|
Major Esophageal Disorders
|
Facility
|
IP
|
$3,730.05
|
|
|
Service Code
|
APR-DRG 2421
|
| Hospital Charge Code |
APRDRG2424
|
| Min. Negotiated Rate |
$3,730.05 |
| Max. Negotiated Rate |
$3,730.05 |
| Rate for Payer: AHCCCS Medicaid |
$3,730.05
|
| Rate for Payer: Allwell Medicaid |
$3,730.05
|
| Rate for Payer: AZCH Complete Medicaid |
$3,730.05
|
| Rate for Payer: Banner UC Health Medicaid |
$3,730.05
|
| Rate for Payer: Mercy Care Medicaid |
$3,730.05
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$4,775.13
|
|
|
Service Code
|
APR-DRG 2422
|
| Hospital Charge Code |
APRDRG2423
|
| Min. Negotiated Rate |
$4,775.13 |
| Max. Negotiated Rate |
$4,775.13 |
| Rate for Payer: AHCCCS Medicaid |
$4,775.13
|
| Rate for Payer: Allwell Medicaid |
$4,775.13
|
| Rate for Payer: AZCH Complete Medicaid |
$4,775.13
|
| Rate for Payer: Banner UC Health Medicaid |
$4,775.13
|
| Rate for Payer: Mercy Care Medicaid |
$4,775.13
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$6,946.67
|
|
|
Service Code
|
APR-DRG 2423
|
| Hospital Charge Code |
APRDRG2423
|
| Min. Negotiated Rate |
$6,946.67 |
| Max. Negotiated Rate |
$6,946.67 |
| Rate for Payer: AHCCCS Medicaid |
$6,946.67
|
| Rate for Payer: Allwell Medicaid |
$6,946.67
|
| Rate for Payer: AZCH Complete Medicaid |
$6,946.67
|
| Rate for Payer: Banner UC Health Medicaid |
$6,946.67
|
| Rate for Payer: Mercy Care Medicaid |
$6,946.67
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$4,775.13
|
|
|
Service Code
|
APR-DRG 2422
|
| Hospital Charge Code |
APRDRG2424
|
| Min. Negotiated Rate |
$4,775.13 |
| Max. Negotiated Rate |
$4,775.13 |
| Rate for Payer: AHCCCS Medicaid |
$4,775.13
|
| Rate for Payer: Allwell Medicaid |
$4,775.13
|
| Rate for Payer: AZCH Complete Medicaid |
$4,775.13
|
| Rate for Payer: Banner UC Health Medicaid |
$4,775.13
|
| Rate for Payer: Mercy Care Medicaid |
$4,775.13
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$3,730.05
|
|
|
Service Code
|
APR-DRG 2421
|
| Hospital Charge Code |
APRDRG2421
|
| Min. Negotiated Rate |
$3,730.05 |
| Max. Negotiated Rate |
$3,730.05 |
| Rate for Payer: AHCCCS Medicaid |
$3,730.05
|
| Rate for Payer: Allwell Medicaid |
$3,730.05
|
| Rate for Payer: AZCH Complete Medicaid |
$3,730.05
|
| Rate for Payer: Banner UC Health Medicaid |
$3,730.05
|
| Rate for Payer: Mercy Care Medicaid |
$3,730.05
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$6,946.67
|
|
|
Service Code
|
APR-DRG 2423
|
| Hospital Charge Code |
APRDRG2422
|
| Min. Negotiated Rate |
$6,946.67 |
| Max. Negotiated Rate |
$6,946.67 |
| Rate for Payer: AHCCCS Medicaid |
$6,946.67
|
| Rate for Payer: Allwell Medicaid |
$6,946.67
|
| Rate for Payer: AZCH Complete Medicaid |
$6,946.67
|
| Rate for Payer: Banner UC Health Medicaid |
$6,946.67
|
| Rate for Payer: Mercy Care Medicaid |
$6,946.67
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$3,730.05
|
|
|
Service Code
|
APR-DRG 2421
|
| Hospital Charge Code |
APRDRG2422
|
| Min. Negotiated Rate |
$3,730.05 |
| Max. Negotiated Rate |
$3,730.05 |
| Rate for Payer: AHCCCS Medicaid |
$3,730.05
|
| Rate for Payer: Allwell Medicaid |
$3,730.05
|
| Rate for Payer: AZCH Complete Medicaid |
$3,730.05
|
| Rate for Payer: Banner UC Health Medicaid |
$3,730.05
|
| Rate for Payer: Mercy Care Medicaid |
$3,730.05
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$6,946.67
|
|
|
Service Code
|
APR-DRG 2423
|
| Hospital Charge Code |
APRDRG2421
|
| Min. Negotiated Rate |
$6,946.67 |
| Max. Negotiated Rate |
$6,946.67 |
| Rate for Payer: AHCCCS Medicaid |
$6,946.67
|
| Rate for Payer: Allwell Medicaid |
$6,946.67
|
| Rate for Payer: AZCH Complete Medicaid |
$6,946.67
|
| Rate for Payer: Banner UC Health Medicaid |
$6,946.67
|
| Rate for Payer: Mercy Care Medicaid |
$6,946.67
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$16,215.67
|
|
|
Service Code
|
APR-DRG 2424
|
| Hospital Charge Code |
APRDRG2421
|
| Min. Negotiated Rate |
$16,215.67 |
| Max. Negotiated Rate |
$16,215.67 |
| Rate for Payer: AHCCCS Medicaid |
$16,215.67
|
| Rate for Payer: Allwell Medicaid |
$16,215.67
|
| Rate for Payer: AZCH Complete Medicaid |
$16,215.67
|
| Rate for Payer: Banner UC Health Medicaid |
$16,215.67
|
| Rate for Payer: Mercy Care Medicaid |
$16,215.67
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$16,215.67
|
|
|
Service Code
|
APR-DRG 2424
|
| Hospital Charge Code |
APRDRG2424
|
| Min. Negotiated Rate |
$16,215.67 |
| Max. Negotiated Rate |
$16,215.67 |
| Rate for Payer: AHCCCS Medicaid |
$16,215.67
|
| Rate for Payer: Allwell Medicaid |
$16,215.67
|
| Rate for Payer: AZCH Complete Medicaid |
$16,215.67
|
| Rate for Payer: Banner UC Health Medicaid |
$16,215.67
|
| Rate for Payer: Mercy Care Medicaid |
$16,215.67
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$3,730.05
|
|
|
Service Code
|
APR-DRG 2421
|
| Hospital Charge Code |
APRDRG2423
|
| Min. Negotiated Rate |
$3,730.05 |
| Max. Negotiated Rate |
$3,730.05 |
| Rate for Payer: AHCCCS Medicaid |
$3,730.05
|
| Rate for Payer: Allwell Medicaid |
$3,730.05
|
| Rate for Payer: AZCH Complete Medicaid |
$3,730.05
|
| Rate for Payer: Banner UC Health Medicaid |
$3,730.05
|
| Rate for Payer: Mercy Care Medicaid |
$3,730.05
|
|
|
Major Esophageal Disorders
|
Facility
|
IP
|
$4,775.13
|
|
|
Service Code
|
APR-DRG 2422
|
| Hospital Charge Code |
APRDRG2422
|
| Min. Negotiated Rate |
$4,775.13 |
| Max. Negotiated Rate |
$4,775.13 |
| Rate for Payer: AHCCCS Medicaid |
$4,775.13
|
| Rate for Payer: Allwell Medicaid |
$4,775.13
|
| Rate for Payer: AZCH Complete Medicaid |
$4,775.13
|
| Rate for Payer: Banner UC Health Medicaid |
$4,775.13
|
| Rate for Payer: Mercy Care Medicaid |
$4,775.13
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$13,927.00
|
|
|
Service Code
|
APR-DRG 2484
|
| Hospital Charge Code |
APRDRG2484
|
| Min. Negotiated Rate |
$13,927.00 |
| Max. Negotiated Rate |
$13,927.00 |
| Rate for Payer: AHCCCS Medicaid |
$13,927.00
|
| Rate for Payer: Allwell Medicaid |
$13,927.00
|
| Rate for Payer: AZCH Complete Medicaid |
$13,927.00
|
| Rate for Payer: Banner UC Health Medicaid |
$13,927.00
|
| Rate for Payer: Mercy Care Medicaid |
$13,927.00
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$4,683.95
|
|
|
Service Code
|
APR-DRG 2482
|
| Hospital Charge Code |
APRDRG2484
|
| Min. Negotiated Rate |
$4,683.95 |
| Max. Negotiated Rate |
$4,683.95 |
| Rate for Payer: AHCCCS Medicaid |
$4,683.95
|
| Rate for Payer: Allwell Medicaid |
$4,683.95
|
| Rate for Payer: AZCH Complete Medicaid |
$4,683.95
|
| Rate for Payer: Banner UC Health Medicaid |
$4,683.95
|
| Rate for Payer: Mercy Care Medicaid |
$4,683.95
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$4,683.95
|
|
|
Service Code
|
APR-DRG 2482
|
| Hospital Charge Code |
APRDRG2482
|
| Min. Negotiated Rate |
$4,683.95 |
| Max. Negotiated Rate |
$4,683.95 |
| Rate for Payer: AHCCCS Medicaid |
$4,683.95
|
| Rate for Payer: Allwell Medicaid |
$4,683.95
|
| Rate for Payer: AZCH Complete Medicaid |
$4,683.95
|
| Rate for Payer: Banner UC Health Medicaid |
$4,683.95
|
| Rate for Payer: Mercy Care Medicaid |
$4,683.95
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$7,124.12
|
|
|
Service Code
|
APR-DRG 2483
|
| Hospital Charge Code |
APRDRG2482
|
| Min. Negotiated Rate |
$7,124.12 |
| Max. Negotiated Rate |
$7,124.12 |
| Rate for Payer: AHCCCS Medicaid |
$7,124.12
|
| Rate for Payer: Allwell Medicaid |
$7,124.12
|
| Rate for Payer: AZCH Complete Medicaid |
$7,124.12
|
| Rate for Payer: Banner UC Health Medicaid |
$7,124.12
|
| Rate for Payer: Mercy Care Medicaid |
$7,124.12
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$7,124.12
|
|
|
Service Code
|
APR-DRG 2483
|
| Hospital Charge Code |
APRDRG2483
|
| Min. Negotiated Rate |
$7,124.12 |
| Max. Negotiated Rate |
$7,124.12 |
| Rate for Payer: AHCCCS Medicaid |
$7,124.12
|
| Rate for Payer: Allwell Medicaid |
$7,124.12
|
| Rate for Payer: AZCH Complete Medicaid |
$7,124.12
|
| Rate for Payer: Banner UC Health Medicaid |
$7,124.12
|
| Rate for Payer: Mercy Care Medicaid |
$7,124.12
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$3,445.98
|
|
|
Service Code
|
APR-DRG 2481
|
| Hospital Charge Code |
APRDRG2484
|
| Min. Negotiated Rate |
$3,445.98 |
| Max. Negotiated Rate |
$3,445.98 |
| Rate for Payer: AHCCCS Medicaid |
$3,445.98
|
| Rate for Payer: Allwell Medicaid |
$3,445.98
|
| Rate for Payer: AZCH Complete Medicaid |
$3,445.98
|
| Rate for Payer: Banner UC Health Medicaid |
$3,445.98
|
| Rate for Payer: Mercy Care Medicaid |
$3,445.98
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$13,927.00
|
|
|
Service Code
|
APR-DRG 2484
|
| Hospital Charge Code |
APRDRG2482
|
| Min. Negotiated Rate |
$13,927.00 |
| Max. Negotiated Rate |
$13,927.00 |
| Rate for Payer: AHCCCS Medicaid |
$13,927.00
|
| Rate for Payer: Allwell Medicaid |
$13,927.00
|
| Rate for Payer: AZCH Complete Medicaid |
$13,927.00
|
| Rate for Payer: Banner UC Health Medicaid |
$13,927.00
|
| Rate for Payer: Mercy Care Medicaid |
$13,927.00
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$7,124.12
|
|
|
Service Code
|
APR-DRG 2483
|
| Hospital Charge Code |
APRDRG2484
|
| Min. Negotiated Rate |
$7,124.12 |
| Max. Negotiated Rate |
$7,124.12 |
| Rate for Payer: AHCCCS Medicaid |
$7,124.12
|
| Rate for Payer: Allwell Medicaid |
$7,124.12
|
| Rate for Payer: AZCH Complete Medicaid |
$7,124.12
|
| Rate for Payer: Banner UC Health Medicaid |
$7,124.12
|
| Rate for Payer: Mercy Care Medicaid |
$7,124.12
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$3,445.98
|
|
|
Service Code
|
APR-DRG 2481
|
| Hospital Charge Code |
APRDRG2481
|
| Min. Negotiated Rate |
$3,445.98 |
| Max. Negotiated Rate |
$3,445.98 |
| Rate for Payer: AHCCCS Medicaid |
$3,445.98
|
| Rate for Payer: Allwell Medicaid |
$3,445.98
|
| Rate for Payer: AZCH Complete Medicaid |
$3,445.98
|
| Rate for Payer: Banner UC Health Medicaid |
$3,445.98
|
| Rate for Payer: Mercy Care Medicaid |
$3,445.98
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$3,445.98
|
|
|
Service Code
|
APR-DRG 2481
|
| Hospital Charge Code |
APRDRG2483
|
| Min. Negotiated Rate |
$3,445.98 |
| Max. Negotiated Rate |
$3,445.98 |
| Rate for Payer: AHCCCS Medicaid |
$3,445.98
|
| Rate for Payer: Allwell Medicaid |
$3,445.98
|
| Rate for Payer: AZCH Complete Medicaid |
$3,445.98
|
| Rate for Payer: Banner UC Health Medicaid |
$3,445.98
|
| Rate for Payer: Mercy Care Medicaid |
$3,445.98
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$4,683.95
|
|
|
Service Code
|
APR-DRG 2482
|
| Hospital Charge Code |
APRDRG2483
|
| Min. Negotiated Rate |
$4,683.95 |
| Max. Negotiated Rate |
$4,683.95 |
| Rate for Payer: AHCCCS Medicaid |
$4,683.95
|
| Rate for Payer: Allwell Medicaid |
$4,683.95
|
| Rate for Payer: AZCH Complete Medicaid |
$4,683.95
|
| Rate for Payer: Banner UC Health Medicaid |
$4,683.95
|
| Rate for Payer: Mercy Care Medicaid |
$4,683.95
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$7,124.12
|
|
|
Service Code
|
APR-DRG 2483
|
| Hospital Charge Code |
APRDRG2481
|
| Min. Negotiated Rate |
$7,124.12 |
| Max. Negotiated Rate |
$7,124.12 |
| Rate for Payer: AHCCCS Medicaid |
$7,124.12
|
| Rate for Payer: Allwell Medicaid |
$7,124.12
|
| Rate for Payer: AZCH Complete Medicaid |
$7,124.12
|
| Rate for Payer: Banner UC Health Medicaid |
$7,124.12
|
| Rate for Payer: Mercy Care Medicaid |
$7,124.12
|
|
|
Major Gastrointestinal And Peritoneal Infections
|
Facility
|
IP
|
$13,927.00
|
|
|
Service Code
|
APR-DRG 2484
|
| Hospital Charge Code |
APRDRG2481
|
| Min. Negotiated Rate |
$13,927.00 |
| Max. Negotiated Rate |
$13,927.00 |
| Rate for Payer: AHCCCS Medicaid |
$13,927.00
|
| Rate for Payer: Allwell Medicaid |
$13,927.00
|
| Rate for Payer: AZCH Complete Medicaid |
$13,927.00
|
| Rate for Payer: Banner UC Health Medicaid |
$13,927.00
|
| Rate for Payer: Mercy Care Medicaid |
$13,927.00
|
|
