|
Defibrillator Implants
|
Facility
|
IP
|
$23,301.21
|
|
|
Service Code
|
APR-DRG 1791
|
| Hospital Charge Code |
APRDRG1794
|
| Min. Negotiated Rate |
$23,301.21 |
| Max. Negotiated Rate |
$23,301.21 |
| Rate for Payer: AHCCCS Medicaid |
$23,301.21
|
| Rate for Payer: Allwell Medicaid |
$23,301.21
|
| Rate for Payer: AZCH Complete Medicaid |
$23,301.21
|
| Rate for Payer: Banner UC Health Medicaid |
$23,301.21
|
| Rate for Payer: Mercy Care Medicaid |
$23,301.21
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$23,301.21
|
|
|
Service Code
|
APR-DRG 1791
|
| Hospital Charge Code |
APRDRG1792
|
| Min. Negotiated Rate |
$23,301.21 |
| Max. Negotiated Rate |
$23,301.21 |
| Rate for Payer: AHCCCS Medicaid |
$23,301.21
|
| Rate for Payer: Allwell Medicaid |
$23,301.21
|
| Rate for Payer: AZCH Complete Medicaid |
$23,301.21
|
| Rate for Payer: Banner UC Health Medicaid |
$23,301.21
|
| Rate for Payer: Mercy Care Medicaid |
$23,301.21
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$32,110.79
|
|
|
Service Code
|
APR-DRG 1793
|
| Hospital Charge Code |
APRDRG1794
|
| Min. Negotiated Rate |
$32,110.79 |
| Max. Negotiated Rate |
$32,110.79 |
| Rate for Payer: AHCCCS Medicaid |
$32,110.79
|
| Rate for Payer: Allwell Medicaid |
$32,110.79
|
| Rate for Payer: AZCH Complete Medicaid |
$32,110.79
|
| Rate for Payer: Banner UC Health Medicaid |
$32,110.79
|
| Rate for Payer: Mercy Care Medicaid |
$32,110.79
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$23,301.21
|
|
|
Service Code
|
APR-DRG 1791
|
| Hospital Charge Code |
APRDRG1793
|
| Min. Negotiated Rate |
$23,301.21 |
| Max. Negotiated Rate |
$23,301.21 |
| Rate for Payer: AHCCCS Medicaid |
$23,301.21
|
| Rate for Payer: Allwell Medicaid |
$23,301.21
|
| Rate for Payer: AZCH Complete Medicaid |
$23,301.21
|
| Rate for Payer: Banner UC Health Medicaid |
$23,301.21
|
| Rate for Payer: Mercy Care Medicaid |
$23,301.21
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$32,110.79
|
|
|
Service Code
|
APR-DRG 1793
|
| Hospital Charge Code |
APRDRG1792
|
| Min. Negotiated Rate |
$32,110.79 |
| Max. Negotiated Rate |
$32,110.79 |
| Rate for Payer: AHCCCS Medicaid |
$32,110.79
|
| Rate for Payer: Allwell Medicaid |
$32,110.79
|
| Rate for Payer: AZCH Complete Medicaid |
$32,110.79
|
| Rate for Payer: Banner UC Health Medicaid |
$32,110.79
|
| Rate for Payer: Mercy Care Medicaid |
$32,110.79
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$43,469.97
|
|
|
Service Code
|
APR-DRG 1794
|
| Hospital Charge Code |
APRDRG1793
|
| Min. Negotiated Rate |
$43,469.97 |
| Max. Negotiated Rate |
$43,469.97 |
| Rate for Payer: AHCCCS Medicaid |
$43,469.97
|
| Rate for Payer: Allwell Medicaid |
$43,469.97
|
| Rate for Payer: AZCH Complete Medicaid |
$43,469.97
|
| Rate for Payer: Banner UC Health Medicaid |
$43,469.97
|
| Rate for Payer: Mercy Care Medicaid |
$43,469.97
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$26,401.40
|
|
|
Service Code
|
APR-DRG 1792
|
| Hospital Charge Code |
APRDRG1792
|
| Min. Negotiated Rate |
$26,401.40 |
| Max. Negotiated Rate |
$26,401.40 |
| Rate for Payer: AHCCCS Medicaid |
$26,401.40
|
| Rate for Payer: Allwell Medicaid |
$26,401.40
|
| Rate for Payer: AZCH Complete Medicaid |
$26,401.40
|
| Rate for Payer: Banner UC Health Medicaid |
$26,401.40
|
| Rate for Payer: Mercy Care Medicaid |
$26,401.40
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$23,301.21
|
|
|
Service Code
|
APR-DRG 1791
|
| Hospital Charge Code |
APRDRG1791
|
| Min. Negotiated Rate |
$23,301.21 |
| Max. Negotiated Rate |
$23,301.21 |
| Rate for Payer: AHCCCS Medicaid |
$23,301.21
|
| Rate for Payer: Allwell Medicaid |
$23,301.21
|
| Rate for Payer: AZCH Complete Medicaid |
$23,301.21
|
| Rate for Payer: Banner UC Health Medicaid |
$23,301.21
|
| Rate for Payer: Mercy Care Medicaid |
$23,301.21
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$26,401.40
|
|
|
Service Code
|
APR-DRG 1792
|
| Hospital Charge Code |
APRDRG1794
|
| Min. Negotiated Rate |
$26,401.40 |
| Max. Negotiated Rate |
$26,401.40 |
| Rate for Payer: AHCCCS Medicaid |
$26,401.40
|
| Rate for Payer: Allwell Medicaid |
$26,401.40
|
| Rate for Payer: AZCH Complete Medicaid |
$26,401.40
|
| Rate for Payer: Banner UC Health Medicaid |
$26,401.40
|
| Rate for Payer: Mercy Care Medicaid |
$26,401.40
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$43,469.97
|
|
|
Service Code
|
APR-DRG 1794
|
| Hospital Charge Code |
APRDRG1792
|
| Min. Negotiated Rate |
$43,469.97 |
| Max. Negotiated Rate |
$43,469.97 |
| Rate for Payer: AHCCCS Medicaid |
$43,469.97
|
| Rate for Payer: Allwell Medicaid |
$43,469.97
|
| Rate for Payer: AZCH Complete Medicaid |
$43,469.97
|
| Rate for Payer: Banner UC Health Medicaid |
$43,469.97
|
| Rate for Payer: Mercy Care Medicaid |
$43,469.97
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$32,110.79
|
|
|
Service Code
|
APR-DRG 1793
|
| Hospital Charge Code |
APRDRG1791
|
| Min. Negotiated Rate |
$32,110.79 |
| Max. Negotiated Rate |
$32,110.79 |
| Rate for Payer: AHCCCS Medicaid |
$32,110.79
|
| Rate for Payer: Allwell Medicaid |
$32,110.79
|
| Rate for Payer: AZCH Complete Medicaid |
$32,110.79
|
| Rate for Payer: Banner UC Health Medicaid |
$32,110.79
|
| Rate for Payer: Mercy Care Medicaid |
$32,110.79
|
|
|
Defibrillator Implants
|
Facility
|
IP
|
$32,110.79
|
|
|
Service Code
|
APR-DRG 1793
|
| Hospital Charge Code |
APRDRG1793
|
| Min. Negotiated Rate |
$32,110.79 |
| Max. Negotiated Rate |
$32,110.79 |
| Rate for Payer: AHCCCS Medicaid |
$32,110.79
|
| Rate for Payer: Allwell Medicaid |
$32,110.79
|
| Rate for Payer: AZCH Complete Medicaid |
$32,110.79
|
| Rate for Payer: Banner UC Health Medicaid |
$32,110.79
|
| Rate for Payer: Mercy Care Medicaid |
$32,110.79
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$17,275.48
|
|
|
Service Code
|
APR-DRG 0424
|
| Hospital Charge Code |
APRDRG0424
|
| Min. Negotiated Rate |
$17,275.48 |
| Max. Negotiated Rate |
$17,275.48 |
| Rate for Payer: AHCCCS Medicaid |
$17,275.48
|
| Rate for Payer: Allwell Medicaid |
$17,275.48
|
| Rate for Payer: AZCH Complete Medicaid |
$17,275.48
|
| Rate for Payer: Banner UC Health Medicaid |
$17,275.48
|
| Rate for Payer: Mercy Care Medicaid |
$17,275.48
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$8,202.87
|
|
|
Service Code
|
APR-DRG 0423
|
| Hospital Charge Code |
APRDRG0422
|
| Min. Negotiated Rate |
$8,202.87 |
| Max. Negotiated Rate |
$8,202.87 |
| Rate for Payer: AHCCCS Medicaid |
$8,202.87
|
| Rate for Payer: Allwell Medicaid |
$8,202.87
|
| Rate for Payer: AZCH Complete Medicaid |
$8,202.87
|
| Rate for Payer: Banner UC Health Medicaid |
$8,202.87
|
| Rate for Payer: Mercy Care Medicaid |
$8,202.87
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$5,412.00
|
|
|
Service Code
|
APR-DRG 0422
|
| Hospital Charge Code |
APRDRG0422
|
| Min. Negotiated Rate |
$5,412.00 |
| Max. Negotiated Rate |
$5,412.00 |
| Rate for Payer: AHCCCS Medicaid |
$5,412.00
|
| Rate for Payer: Allwell Medicaid |
$5,412.00
|
| Rate for Payer: AZCH Complete Medicaid |
$5,412.00
|
| Rate for Payer: Banner UC Health Medicaid |
$5,412.00
|
| Rate for Payer: Mercy Care Medicaid |
$5,412.00
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$4,510.70
|
|
|
Service Code
|
APR-DRG 0421
|
| Hospital Charge Code |
APRDRG0421
|
| Min. Negotiated Rate |
$4,510.70 |
| Max. Negotiated Rate |
$4,510.70 |
| Rate for Payer: AHCCCS Medicaid |
$4,510.70
|
| Rate for Payer: Allwell Medicaid |
$4,510.70
|
| Rate for Payer: AZCH Complete Medicaid |
$4,510.70
|
| Rate for Payer: Banner UC Health Medicaid |
$4,510.70
|
| Rate for Payer: Mercy Care Medicaid |
$4,510.70
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$8,202.87
|
|
|
Service Code
|
APR-DRG 0423
|
| Hospital Charge Code |
APRDRG0423
|
| Min. Negotiated Rate |
$8,202.87 |
| Max. Negotiated Rate |
$8,202.87 |
| Rate for Payer: AHCCCS Medicaid |
$8,202.87
|
| Rate for Payer: Allwell Medicaid |
$8,202.87
|
| Rate for Payer: AZCH Complete Medicaid |
$8,202.87
|
| Rate for Payer: Banner UC Health Medicaid |
$8,202.87
|
| Rate for Payer: Mercy Care Medicaid |
$8,202.87
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$4,510.70
|
|
|
Service Code
|
APR-DRG 0421
|
| Hospital Charge Code |
APRDRG0424
|
| Min. Negotiated Rate |
$4,510.70 |
| Max. Negotiated Rate |
$4,510.70 |
| Rate for Payer: AHCCCS Medicaid |
$4,510.70
|
| Rate for Payer: Allwell Medicaid |
$4,510.70
|
| Rate for Payer: AZCH Complete Medicaid |
$4,510.70
|
| Rate for Payer: Banner UC Health Medicaid |
$4,510.70
|
| Rate for Payer: Mercy Care Medicaid |
$4,510.70
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$5,412.00
|
|
|
Service Code
|
APR-DRG 0422
|
| Hospital Charge Code |
APRDRG0424
|
| Min. Negotiated Rate |
$5,412.00 |
| Max. Negotiated Rate |
$5,412.00 |
| Rate for Payer: AHCCCS Medicaid |
$5,412.00
|
| Rate for Payer: Allwell Medicaid |
$5,412.00
|
| Rate for Payer: AZCH Complete Medicaid |
$5,412.00
|
| Rate for Payer: Banner UC Health Medicaid |
$5,412.00
|
| Rate for Payer: Mercy Care Medicaid |
$5,412.00
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$5,412.00
|
|
|
Service Code
|
APR-DRG 0422
|
| Hospital Charge Code |
APRDRG0421
|
| Min. Negotiated Rate |
$5,412.00 |
| Max. Negotiated Rate |
$5,412.00 |
| Rate for Payer: AHCCCS Medicaid |
$5,412.00
|
| Rate for Payer: Allwell Medicaid |
$5,412.00
|
| Rate for Payer: AZCH Complete Medicaid |
$5,412.00
|
| Rate for Payer: Banner UC Health Medicaid |
$5,412.00
|
| Rate for Payer: Mercy Care Medicaid |
$5,412.00
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$5,412.00
|
|
|
Service Code
|
APR-DRG 0422
|
| Hospital Charge Code |
APRDRG0423
|
| Min. Negotiated Rate |
$5,412.00 |
| Max. Negotiated Rate |
$5,412.00 |
| Rate for Payer: AHCCCS Medicaid |
$5,412.00
|
| Rate for Payer: Allwell Medicaid |
$5,412.00
|
| Rate for Payer: AZCH Complete Medicaid |
$5,412.00
|
| Rate for Payer: Banner UC Health Medicaid |
$5,412.00
|
| Rate for Payer: Mercy Care Medicaid |
$5,412.00
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$4,510.70
|
|
|
Service Code
|
APR-DRG 0421
|
| Hospital Charge Code |
APRDRG0423
|
| Min. Negotiated Rate |
$4,510.70 |
| Max. Negotiated Rate |
$4,510.70 |
| Rate for Payer: AHCCCS Medicaid |
$4,510.70
|
| Rate for Payer: Allwell Medicaid |
$4,510.70
|
| Rate for Payer: AZCH Complete Medicaid |
$4,510.70
|
| Rate for Payer: Banner UC Health Medicaid |
$4,510.70
|
| Rate for Payer: Mercy Care Medicaid |
$4,510.70
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$8,202.87
|
|
|
Service Code
|
APR-DRG 0423
|
| Hospital Charge Code |
APRDRG0424
|
| Min. Negotiated Rate |
$8,202.87 |
| Max. Negotiated Rate |
$8,202.87 |
| Rate for Payer: AHCCCS Medicaid |
$8,202.87
|
| Rate for Payer: Allwell Medicaid |
$8,202.87
|
| Rate for Payer: AZCH Complete Medicaid |
$8,202.87
|
| Rate for Payer: Banner UC Health Medicaid |
$8,202.87
|
| Rate for Payer: Mercy Care Medicaid |
$8,202.87
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$17,275.48
|
|
|
Service Code
|
APR-DRG 0424
|
| Hospital Charge Code |
APRDRG0423
|
| Min. Negotiated Rate |
$17,275.48 |
| Max. Negotiated Rate |
$17,275.48 |
| Rate for Payer: AHCCCS Medicaid |
$17,275.48
|
| Rate for Payer: Allwell Medicaid |
$17,275.48
|
| Rate for Payer: AZCH Complete Medicaid |
$17,275.48
|
| Rate for Payer: Banner UC Health Medicaid |
$17,275.48
|
| Rate for Payer: Mercy Care Medicaid |
$17,275.48
|
|
|
Degenerative Nervous System Disorders Except Multiple Sclerosis
|
Facility
|
IP
|
$17,275.48
|
|
|
Service Code
|
APR-DRG 0424
|
| Hospital Charge Code |
APRDRG0422
|
| Min. Negotiated Rate |
$17,275.48 |
| Max. Negotiated Rate |
$17,275.48 |
| Rate for Payer: AHCCCS Medicaid |
$17,275.48
|
| Rate for Payer: Allwell Medicaid |
$17,275.48
|
| Rate for Payer: AZCH Complete Medicaid |
$17,275.48
|
| Rate for Payer: Banner UC Health Medicaid |
$17,275.48
|
| Rate for Payer: Mercy Care Medicaid |
$17,275.48
|
|
