86
|
|
Service Code
|
EAPG 00575
|
Hospital Charge Code |
EAPG 00575
|
Min. Negotiated Rate |
$74.86 |
Max. Negotiated Rate |
$74.86 |
Rate for Payer: Buckeye Health Medicaid OOS |
$74.86
|
Rate for Payer: Molina Healthcare of OH Medicare |
$74.86
|
|
OUTPATIENT EAPG 00576: LEVEL I OTHER RESPIRATORY DIAGNOSES
|
Facility
OP
|
$75.89
|
|
Service Code
|
EAPG 00576
|
Hospital Charge Code |
EAPG 00576
|
Min. Negotiated Rate |
$75.89 |
Max. Negotiated Rate |
$75.89 |
Rate for Payer: Buckeye Health Medicaid OOS |
$75.89
|
Rate for Payer: Molina Healthcare of OH Medicare |
$75.89
|
|
OUTPATIENT EAPG 00577: LEVEL II OTHER RESPIRATORY DIAGNOSES
|
Facility
OP
|
$67.79
|
|
Service Code
|
EAPG 00577
|
Hospital Charge Code |
EAPG 00577
|
Min. Negotiated Rate |
$67.79 |
Max. Negotiated Rate |
$67.79 |
Rate for Payer: Buckeye Health Medicaid OOS |
$67.79
|
Rate for Payer: Molina Healthcare of OH Medicare |
$67.79
|
|