|
OUTPATIENT EAPG 00828: INTELLECTUAL DISABILITY
|
Facility
OP
|
$83.51
|
|
|
Service Code
|
EAPG 00828
|
| Hospital Charge Code |
EAPG 00828
|
| Min. Negotiated Rate |
$83.51 |
| Max. Negotiated Rate |
$83.51 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$83.51
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$83.51
|
|
|
OUTPATIENT EAPG 00829: CHILDHOOD BEHAVIORAL DIAGNOSES
|
Facility
OP
|
$49.50
|
|
|
Service Code
|
EAPG 00829
|
| Hospital Charge Code |
EAPG 00829
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$49.50
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$49.50
|
|
|
OUTPATIENT EAPG 00830: EATING DISORDERS
|
Facility
OP
|
$68.00
|
|
|
Service Code
|
EAPG 00830
|
| Hospital Charge Code |
EAPG 00830
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$68.00
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$68.00
|
|
|
OUTPATIENT EAPG 00831: OTHER BEHAVIORAL HEALTH DIAGNOSES
|
Facility
OP
|
$70.65
|
|
|
Service Code
|
EAPG 00831
|
| Hospital Charge Code |
EAPG 00831
|
| Min. Negotiated Rate |
$70.65 |
| Max. Negotiated Rate |
$70.65 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$70.65
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$70.65
|
|
|
OUTPATIENT EAPG 00840: OPIOID ABUSE & DEPENDENCE
|
Facility
OP
|
$89.63
|
|
|
Service Code
|
EAPG 00840
|
| Hospital Charge Code |
EAPG 00840
|
| Min. Negotiated Rate |
$89.63 |
| Max. Negotiated Rate |
$89.63 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$89.63
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$89.63
|
|
|
OUTPATIENT EAPG 00841: COCAINE ABUSE & DEPENDENCE
|
Facility
OP
|
$179.14
|
|
|
Service Code
|
EAPG 00841
|
| Hospital Charge Code |
EAPG 00841
|
| Min. Negotiated Rate |
$179.14 |
| Max. Negotiated Rate |
$179.14 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$179.14
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$179.14
|
|
|
OUTPATIENT EAPG 00842: ALCOHOL ABUSE & DEPENDENCE
|
Facility
OP
|
$157.96
|
|
|
Service Code
|
EAPG 00842
|
| Hospital Charge Code |
EAPG 00842
|
| Min. Negotiated Rate |
$157.96 |
| Max. Negotiated Rate |
$157.96 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$157.96
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$157.96
|
|
|
OUTPATIENT EAPG 00843: OTHER DRUG ABUSE & DEPENDENCE
|
Facility
OP
|
$137.24
|
|
|
Service Code
|
EAPG 00843
|
| Hospital Charge Code |
EAPG 00843
|
| Min. Negotiated Rate |
$137.24 |
| Max. Negotiated Rate |
$137.24 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$137.24
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$137.24
|
|
|
OUTPATIENT EAPG 00850: ALLERGIC REACTIONS
|
Facility
OP
|
$80.29
|
|
|
Service Code
|
EAPG 00850
|
| Hospital Charge Code |
EAPG 00850
|
| Min. Negotiated Rate |
$80.29 |
| Max. Negotiated Rate |
$80.29 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$80.29
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$80.29
|
|
|
OUTPATIENT EAPG 00851: POISONING OF MEDICINAL AGENTS
|
Facility
OP
|
$162.66
|
|
|
Service Code
|
EAPG 00851
|
| Hospital Charge Code |
EAPG 00851
|
| Min. Negotiated Rate |
$162.66 |
| Max. Negotiated Rate |
$162.66 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$162.66
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$162.66
|
|
|
OUTPATIENT EAPG 00852: OTHER COMPLICATIONS OF TREATMENT
|
Facility
OP
|
$68.66
|
|
|
Service Code
|
EAPG 00852
|
| Hospital Charge Code |
EAPG 00852
|
| Min. Negotiated Rate |
$68.66 |
| Max. Negotiated Rate |
$68.66 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$68.66
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$68.66
|
|
|
OUTPATIENT EAPG 00853: OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES
|
Facility
OP
|
$79.08
|
|
|
Service Code
|
EAPG 00853
|
| Hospital Charge Code |
EAPG 00853
|
| Min. Negotiated Rate |
$79.08 |
| Max. Negotiated Rate |
$79.08 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$79.08
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$79.08
|
|
|
OUTPATIENT EAPG 00854: TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES
|
Facility
OP
|
$99.28
|
|
|
Service Code
|
EAPG 00854
|
| Hospital Charge Code |
EAPG 00854
|
| Min. Negotiated Rate |
$99.28 |
| Max. Negotiated Rate |
$99.28 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$99.28
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$99.28
|
|
|
OUTPATIENT EAPG 00860: EXTENSIVE 3RD DEGREE OR FULL THICKNESS BURNS W/O SKIN GRAFT
|
Facility
OP
|
$53.01
|
|
|
Service Code
|
EAPG 00860
|
| Hospital Charge Code |
EAPG 00860
|
| Min. Negotiated Rate |
$53.01 |
| Max. Negotiated Rate |
$53.01 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$53.01
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$53.01
|
|
|
OUTPATIENT EAPG 00861: PARTIAL THICKNESS BURNS W OR W/O SKIN GRAFT
|
Facility
OP
|
$66.63
|
|
|
Service Code
|
EAPG 00861
|
| Hospital Charge Code |
EAPG 00861
|
| Min. Negotiated Rate |
$66.63 |
| Max. Negotiated Rate |
$66.63 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$66.63
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$66.63
|
|
|
OUTPATIENT EAPG 00869: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE INJURIES
|
Facility
OP
|
$59.16
|
|
|
Service Code
|
EAPG 00869
|
| Hospital Charge Code |
EAPG 00869
|
| Min. Negotiated Rate |
$59.16 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$59.16
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$59.16
|
|
|
OUTPATIENT EAPG 00870: REHABILITATION
|
Facility
OP
|
$62.01
|
|
|
Service Code
|
EAPG 00870
|
| Hospital Charge Code |
EAPG 00870
|
| Min. Negotiated Rate |
$62.01 |
| Max. Negotiated Rate |
$62.01 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$62.01
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$62.01
|
|
|
OUTPATIENT EAPG 00871: SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
OP
|
$65.18
|
|
|
Service Code
|
EAPG 00871
|
| Hospital Charge Code |
EAPG 00871
|
| Min. Negotiated Rate |
$65.18 |
| Max. Negotiated Rate |
$65.18 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$65.18
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$65.18
|
|
|
OUTPATIENT EAPG 00872: OTHER AFTERCARE & CONVALESCENCE
|
Facility
OP
|
$37.35
|
|
|
Service Code
|
EAPG 00872
|
| Hospital Charge Code |
EAPG 00872
|
| Min. Negotiated Rate |
$37.35 |
| Max. Negotiated Rate |
$37.35 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$37.35
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$37.35
|
|
|
OUTPATIENT EAPG 00873: NEONATAL AFTERCARE
|
Facility
OP
|
$56.55
|
|
|
Service Code
|
EAPG 00873
|
| Hospital Charge Code |
EAPG 00873
|
| Min. Negotiated Rate |
$56.55 |
| Max. Negotiated Rate |
$56.55 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$56.55
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$56.55
|
|
|
OUTPATIENT EAPG 00874: JOINT REPLACEMENT
|
Facility
OP
|
$42.14
|
|
|
Service Code
|
EAPG 00874
|
| Hospital Charge Code |
EAPG 00874
|
| Min. Negotiated Rate |
$42.14 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$42.14
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$42.14
|
|
|
OUTPATIENT EAPG 00875: CONTRACEPTIVE MANAGEMENT
|
Facility
OP
|
$50.33
|
|
|
Service Code
|
EAPG 00875
|
| Hospital Charge Code |
EAPG 00875
|
| Min. Negotiated Rate |
$50.33 |
| Max. Negotiated Rate |
$50.33 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$50.33
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$50.33
|
|
|
OUTPATIENT EAPG 00876: ADULT PREVENTIVE MEDICINE
|
Facility
OP
|
$62.42
|
|
|
Service Code
|
EAPG 00876
|
| Hospital Charge Code |
EAPG 00876
|
| Min. Negotiated Rate |
$62.42 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$62.42
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$62.42
|
|
|
OUTPATIENT EAPG 00877: CHILD PREVENTIVE MEDICINE
|
Facility
OP
|
$62.96
|
|
|
Service Code
|
EAPG 00877
|
| Hospital Charge Code |
EAPG 00877
|
| Min. Negotiated Rate |
$62.96 |
| Max. Negotiated Rate |
$62.96 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$62.96
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$62.96
|
|
|
OUTPATIENT EAPG 00878: GYNECOLOGIC PREVENTIVE MEDICINE
|
Facility
OP
|
$66.39
|
|
|
Service Code
|
EAPG 00878
|
| Hospital Charge Code |
EAPG 00878
|
| Min. Negotiated Rate |
$66.39 |
| Max. Negotiated Rate |
$66.39 |
| Rate for Payer: Buckeye Health Medicaid OOS |
$66.39
|
| Rate for Payer: Molina Healthcare of OH Medicare |
$66.39
|
|
