|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$5,410.60
|
|
|
Service Code
|
APR-DRG 8922
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$5,410.60 |
| Max. Negotiated Rate |
$5,410.60 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,410.60
|
| Rate for Payer: Mercy Care Medicaid |
$5,410.60
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,410.60
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$5,410.60
|
|
|
Service Code
|
APR-DRG 8922
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$5,410.60 |
| Max. Negotiated Rate |
$5,410.60 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,410.60
|
| Rate for Payer: Mercy Care Medicaid |
$5,410.60
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,410.60
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8921
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,266.62
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$13,882.81
|
|
|
Service Code
|
APR-DRG 8924
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$13,882.81 |
| Max. Negotiated Rate |
$13,882.81 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,882.81
|
| Rate for Payer: Mercy Care Medicaid |
$13,882.81
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,882.81
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$8,022.61
|
|
|
Service Code
|
APR-DRG 8923
|
| Hospital Charge Code |
APRDRG8922
|
| Min. Negotiated Rate |
$8,022.61 |
| Max. Negotiated Rate |
$8,022.61 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,022.61
|
| Rate for Payer: Mercy Care Medicaid |
$8,022.61
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,022.61
|
|
|
Hiv With Major Hiv Related Condition
|
Facility
|
IP
|
$4,266.62
|
|
|
Service Code
|
APR-DRG 8921
|
| Hospital Charge Code |
APRDRG8924
|
| Min. Negotiated Rate |
$4,266.62 |
| Max. Negotiated Rate |
$4,266.62 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,266.62
|
| Rate for Payer: Mercy Care Medicaid |
$4,266.62
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,266.62
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$16,764.61
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$16,764.61 |
| Max. Negotiated Rate |
$16,764.61 |
| Rate for Payer: Seven Corners Travel Insurance |
$16,764.61
|
|
|
HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$37,299.06
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$37,299.06 |
| Max. Negotiated Rate |
$37,299.06 |
| Rate for Payer: Seven Corners Travel Insurance |
$37,299.06
|
|
|
HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$11,793.71
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$11,793.71 |
| Max. Negotiated Rate |
$11,793.71 |
| Rate for Payer: Seven Corners Travel Insurance |
$11,793.71
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$21,881.58
|
|
|
Service Code
|
APR-DRG 8904
|
| Hospital Charge Code |
APRDRG8904
|
| Min. Negotiated Rate |
$21,881.58 |
| Max. Negotiated Rate |
$21,881.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,881.58
|
| Rate for Payer: Mercy Care Medicaid |
$21,881.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,881.58
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$6,368.71
|
|
|
Service Code
|
APR-DRG 8902
|
| Hospital Charge Code |
APRDRG8901
|
| Min. Negotiated Rate |
$6,368.71 |
| Max. Negotiated Rate |
$6,368.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,368.71
|
| Rate for Payer: Mercy Care Medicaid |
$6,368.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,368.71
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$6,368.71
|
|
|
Service Code
|
APR-DRG 8902
|
| Hospital Charge Code |
APRDRG8904
|
| Min. Negotiated Rate |
$6,368.71 |
| Max. Negotiated Rate |
$6,368.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,368.71
|
| Rate for Payer: Mercy Care Medicaid |
$6,368.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,368.71
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$21,881.58
|
|
|
Service Code
|
APR-DRG 8904
|
| Hospital Charge Code |
APRDRG8901
|
| Min. Negotiated Rate |
$21,881.58 |
| Max. Negotiated Rate |
$21,881.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,881.58
|
| Rate for Payer: Mercy Care Medicaid |
$21,881.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,881.58
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$21,881.58
|
|
|
Service Code
|
APR-DRG 8904
|
| Hospital Charge Code |
APRDRG8902
|
| Min. Negotiated Rate |
$21,881.58 |
| Max. Negotiated Rate |
$21,881.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,881.58
|
| Rate for Payer: Mercy Care Medicaid |
$21,881.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,881.58
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$21,881.58
|
|
|
Service Code
|
APR-DRG 8904
|
| Hospital Charge Code |
APRDRG8903
|
| Min. Negotiated Rate |
$21,881.58 |
| Max. Negotiated Rate |
$21,881.58 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$21,881.58
|
| Rate for Payer: Mercy Care Medicaid |
$21,881.58
|
| Rate for Payer: NaphCare Correctional Healthcare |
$21,881.58
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$10,661.28
|
|
|
Service Code
|
APR-DRG 8903
|
| Hospital Charge Code |
APRDRG8901
|
| Min. Negotiated Rate |
$10,661.28 |
| Max. Negotiated Rate |
$10,661.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,661.28
|
| Rate for Payer: Mercy Care Medicaid |
$10,661.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,661.28
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$5,891.76
|
|
|
Service Code
|
APR-DRG 8901
|
| Hospital Charge Code |
APRDRG8904
|
| Min. Negotiated Rate |
$5,891.76 |
| Max. Negotiated Rate |
$5,891.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,891.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,891.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,891.76
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$6,368.71
|
|
|
Service Code
|
APR-DRG 8902
|
| Hospital Charge Code |
APRDRG8903
|
| Min. Negotiated Rate |
$6,368.71 |
| Max. Negotiated Rate |
$6,368.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,368.71
|
| Rate for Payer: Mercy Care Medicaid |
$6,368.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,368.71
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$5,891.76
|
|
|
Service Code
|
APR-DRG 8901
|
| Hospital Charge Code |
APRDRG8903
|
| Min. Negotiated Rate |
$5,891.76 |
| Max. Negotiated Rate |
$5,891.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,891.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,891.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,891.76
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$10,661.28
|
|
|
Service Code
|
APR-DRG 8903
|
| Hospital Charge Code |
APRDRG8902
|
| Min. Negotiated Rate |
$10,661.28 |
| Max. Negotiated Rate |
$10,661.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,661.28
|
| Rate for Payer: Mercy Care Medicaid |
$10,661.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,661.28
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$6,368.71
|
|
|
Service Code
|
APR-DRG 8902
|
| Hospital Charge Code |
APRDRG8902
|
| Min. Negotiated Rate |
$6,368.71 |
| Max. Negotiated Rate |
$6,368.71 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$6,368.71
|
| Rate for Payer: Mercy Care Medicaid |
$6,368.71
|
| Rate for Payer: NaphCare Correctional Healthcare |
$6,368.71
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$10,661.28
|
|
|
Service Code
|
APR-DRG 8903
|
| Hospital Charge Code |
APRDRG8903
|
| Min. Negotiated Rate |
$10,661.28 |
| Max. Negotiated Rate |
$10,661.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,661.28
|
| Rate for Payer: Mercy Care Medicaid |
$10,661.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,661.28
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$10,661.28
|
|
|
Service Code
|
APR-DRG 8903
|
| Hospital Charge Code |
APRDRG8904
|
| Min. Negotiated Rate |
$10,661.28 |
| Max. Negotiated Rate |
$10,661.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$10,661.28
|
| Rate for Payer: Mercy Care Medicaid |
$10,661.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$10,661.28
|
|
|
Hiv With Multiple Major Hiv Related Conditions
|
Facility
|
IP
|
$5,891.76
|
|
|
Service Code
|
APR-DRG 8901
|
| Hospital Charge Code |
APRDRG8902
|
| Min. Negotiated Rate |
$5,891.76 |
| Max. Negotiated Rate |
$5,891.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,891.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,891.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,891.76
|
|
