|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$12,095.64
|
|
|
Service Code
|
APR-DRG 2601
|
| Hospital Charge Code |
APRDRG2603
|
| Min. Negotiated Rate |
$12,095.64 |
| Max. Negotiated Rate |
$12,095.64 |
| Rate for Payer: AHCCCS Medicaid |
$12,095.64
|
| Rate for Payer: Allwell Medicaid |
$12,095.64
|
| Rate for Payer: AZCH Complete Medicaid |
$12,095.64
|
| Rate for Payer: Banner UC Health Medicaid |
$12,095.64
|
| Rate for Payer: Mercy Care Medicaid |
$12,095.64
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$22,261.73
|
|
|
Service Code
|
APR-DRG 2603
|
| Hospital Charge Code |
APRDRG2601
|
| Min. Negotiated Rate |
$22,261.73 |
| Max. Negotiated Rate |
$22,261.73 |
| Rate for Payer: AHCCCS Medicaid |
$22,261.73
|
| Rate for Payer: Allwell Medicaid |
$22,261.73
|
| Rate for Payer: AZCH Complete Medicaid |
$22,261.73
|
| Rate for Payer: Banner UC Health Medicaid |
$22,261.73
|
| Rate for Payer: Mercy Care Medicaid |
$22,261.73
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$47,113.04
|
|
|
Service Code
|
APR-DRG 2604
|
| Hospital Charge Code |
APRDRG2603
|
| Min. Negotiated Rate |
$47,113.04 |
| Max. Negotiated Rate |
$47,113.04 |
| Rate for Payer: AHCCCS Medicaid |
$47,113.04
|
| Rate for Payer: Allwell Medicaid |
$47,113.04
|
| Rate for Payer: AZCH Complete Medicaid |
$47,113.04
|
| Rate for Payer: Banner UC Health Medicaid |
$47,113.04
|
| Rate for Payer: Mercy Care Medicaid |
$47,113.04
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$15,280.00
|
|
|
Service Code
|
APR-DRG 2602
|
| Hospital Charge Code |
APRDRG2603
|
| Min. Negotiated Rate |
$15,280.00 |
| Max. Negotiated Rate |
$15,280.00 |
| Rate for Payer: AHCCCS Medicaid |
$15,280.00
|
| Rate for Payer: Allwell Medicaid |
$15,280.00
|
| Rate for Payer: AZCH Complete Medicaid |
$15,280.00
|
| Rate for Payer: Banner UC Health Medicaid |
$15,280.00
|
| Rate for Payer: Mercy Care Medicaid |
$15,280.00
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$12,095.64
|
|
|
Service Code
|
APR-DRG 2601
|
| Hospital Charge Code |
APRDRG2602
|
| Min. Negotiated Rate |
$12,095.64 |
| Max. Negotiated Rate |
$12,095.64 |
| Rate for Payer: AHCCCS Medicaid |
$12,095.64
|
| Rate for Payer: Allwell Medicaid |
$12,095.64
|
| Rate for Payer: AZCH Complete Medicaid |
$12,095.64
|
| Rate for Payer: Banner UC Health Medicaid |
$12,095.64
|
| Rate for Payer: Mercy Care Medicaid |
$12,095.64
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$15,280.00
|
|
|
Service Code
|
APR-DRG 2602
|
| Hospital Charge Code |
APRDRG2601
|
| Min. Negotiated Rate |
$15,280.00 |
| Max. Negotiated Rate |
$15,280.00 |
| Rate for Payer: AHCCCS Medicaid |
$15,280.00
|
| Rate for Payer: Allwell Medicaid |
$15,280.00
|
| Rate for Payer: AZCH Complete Medicaid |
$15,280.00
|
| Rate for Payer: Banner UC Health Medicaid |
$15,280.00
|
| Rate for Payer: Mercy Care Medicaid |
$15,280.00
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$47,113.04
|
|
|
Service Code
|
APR-DRG 2604
|
| Hospital Charge Code |
APRDRG2604
|
| Min. Negotiated Rate |
$47,113.04 |
| Max. Negotiated Rate |
$47,113.04 |
| Rate for Payer: AHCCCS Medicaid |
$47,113.04
|
| Rate for Payer: Allwell Medicaid |
$47,113.04
|
| Rate for Payer: AZCH Complete Medicaid |
$47,113.04
|
| Rate for Payer: Banner UC Health Medicaid |
$47,113.04
|
| Rate for Payer: Mercy Care Medicaid |
$47,113.04
|
|
|
Major Pancreas, Liver And Shunt Procedures
|
Facility
|
IP
|
$47,113.04
|
|
|
Service Code
|
APR-DRG 2604
|
| Hospital Charge Code |
APRDRG2602
|
| Min. Negotiated Rate |
$47,113.04 |
| Max. Negotiated Rate |
$47,113.04 |
| Rate for Payer: AHCCCS Medicaid |
$47,113.04
|
| Rate for Payer: Allwell Medicaid |
$47,113.04
|
| Rate for Payer: AZCH Complete Medicaid |
$47,113.04
|
| Rate for Payer: Banner UC Health Medicaid |
$47,113.04
|
| Rate for Payer: Mercy Care Medicaid |
$47,113.04
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$21,706.93
|
|
|
Service Code
|
APR-DRG 1203
|
| Hospital Charge Code |
APRDRG1204
|
| Min. Negotiated Rate |
$21,706.93 |
| Max. Negotiated Rate |
$21,706.93 |
| Rate for Payer: AHCCCS Medicaid |
$21,706.93
|
| Rate for Payer: Allwell Medicaid |
$21,706.93
|
| Rate for Payer: AZCH Complete Medicaid |
$21,706.93
|
| Rate for Payer: Banner UC Health Medicaid |
$21,706.93
|
| Rate for Payer: Mercy Care Medicaid |
$21,706.93
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$37,990.63
|
|
|
Service Code
|
APR-DRG 1204
|
| Hospital Charge Code |
APRDRG1202
|
| Min. Negotiated Rate |
$37,990.63 |
| Max. Negotiated Rate |
$37,990.63 |
| Rate for Payer: AHCCCS Medicaid |
$37,990.63
|
| Rate for Payer: Allwell Medicaid |
$37,990.63
|
| Rate for Payer: AZCH Complete Medicaid |
$37,990.63
|
| Rate for Payer: Banner UC Health Medicaid |
$37,990.63
|
| Rate for Payer: Mercy Care Medicaid |
$37,990.63
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$37,990.63
|
|
|
Service Code
|
APR-DRG 1204
|
| Hospital Charge Code |
APRDRG1203
|
| Min. Negotiated Rate |
$37,990.63 |
| Max. Negotiated Rate |
$37,990.63 |
| Rate for Payer: AHCCCS Medicaid |
$37,990.63
|
| Rate for Payer: Allwell Medicaid |
$37,990.63
|
| Rate for Payer: AZCH Complete Medicaid |
$37,990.63
|
| Rate for Payer: Banner UC Health Medicaid |
$37,990.63
|
| Rate for Payer: Mercy Care Medicaid |
$37,990.63
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$14,252.45
|
|
|
Service Code
|
APR-DRG 1202
|
| Hospital Charge Code |
APRDRG1204
|
| Min. Negotiated Rate |
$14,252.45 |
| Max. Negotiated Rate |
$14,252.45 |
| Rate for Payer: AHCCCS Medicaid |
$14,252.45
|
| Rate for Payer: Allwell Medicaid |
$14,252.45
|
| Rate for Payer: AZCH Complete Medicaid |
$14,252.45
|
| Rate for Payer: Banner UC Health Medicaid |
$14,252.45
|
| Rate for Payer: Mercy Care Medicaid |
$14,252.45
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$21,706.93
|
|
|
Service Code
|
APR-DRG 1203
|
| Hospital Charge Code |
APRDRG1203
|
| Min. Negotiated Rate |
$21,706.93 |
| Max. Negotiated Rate |
$21,706.93 |
| Rate for Payer: AHCCCS Medicaid |
$21,706.93
|
| Rate for Payer: Allwell Medicaid |
$21,706.93
|
| Rate for Payer: AZCH Complete Medicaid |
$21,706.93
|
| Rate for Payer: Banner UC Health Medicaid |
$21,706.93
|
| Rate for Payer: Mercy Care Medicaid |
$21,706.93
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,484.72
|
|
|
Service Code
|
APR-DRG 1201
|
| Hospital Charge Code |
APRDRG1203
|
| Min. Negotiated Rate |
$11,484.72 |
| Max. Negotiated Rate |
$11,484.72 |
| Rate for Payer: AHCCCS Medicaid |
$11,484.72
|
| Rate for Payer: Allwell Medicaid |
$11,484.72
|
| Rate for Payer: AZCH Complete Medicaid |
$11,484.72
|
| Rate for Payer: Banner UC Health Medicaid |
$11,484.72
|
| Rate for Payer: Mercy Care Medicaid |
$11,484.72
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,484.72
|
|
|
Service Code
|
APR-DRG 1201
|
| Hospital Charge Code |
APRDRG1201
|
| Min. Negotiated Rate |
$11,484.72 |
| Max. Negotiated Rate |
$11,484.72 |
| Rate for Payer: AHCCCS Medicaid |
$11,484.72
|
| Rate for Payer: Allwell Medicaid |
$11,484.72
|
| Rate for Payer: AZCH Complete Medicaid |
$11,484.72
|
| Rate for Payer: Banner UC Health Medicaid |
$11,484.72
|
| Rate for Payer: Mercy Care Medicaid |
$11,484.72
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,484.72
|
|
|
Service Code
|
APR-DRG 1201
|
| Hospital Charge Code |
APRDRG1202
|
| Min. Negotiated Rate |
$11,484.72 |
| Max. Negotiated Rate |
$11,484.72 |
| Rate for Payer: AHCCCS Medicaid |
$11,484.72
|
| Rate for Payer: Allwell Medicaid |
$11,484.72
|
| Rate for Payer: AZCH Complete Medicaid |
$11,484.72
|
| Rate for Payer: Banner UC Health Medicaid |
$11,484.72
|
| Rate for Payer: Mercy Care Medicaid |
$11,484.72
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$37,990.63
|
|
|
Service Code
|
APR-DRG 1204
|
| Hospital Charge Code |
APRDRG1204
|
| Min. Negotiated Rate |
$37,990.63 |
| Max. Negotiated Rate |
$37,990.63 |
| Rate for Payer: AHCCCS Medicaid |
$37,990.63
|
| Rate for Payer: Allwell Medicaid |
$37,990.63
|
| Rate for Payer: AZCH Complete Medicaid |
$37,990.63
|
| Rate for Payer: Banner UC Health Medicaid |
$37,990.63
|
| Rate for Payer: Mercy Care Medicaid |
$37,990.63
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$21,706.93
|
|
|
Service Code
|
APR-DRG 1203
|
| Hospital Charge Code |
APRDRG1201
|
| Min. Negotiated Rate |
$21,706.93 |
| Max. Negotiated Rate |
$21,706.93 |
| Rate for Payer: AHCCCS Medicaid |
$21,706.93
|
| Rate for Payer: Allwell Medicaid |
$21,706.93
|
| Rate for Payer: AZCH Complete Medicaid |
$21,706.93
|
| Rate for Payer: Banner UC Health Medicaid |
$21,706.93
|
| Rate for Payer: Mercy Care Medicaid |
$21,706.93
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$11,484.72
|
|
|
Service Code
|
APR-DRG 1201
|
| Hospital Charge Code |
APRDRG1204
|
| Min. Negotiated Rate |
$11,484.72 |
| Max. Negotiated Rate |
$11,484.72 |
| Rate for Payer: AHCCCS Medicaid |
$11,484.72
|
| Rate for Payer: Allwell Medicaid |
$11,484.72
|
| Rate for Payer: AZCH Complete Medicaid |
$11,484.72
|
| Rate for Payer: Banner UC Health Medicaid |
$11,484.72
|
| Rate for Payer: Mercy Care Medicaid |
$11,484.72
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$21,706.93
|
|
|
Service Code
|
APR-DRG 1203
|
| Hospital Charge Code |
APRDRG1202
|
| Min. Negotiated Rate |
$21,706.93 |
| Max. Negotiated Rate |
$21,706.93 |
| Rate for Payer: AHCCCS Medicaid |
$21,706.93
|
| Rate for Payer: Allwell Medicaid |
$21,706.93
|
| Rate for Payer: AZCH Complete Medicaid |
$21,706.93
|
| Rate for Payer: Banner UC Health Medicaid |
$21,706.93
|
| Rate for Payer: Mercy Care Medicaid |
$21,706.93
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$14,252.45
|
|
|
Service Code
|
APR-DRG 1202
|
| Hospital Charge Code |
APRDRG1202
|
| Min. Negotiated Rate |
$14,252.45 |
| Max. Negotiated Rate |
$14,252.45 |
| Rate for Payer: AHCCCS Medicaid |
$14,252.45
|
| Rate for Payer: Allwell Medicaid |
$14,252.45
|
| Rate for Payer: AZCH Complete Medicaid |
$14,252.45
|
| Rate for Payer: Banner UC Health Medicaid |
$14,252.45
|
| Rate for Payer: Mercy Care Medicaid |
$14,252.45
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$37,990.63
|
|
|
Service Code
|
APR-DRG 1204
|
| Hospital Charge Code |
APRDRG1201
|
| Min. Negotiated Rate |
$37,990.63 |
| Max. Negotiated Rate |
$37,990.63 |
| Rate for Payer: AHCCCS Medicaid |
$37,990.63
|
| Rate for Payer: Allwell Medicaid |
$37,990.63
|
| Rate for Payer: AZCH Complete Medicaid |
$37,990.63
|
| Rate for Payer: Banner UC Health Medicaid |
$37,990.63
|
| Rate for Payer: Mercy Care Medicaid |
$37,990.63
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$14,252.45
|
|
|
Service Code
|
APR-DRG 1202
|
| Hospital Charge Code |
APRDRG1203
|
| Min. Negotiated Rate |
$14,252.45 |
| Max. Negotiated Rate |
$14,252.45 |
| Rate for Payer: AHCCCS Medicaid |
$14,252.45
|
| Rate for Payer: Allwell Medicaid |
$14,252.45
|
| Rate for Payer: AZCH Complete Medicaid |
$14,252.45
|
| Rate for Payer: Banner UC Health Medicaid |
$14,252.45
|
| Rate for Payer: Mercy Care Medicaid |
$14,252.45
|
|
|
Major Respiratory And Chest Procedures
|
Facility
|
IP
|
$14,252.45
|
|
|
Service Code
|
APR-DRG 1202
|
| Hospital Charge Code |
APRDRG1201
|
| Min. Negotiated Rate |
$14,252.45 |
| Max. Negotiated Rate |
$14,252.45 |
| Rate for Payer: AHCCCS Medicaid |
$14,252.45
|
| Rate for Payer: Allwell Medicaid |
$14,252.45
|
| Rate for Payer: AZCH Complete Medicaid |
$14,252.45
|
| Rate for Payer: Banner UC Health Medicaid |
$14,252.45
|
| Rate for Payer: Mercy Care Medicaid |
$14,252.45
|
|
|
Major Respiratory Infections And Inflammations
|
Facility
|
IP
|
$7,371.01
|
|
|
Service Code
|
APR-DRG 1373
|
| Hospital Charge Code |
APRDRG1372
|
| Min. Negotiated Rate |
$7,371.01 |
| Max. Negotiated Rate |
$7,371.01 |
| Rate for Payer: AHCCCS Medicaid |
$7,371.01
|
| Rate for Payer: Allwell Medicaid |
$7,371.01
|
| Rate for Payer: AZCH Complete Medicaid |
$7,371.01
|
| Rate for Payer: Banner UC Health Medicaid |
$7,371.01
|
| Rate for Payer: Mercy Care Medicaid |
$7,371.01
|
|
