|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$6,902.48
|
|
|
Service Code
|
APR-DRG 8432
|
| Hospital Charge Code |
APRDRG8432
|
| Min. Negotiated Rate |
$6,902.48 |
| Max. Negotiated Rate |
$6,902.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,902.48
|
| Rate for Payer: Allwell Medicaid |
$6,902.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,902.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,902.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,902.48
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$6,902.48
|
|
|
Service Code
|
APR-DRG 8432
|
| Hospital Charge Code |
APRDRG8434
|
| Min. Negotiated Rate |
$6,902.48 |
| Max. Negotiated Rate |
$6,902.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,902.48
|
| Rate for Payer: Allwell Medicaid |
$6,902.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,902.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,902.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,902.48
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$9,698.96
|
|
|
Service Code
|
APR-DRG 8433
|
| Hospital Charge Code |
APRDRG8431
|
| Min. Negotiated Rate |
$9,698.96 |
| Max. Negotiated Rate |
$9,698.96 |
| Rate for Payer: AHCCCS Medicaid |
$9,698.96
|
| Rate for Payer: Allwell Medicaid |
$9,698.96
|
| Rate for Payer: AZCH Complete Medicaid |
$9,698.96
|
| Rate for Payer: Banner UC Health Medicaid |
$9,698.96
|
| Rate for Payer: Mercy Care Medicaid |
$9,698.96
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$9,698.96
|
|
|
Service Code
|
APR-DRG 8433
|
| Hospital Charge Code |
APRDRG8434
|
| Min. Negotiated Rate |
$9,698.96 |
| Max. Negotiated Rate |
$9,698.96 |
| Rate for Payer: AHCCCS Medicaid |
$9,698.96
|
| Rate for Payer: Allwell Medicaid |
$9,698.96
|
| Rate for Payer: AZCH Complete Medicaid |
$9,698.96
|
| Rate for Payer: Banner UC Health Medicaid |
$9,698.96
|
| Rate for Payer: Mercy Care Medicaid |
$9,698.96
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$4,065.31
|
|
|
Service Code
|
APR-DRG 8431
|
| Hospital Charge Code |
APRDRG8434
|
| Min. Negotiated Rate |
$4,065.31 |
| Max. Negotiated Rate |
$4,065.31 |
| Rate for Payer: AHCCCS Medicaid |
$4,065.31
|
| Rate for Payer: Allwell Medicaid |
$4,065.31
|
| Rate for Payer: AZCH Complete Medicaid |
$4,065.31
|
| Rate for Payer: Banner UC Health Medicaid |
$4,065.31
|
| Rate for Payer: Mercy Care Medicaid |
$4,065.31
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$6,902.48
|
|
|
Service Code
|
APR-DRG 8432
|
| Hospital Charge Code |
APRDRG8431
|
| Min. Negotiated Rate |
$6,902.48 |
| Max. Negotiated Rate |
$6,902.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,902.48
|
| Rate for Payer: Allwell Medicaid |
$6,902.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,902.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,902.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,902.48
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$4,065.31
|
|
|
Service Code
|
APR-DRG 8431
|
| Hospital Charge Code |
APRDRG8432
|
| Min. Negotiated Rate |
$4,065.31 |
| Max. Negotiated Rate |
$4,065.31 |
| Rate for Payer: AHCCCS Medicaid |
$4,065.31
|
| Rate for Payer: Allwell Medicaid |
$4,065.31
|
| Rate for Payer: AZCH Complete Medicaid |
$4,065.31
|
| Rate for Payer: Banner UC Health Medicaid |
$4,065.31
|
| Rate for Payer: Mercy Care Medicaid |
$4,065.31
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$35,683.02
|
|
|
Service Code
|
APR-DRG 8434
|
| Hospital Charge Code |
APRDRG8432
|
| Min. Negotiated Rate |
$35,683.02 |
| Max. Negotiated Rate |
$35,683.02 |
| Rate for Payer: AHCCCS Medicaid |
$35,683.02
|
| Rate for Payer: Allwell Medicaid |
$35,683.02
|
| Rate for Payer: AZCH Complete Medicaid |
$35,683.02
|
| Rate for Payer: Banner UC Health Medicaid |
$35,683.02
|
| Rate for Payer: Mercy Care Medicaid |
$35,683.02
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$4,065.31
|
|
|
Service Code
|
APR-DRG 8431
|
| Hospital Charge Code |
APRDRG8433
|
| Min. Negotiated Rate |
$4,065.31 |
| Max. Negotiated Rate |
$4,065.31 |
| Rate for Payer: AHCCCS Medicaid |
$4,065.31
|
| Rate for Payer: Allwell Medicaid |
$4,065.31
|
| Rate for Payer: AZCH Complete Medicaid |
$4,065.31
|
| Rate for Payer: Banner UC Health Medicaid |
$4,065.31
|
| Rate for Payer: Mercy Care Medicaid |
$4,065.31
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$35,683.02
|
|
|
Service Code
|
APR-DRG 8434
|
| Hospital Charge Code |
APRDRG8433
|
| Min. Negotiated Rate |
$35,683.02 |
| Max. Negotiated Rate |
$35,683.02 |
| Rate for Payer: AHCCCS Medicaid |
$35,683.02
|
| Rate for Payer: Allwell Medicaid |
$35,683.02
|
| Rate for Payer: AZCH Complete Medicaid |
$35,683.02
|
| Rate for Payer: Banner UC Health Medicaid |
$35,683.02
|
| Rate for Payer: Mercy Care Medicaid |
$35,683.02
|
|
|
Extensive Third Degree Burns Without Skin Graft
|
Facility
|
IP
|
$9,698.96
|
|
|
Service Code
|
APR-DRG 8433
|
| Hospital Charge Code |
APRDRG8432
|
| Min. Negotiated Rate |
$9,698.96 |
| Max. Negotiated Rate |
$9,698.96 |
| Rate for Payer: AHCCCS Medicaid |
$9,698.96
|
| Rate for Payer: Allwell Medicaid |
$9,698.96
|
| Rate for Payer: AZCH Complete Medicaid |
$9,698.96
|
| Rate for Payer: Banner UC Health Medicaid |
$9,698.96
|
| Rate for Payer: Mercy Care Medicaid |
$9,698.96
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8412
|
| Hospital Charge Code |
APRDRG8414
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8412
|
| Hospital Charge Code |
APRDRG8412
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8411
|
| Hospital Charge Code |
APRDRG8411
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8412
|
| Hospital Charge Code |
APRDRG8413
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$144,168.56
|
|
|
Service Code
|
APR-DRG 8414
|
| Hospital Charge Code |
APRDRG8412
|
| Min. Negotiated Rate |
$144,168.56 |
| Max. Negotiated Rate |
$144,168.56 |
| Rate for Payer: AHCCCS Medicaid |
$144,168.56
|
| Rate for Payer: Allwell Medicaid |
$144,168.56
|
| Rate for Payer: AZCH Complete Medicaid |
$144,168.56
|
| Rate for Payer: Banner UC Health Medicaid |
$144,168.56
|
| Rate for Payer: Mercy Care Medicaid |
$144,168.56
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8412
|
| Hospital Charge Code |
APRDRG8411
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$57,269.31
|
|
|
Service Code
|
APR-DRG 8413
|
| Hospital Charge Code |
APRDRG8413
|
| Min. Negotiated Rate |
$57,269.31 |
| Max. Negotiated Rate |
$57,269.31 |
| Rate for Payer: AHCCCS Medicaid |
$57,269.31
|
| Rate for Payer: Allwell Medicaid |
$57,269.31
|
| Rate for Payer: AZCH Complete Medicaid |
$57,269.31
|
| Rate for Payer: Banner UC Health Medicaid |
$57,269.31
|
| Rate for Payer: Mercy Care Medicaid |
$57,269.31
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$57,269.31
|
|
|
Service Code
|
APR-DRG 8413
|
| Hospital Charge Code |
APRDRG8412
|
| Min. Negotiated Rate |
$57,269.31 |
| Max. Negotiated Rate |
$57,269.31 |
| Rate for Payer: AHCCCS Medicaid |
$57,269.31
|
| Rate for Payer: Allwell Medicaid |
$57,269.31
|
| Rate for Payer: AZCH Complete Medicaid |
$57,269.31
|
| Rate for Payer: Banner UC Health Medicaid |
$57,269.31
|
| Rate for Payer: Mercy Care Medicaid |
$57,269.31
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$144,168.56
|
|
|
Service Code
|
APR-DRG 8414
|
| Hospital Charge Code |
APRDRG8414
|
| Min. Negotiated Rate |
$144,168.56 |
| Max. Negotiated Rate |
$144,168.56 |
| Rate for Payer: AHCCCS Medicaid |
$144,168.56
|
| Rate for Payer: Allwell Medicaid |
$144,168.56
|
| Rate for Payer: AZCH Complete Medicaid |
$144,168.56
|
| Rate for Payer: Banner UC Health Medicaid |
$144,168.56
|
| Rate for Payer: Mercy Care Medicaid |
$144,168.56
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8411
|
| Hospital Charge Code |
APRDRG8413
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$144,168.56
|
|
|
Service Code
|
APR-DRG 8414
|
| Hospital Charge Code |
APRDRG8411
|
| Min. Negotiated Rate |
$144,168.56 |
| Max. Negotiated Rate |
$144,168.56 |
| Rate for Payer: AHCCCS Medicaid |
$144,168.56
|
| Rate for Payer: Allwell Medicaid |
$144,168.56
|
| Rate for Payer: AZCH Complete Medicaid |
$144,168.56
|
| Rate for Payer: Banner UC Health Medicaid |
$144,168.56
|
| Rate for Payer: Mercy Care Medicaid |
$144,168.56
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$57,269.31
|
|
|
Service Code
|
APR-DRG 8413
|
| Hospital Charge Code |
APRDRG8411
|
| Min. Negotiated Rate |
$57,269.31 |
| Max. Negotiated Rate |
$57,269.31 |
| Rate for Payer: AHCCCS Medicaid |
$57,269.31
|
| Rate for Payer: Allwell Medicaid |
$57,269.31
|
| Rate for Payer: AZCH Complete Medicaid |
$57,269.31
|
| Rate for Payer: Banner UC Health Medicaid |
$57,269.31
|
| Rate for Payer: Mercy Care Medicaid |
$57,269.31
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$57,269.31
|
|
|
Service Code
|
APR-DRG 8413
|
| Hospital Charge Code |
APRDRG8414
|
| Min. Negotiated Rate |
$57,269.31 |
| Max. Negotiated Rate |
$57,269.31 |
| Rate for Payer: AHCCCS Medicaid |
$57,269.31
|
| Rate for Payer: Allwell Medicaid |
$57,269.31
|
| Rate for Payer: AZCH Complete Medicaid |
$57,269.31
|
| Rate for Payer: Banner UC Health Medicaid |
$57,269.31
|
| Rate for Payer: Mercy Care Medicaid |
$57,269.31
|
|
|
Extensive Third Degree Burns With Skin Graft
|
Facility
|
IP
|
$37,216.28
|
|
|
Service Code
|
APR-DRG 8411
|
| Hospital Charge Code |
APRDRG8414
|
| Min. Negotiated Rate |
$37,216.28 |
| Max. Negotiated Rate |
$37,216.28 |
| Rate for Payer: AHCCCS Medicaid |
$37,216.28
|
| Rate for Payer: Allwell Medicaid |
$37,216.28
|
| Rate for Payer: AZCH Complete Medicaid |
$37,216.28
|
| Rate for Payer: Banner UC Health Medicaid |
$37,216.28
|
| Rate for Payer: Mercy Care Medicaid |
$37,216.28
|
|
