|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$10,993.74
|
|
|
Service Code
|
APR-DRG 0891
|
| Hospital Charge Code |
APRDRG0893
|
| Min. Negotiated Rate |
$10,993.74 |
| Max. Negotiated Rate |
$10,993.74 |
| Rate for Payer: AHCCCS Medicaid |
$10,993.74
|
| Rate for Payer: Allwell Medicaid |
$10,993.74
|
| Rate for Payer: AZCH Complete Medicaid |
$10,993.74
|
| Rate for Payer: Banner UC Health Medicaid |
$10,993.74
|
| Rate for Payer: Mercy Care Medicaid |
$10,993.74
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$25,246.89
|
|
|
Service Code
|
APR-DRG 0893
|
| Hospital Charge Code |
APRDRG0892
|
| Min. Negotiated Rate |
$25,246.89 |
| Max. Negotiated Rate |
$25,246.89 |
| Rate for Payer: AHCCCS Medicaid |
$25,246.89
|
| Rate for Payer: Allwell Medicaid |
$25,246.89
|
| Rate for Payer: AZCH Complete Medicaid |
$25,246.89
|
| Rate for Payer: Banner UC Health Medicaid |
$25,246.89
|
| Rate for Payer: Mercy Care Medicaid |
$25,246.89
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$42,543.42
|
|
|
Service Code
|
APR-DRG 0894
|
| Hospital Charge Code |
APRDRG0893
|
| Min. Negotiated Rate |
$42,543.42 |
| Max. Negotiated Rate |
$42,543.42 |
| Rate for Payer: AHCCCS Medicaid |
$42,543.42
|
| Rate for Payer: Allwell Medicaid |
$42,543.42
|
| Rate for Payer: AZCH Complete Medicaid |
$42,543.42
|
| Rate for Payer: Banner UC Health Medicaid |
$42,543.42
|
| Rate for Payer: Mercy Care Medicaid |
$42,543.42
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$14,373.09
|
|
|
Service Code
|
APR-DRG 0892
|
| Hospital Charge Code |
APRDRG0891
|
| Min. Negotiated Rate |
$14,373.09 |
| Max. Negotiated Rate |
$14,373.09 |
| Rate for Payer: AHCCCS Medicaid |
$14,373.09
|
| Rate for Payer: Allwell Medicaid |
$14,373.09
|
| Rate for Payer: AZCH Complete Medicaid |
$14,373.09
|
| Rate for Payer: Banner UC Health Medicaid |
$14,373.09
|
| Rate for Payer: Mercy Care Medicaid |
$14,373.09
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$42,543.42
|
|
|
Service Code
|
APR-DRG 0894
|
| Hospital Charge Code |
APRDRG0892
|
| Min. Negotiated Rate |
$42,543.42 |
| Max. Negotiated Rate |
$42,543.42 |
| Rate for Payer: AHCCCS Medicaid |
$42,543.42
|
| Rate for Payer: Allwell Medicaid |
$42,543.42
|
| Rate for Payer: AZCH Complete Medicaid |
$42,543.42
|
| Rate for Payer: Banner UC Health Medicaid |
$42,543.42
|
| Rate for Payer: Mercy Care Medicaid |
$42,543.42
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$25,246.89
|
|
|
Service Code
|
APR-DRG 0893
|
| Hospital Charge Code |
APRDRG0891
|
| Min. Negotiated Rate |
$25,246.89 |
| Max. Negotiated Rate |
$25,246.89 |
| Rate for Payer: AHCCCS Medicaid |
$25,246.89
|
| Rate for Payer: Allwell Medicaid |
$25,246.89
|
| Rate for Payer: AZCH Complete Medicaid |
$25,246.89
|
| Rate for Payer: Banner UC Health Medicaid |
$25,246.89
|
| Rate for Payer: Mercy Care Medicaid |
$25,246.89
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$14,373.09
|
|
|
Service Code
|
APR-DRG 0892
|
| Hospital Charge Code |
APRDRG0892
|
| Min. Negotiated Rate |
$14,373.09 |
| Max. Negotiated Rate |
$14,373.09 |
| Rate for Payer: AHCCCS Medicaid |
$14,373.09
|
| Rate for Payer: Allwell Medicaid |
$14,373.09
|
| Rate for Payer: AZCH Complete Medicaid |
$14,373.09
|
| Rate for Payer: Banner UC Health Medicaid |
$14,373.09
|
| Rate for Payer: Mercy Care Medicaid |
$14,373.09
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$10,993.74
|
|
|
Service Code
|
APR-DRG 0891
|
| Hospital Charge Code |
APRDRG0892
|
| Min. Negotiated Rate |
$10,993.74 |
| Max. Negotiated Rate |
$10,993.74 |
| Rate for Payer: AHCCCS Medicaid |
$10,993.74
|
| Rate for Payer: Allwell Medicaid |
$10,993.74
|
| Rate for Payer: AZCH Complete Medicaid |
$10,993.74
|
| Rate for Payer: Banner UC Health Medicaid |
$10,993.74
|
| Rate for Payer: Mercy Care Medicaid |
$10,993.74
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$25,246.89
|
|
|
Service Code
|
APR-DRG 0893
|
| Hospital Charge Code |
APRDRG0894
|
| Min. Negotiated Rate |
$25,246.89 |
| Max. Negotiated Rate |
$25,246.89 |
| Rate for Payer: AHCCCS Medicaid |
$25,246.89
|
| Rate for Payer: Allwell Medicaid |
$25,246.89
|
| Rate for Payer: AZCH Complete Medicaid |
$25,246.89
|
| Rate for Payer: Banner UC Health Medicaid |
$25,246.89
|
| Rate for Payer: Mercy Care Medicaid |
$25,246.89
|
|
|
Major Cranial Or Facial Bone Procedures
|
Facility
|
IP
|
$42,543.42
|
|
|
Service Code
|
APR-DRG 0894
|
| Hospital Charge Code |
APRDRG0894
|
| Min. Negotiated Rate |
$42,543.42 |
| Max. Negotiated Rate |
$42,543.42 |
| Rate for Payer: AHCCCS Medicaid |
$42,543.42
|
| Rate for Payer: Allwell Medicaid |
$42,543.42
|
| Rate for Payer: AZCH Complete Medicaid |
$42,543.42
|
| Rate for Payer: Banner UC Health Medicaid |
$42,543.42
|
| Rate for Payer: Mercy Care Medicaid |
$42,543.42
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$6,587.55
|
|
|
Service Code
|
APR-DRG 7513
|
| Hospital Charge Code |
APRDRG7511
|
| Min. Negotiated Rate |
$6,587.55 |
| Max. Negotiated Rate |
$6,587.55 |
| Rate for Payer: AHCCCS Medicaid |
$6,587.55
|
| Rate for Payer: Allwell Medicaid |
$6,587.55
|
| Rate for Payer: AZCH Complete Medicaid |
$6,587.55
|
| Rate for Payer: Banner UC Health Medicaid |
$6,587.55
|
| Rate for Payer: Mercy Care Medicaid |
$6,587.55
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$6,587.55
|
|
|
Service Code
|
APR-DRG 7513
|
| Hospital Charge Code |
APRDRG7512
|
| Min. Negotiated Rate |
$6,587.55 |
| Max. Negotiated Rate |
$6,587.55 |
| Rate for Payer: AHCCCS Medicaid |
$6,587.55
|
| Rate for Payer: Allwell Medicaid |
$6,587.55
|
| Rate for Payer: AZCH Complete Medicaid |
$6,587.55
|
| Rate for Payer: Banner UC Health Medicaid |
$6,587.55
|
| Rate for Payer: Mercy Care Medicaid |
$6,587.55
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$2,408.61
|
|
|
Service Code
|
APR-DRG 7511
|
| Hospital Charge Code |
APRDRG7512
|
| Min. Negotiated Rate |
$2,408.61 |
| Max. Negotiated Rate |
$2,408.61 |
| Rate for Payer: AHCCCS Medicaid |
$2,408.61
|
| Rate for Payer: Allwell Medicaid |
$2,408.61
|
| Rate for Payer: AZCH Complete Medicaid |
$2,408.61
|
| Rate for Payer: Banner UC Health Medicaid |
$2,408.61
|
| Rate for Payer: Mercy Care Medicaid |
$2,408.61
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$3,351.29
|
|
|
Service Code
|
APR-DRG 7512
|
| Hospital Charge Code |
APRDRG7512
|
| Min. Negotiated Rate |
$3,351.29 |
| Max. Negotiated Rate |
$3,351.29 |
| Rate for Payer: AHCCCS Medicaid |
$3,351.29
|
| Rate for Payer: Allwell Medicaid |
$3,351.29
|
| Rate for Payer: AZCH Complete Medicaid |
$3,351.29
|
| Rate for Payer: Banner UC Health Medicaid |
$3,351.29
|
| Rate for Payer: Mercy Care Medicaid |
$3,351.29
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$3,351.29
|
|
|
Service Code
|
APR-DRG 7512
|
| Hospital Charge Code |
APRDRG7511
|
| Min. Negotiated Rate |
$3,351.29 |
| Max. Negotiated Rate |
$3,351.29 |
| Rate for Payer: AHCCCS Medicaid |
$3,351.29
|
| Rate for Payer: Allwell Medicaid |
$3,351.29
|
| Rate for Payer: AZCH Complete Medicaid |
$3,351.29
|
| Rate for Payer: Banner UC Health Medicaid |
$3,351.29
|
| Rate for Payer: Mercy Care Medicaid |
$3,351.29
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$12,135.62
|
|
|
Service Code
|
APR-DRG 7514
|
| Hospital Charge Code |
APRDRG7513
|
| Min. Negotiated Rate |
$12,135.62 |
| Max. Negotiated Rate |
$12,135.62 |
| Rate for Payer: AHCCCS Medicaid |
$12,135.62
|
| Rate for Payer: Allwell Medicaid |
$12,135.62
|
| Rate for Payer: AZCH Complete Medicaid |
$12,135.62
|
| Rate for Payer: Banner UC Health Medicaid |
$12,135.62
|
| Rate for Payer: Mercy Care Medicaid |
$12,135.62
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$3,351.29
|
|
|
Service Code
|
APR-DRG 7512
|
| Hospital Charge Code |
APRDRG7513
|
| Min. Negotiated Rate |
$3,351.29 |
| Max. Negotiated Rate |
$3,351.29 |
| Rate for Payer: AHCCCS Medicaid |
$3,351.29
|
| Rate for Payer: Allwell Medicaid |
$3,351.29
|
| Rate for Payer: AZCH Complete Medicaid |
$3,351.29
|
| Rate for Payer: Banner UC Health Medicaid |
$3,351.29
|
| Rate for Payer: Mercy Care Medicaid |
$3,351.29
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$3,351.29
|
|
|
Service Code
|
APR-DRG 7512
|
| Hospital Charge Code |
APRDRG7514
|
| Min. Negotiated Rate |
$3,351.29 |
| Max. Negotiated Rate |
$3,351.29 |
| Rate for Payer: AHCCCS Medicaid |
$3,351.29
|
| Rate for Payer: Allwell Medicaid |
$3,351.29
|
| Rate for Payer: AZCH Complete Medicaid |
$3,351.29
|
| Rate for Payer: Banner UC Health Medicaid |
$3,351.29
|
| Rate for Payer: Mercy Care Medicaid |
$3,351.29
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$12,135.62
|
|
|
Service Code
|
APR-DRG 7514
|
| Hospital Charge Code |
APRDRG7512
|
| Min. Negotiated Rate |
$12,135.62 |
| Max. Negotiated Rate |
$12,135.62 |
| Rate for Payer: AHCCCS Medicaid |
$12,135.62
|
| Rate for Payer: Allwell Medicaid |
$12,135.62
|
| Rate for Payer: AZCH Complete Medicaid |
$12,135.62
|
| Rate for Payer: Banner UC Health Medicaid |
$12,135.62
|
| Rate for Payer: Mercy Care Medicaid |
$12,135.62
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$2,408.61
|
|
|
Service Code
|
APR-DRG 7511
|
| Hospital Charge Code |
APRDRG7513
|
| Min. Negotiated Rate |
$2,408.61 |
| Max. Negotiated Rate |
$2,408.61 |
| Rate for Payer: AHCCCS Medicaid |
$2,408.61
|
| Rate for Payer: Allwell Medicaid |
$2,408.61
|
| Rate for Payer: AZCH Complete Medicaid |
$2,408.61
|
| Rate for Payer: Banner UC Health Medicaid |
$2,408.61
|
| Rate for Payer: Mercy Care Medicaid |
$2,408.61
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$6,587.55
|
|
|
Service Code
|
APR-DRG 7513
|
| Hospital Charge Code |
APRDRG7513
|
| Min. Negotiated Rate |
$6,587.55 |
| Max. Negotiated Rate |
$6,587.55 |
| Rate for Payer: AHCCCS Medicaid |
$6,587.55
|
| Rate for Payer: Allwell Medicaid |
$6,587.55
|
| Rate for Payer: AZCH Complete Medicaid |
$6,587.55
|
| Rate for Payer: Banner UC Health Medicaid |
$6,587.55
|
| Rate for Payer: Mercy Care Medicaid |
$6,587.55
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$2,408.61
|
|
|
Service Code
|
APR-DRG 7511
|
| Hospital Charge Code |
APRDRG7514
|
| Min. Negotiated Rate |
$2,408.61 |
| Max. Negotiated Rate |
$2,408.61 |
| Rate for Payer: AHCCCS Medicaid |
$2,408.61
|
| Rate for Payer: Allwell Medicaid |
$2,408.61
|
| Rate for Payer: AZCH Complete Medicaid |
$2,408.61
|
| Rate for Payer: Banner UC Health Medicaid |
$2,408.61
|
| Rate for Payer: Mercy Care Medicaid |
$2,408.61
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$2,408.61
|
|
|
Service Code
|
APR-DRG 7511
|
| Hospital Charge Code |
APRDRG7511
|
| Min. Negotiated Rate |
$2,408.61 |
| Max. Negotiated Rate |
$2,408.61 |
| Rate for Payer: AHCCCS Medicaid |
$2,408.61
|
| Rate for Payer: Allwell Medicaid |
$2,408.61
|
| Rate for Payer: AZCH Complete Medicaid |
$2,408.61
|
| Rate for Payer: Banner UC Health Medicaid |
$2,408.61
|
| Rate for Payer: Mercy Care Medicaid |
$2,408.61
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$12,135.62
|
|
|
Service Code
|
APR-DRG 7514
|
| Hospital Charge Code |
APRDRG7514
|
| Min. Negotiated Rate |
$12,135.62 |
| Max. Negotiated Rate |
$12,135.62 |
| Rate for Payer: AHCCCS Medicaid |
$12,135.62
|
| Rate for Payer: Allwell Medicaid |
$12,135.62
|
| Rate for Payer: AZCH Complete Medicaid |
$12,135.62
|
| Rate for Payer: Banner UC Health Medicaid |
$12,135.62
|
| Rate for Payer: Mercy Care Medicaid |
$12,135.62
|
|
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
Facility
|
IP
|
$6,587.55
|
|
|
Service Code
|
APR-DRG 7513
|
| Hospital Charge Code |
APRDRG7514
|
| Min. Negotiated Rate |
$6,587.55 |
| Max. Negotiated Rate |
$6,587.55 |
| Rate for Payer: AHCCCS Medicaid |
$6,587.55
|
| Rate for Payer: Allwell Medicaid |
$6,587.55
|
| Rate for Payer: AZCH Complete Medicaid |
$6,587.55
|
| Rate for Payer: Banner UC Health Medicaid |
$6,587.55
|
| Rate for Payer: Mercy Care Medicaid |
$6,587.55
|
|
