|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$4,289.76
|
|
|
Service Code
|
APR-DRG 5012
|
| Hospital Charge Code |
APRDRG5013
|
| Min. Negotiated Rate |
$4,289.76 |
| Max. Negotiated Rate |
$4,289.76 |
| Rate for Payer: AHCCCS Medicaid |
$4,289.76
|
| Rate for Payer: Allwell Medicaid |
$4,289.76
|
| Rate for Payer: AZCH Complete Medicaid |
$4,289.76
|
| Rate for Payer: Banner UC Health Medicaid |
$4,289.76
|
| Rate for Payer: Mercy Care Medicaid |
$4,289.76
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$4,289.76
|
|
|
Service Code
|
APR-DRG 5012
|
| Hospital Charge Code |
APRDRG5011
|
| Min. Negotiated Rate |
$4,289.76 |
| Max. Negotiated Rate |
$4,289.76 |
| Rate for Payer: AHCCCS Medicaid |
$4,289.76
|
| Rate for Payer: Allwell Medicaid |
$4,289.76
|
| Rate for Payer: AZCH Complete Medicaid |
$4,289.76
|
| Rate for Payer: Banner UC Health Medicaid |
$4,289.76
|
| Rate for Payer: Mercy Care Medicaid |
$4,289.76
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$4,289.76
|
|
|
Service Code
|
APR-DRG 5012
|
| Hospital Charge Code |
APRDRG5012
|
| Min. Negotiated Rate |
$4,289.76 |
| Max. Negotiated Rate |
$4,289.76 |
| Rate for Payer: AHCCCS Medicaid |
$4,289.76
|
| Rate for Payer: Allwell Medicaid |
$4,289.76
|
| Rate for Payer: AZCH Complete Medicaid |
$4,289.76
|
| Rate for Payer: Banner UC Health Medicaid |
$4,289.76
|
| Rate for Payer: Mercy Care Medicaid |
$4,289.76
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$4,289.76
|
|
|
Service Code
|
APR-DRG 5012
|
| Hospital Charge Code |
APRDRG5014
|
| Min. Negotiated Rate |
$4,289.76 |
| Max. Negotiated Rate |
$4,289.76 |
| Rate for Payer: AHCCCS Medicaid |
$4,289.76
|
| Rate for Payer: Allwell Medicaid |
$4,289.76
|
| Rate for Payer: AZCH Complete Medicaid |
$4,289.76
|
| Rate for Payer: Banner UC Health Medicaid |
$4,289.76
|
| Rate for Payer: Mercy Care Medicaid |
$4,289.76
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$6,284.54
|
|
|
Service Code
|
APR-DRG 5013
|
| Hospital Charge Code |
APRDRG5011
|
| Min. Negotiated Rate |
$6,284.54 |
| Max. Negotiated Rate |
$6,284.54 |
| Rate for Payer: AHCCCS Medicaid |
$6,284.54
|
| Rate for Payer: Allwell Medicaid |
$6,284.54
|
| Rate for Payer: AZCH Complete Medicaid |
$6,284.54
|
| Rate for Payer: Banner UC Health Medicaid |
$6,284.54
|
| Rate for Payer: Mercy Care Medicaid |
$6,284.54
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$6,284.54
|
|
|
Service Code
|
APR-DRG 5013
|
| Hospital Charge Code |
APRDRG5012
|
| Min. Negotiated Rate |
$6,284.54 |
| Max. Negotiated Rate |
$6,284.54 |
| Rate for Payer: AHCCCS Medicaid |
$6,284.54
|
| Rate for Payer: Allwell Medicaid |
$6,284.54
|
| Rate for Payer: AZCH Complete Medicaid |
$6,284.54
|
| Rate for Payer: Banner UC Health Medicaid |
$6,284.54
|
| Rate for Payer: Mercy Care Medicaid |
$6,284.54
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$12,380.41
|
|
|
Service Code
|
APR-DRG 5014
|
| Hospital Charge Code |
APRDRG5012
|
| Min. Negotiated Rate |
$12,380.41 |
| Max. Negotiated Rate |
$12,380.41 |
| Rate for Payer: AHCCCS Medicaid |
$12,380.41
|
| Rate for Payer: Allwell Medicaid |
$12,380.41
|
| Rate for Payer: AZCH Complete Medicaid |
$12,380.41
|
| Rate for Payer: Banner UC Health Medicaid |
$12,380.41
|
| Rate for Payer: Mercy Care Medicaid |
$12,380.41
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$12,380.41
|
|
|
Service Code
|
APR-DRG 5014
|
| Hospital Charge Code |
APRDRG5013
|
| Min. Negotiated Rate |
$12,380.41 |
| Max. Negotiated Rate |
$12,380.41 |
| Rate for Payer: AHCCCS Medicaid |
$12,380.41
|
| Rate for Payer: Allwell Medicaid |
$12,380.41
|
| Rate for Payer: AZCH Complete Medicaid |
$12,380.41
|
| Rate for Payer: Banner UC Health Medicaid |
$12,380.41
|
| Rate for Payer: Mercy Care Medicaid |
$12,380.41
|
|
|
Male Reproductive System Diagnoses Except Malignancy
|
Facility
|
IP
|
$6,284.54
|
|
|
Service Code
|
APR-DRG 5013
|
| Hospital Charge Code |
APRDRG5014
|
| Min. Negotiated Rate |
$6,284.54 |
| Max. Negotiated Rate |
$6,284.54 |
| Rate for Payer: AHCCCS Medicaid |
$6,284.54
|
| Rate for Payer: Allwell Medicaid |
$6,284.54
|
| Rate for Payer: AZCH Complete Medicaid |
$6,284.54
|
| Rate for Payer: Banner UC Health Medicaid |
$6,284.54
|
| Rate for Payer: Mercy Care Medicaid |
$6,284.54
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$16,206.55
|
|
|
Service Code
|
APR-DRG 2524
|
| Hospital Charge Code |
APRDRG2521
|
| Min. Negotiated Rate |
$16,206.55 |
| Max. Negotiated Rate |
$16,206.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,206.55
|
| Rate for Payer: Allwell Medicaid |
$16,206.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,206.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,206.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,206.55
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$16,206.55
|
|
|
Service Code
|
APR-DRG 2524
|
| Hospital Charge Code |
APRDRG2523
|
| Min. Negotiated Rate |
$16,206.55 |
| Max. Negotiated Rate |
$16,206.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,206.55
|
| Rate for Payer: Allwell Medicaid |
$16,206.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,206.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,206.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,206.55
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$7,653.68
|
|
|
Service Code
|
APR-DRG 2523
|
| Hospital Charge Code |
APRDRG2521
|
| Min. Negotiated Rate |
$7,653.68 |
| Max. Negotiated Rate |
$7,653.68 |
| Rate for Payer: AHCCCS Medicaid |
$7,653.68
|
| Rate for Payer: Allwell Medicaid |
$7,653.68
|
| Rate for Payer: AZCH Complete Medicaid |
$7,653.68
|
| Rate for Payer: Banner UC Health Medicaid |
$7,653.68
|
| Rate for Payer: Mercy Care Medicaid |
$7,653.68
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$7,653.68
|
|
|
Service Code
|
APR-DRG 2523
|
| Hospital Charge Code |
APRDRG2522
|
| Min. Negotiated Rate |
$7,653.68 |
| Max. Negotiated Rate |
$7,653.68 |
| Rate for Payer: AHCCCS Medicaid |
$7,653.68
|
| Rate for Payer: Allwell Medicaid |
$7,653.68
|
| Rate for Payer: AZCH Complete Medicaid |
$7,653.68
|
| Rate for Payer: Banner UC Health Medicaid |
$7,653.68
|
| Rate for Payer: Mercy Care Medicaid |
$7,653.68
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$5,019.92
|
|
|
Service Code
|
APR-DRG 2522
|
| Hospital Charge Code |
APRDRG2521
|
| Min. Negotiated Rate |
$5,019.92 |
| Max. Negotiated Rate |
$5,019.92 |
| Rate for Payer: AHCCCS Medicaid |
$5,019.92
|
| Rate for Payer: Allwell Medicaid |
$5,019.92
|
| Rate for Payer: AZCH Complete Medicaid |
$5,019.92
|
| Rate for Payer: Banner UC Health Medicaid |
$5,019.92
|
| Rate for Payer: Mercy Care Medicaid |
$5,019.92
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$16,206.55
|
|
|
Service Code
|
APR-DRG 2524
|
| Hospital Charge Code |
APRDRG2524
|
| Min. Negotiated Rate |
$16,206.55 |
| Max. Negotiated Rate |
$16,206.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,206.55
|
| Rate for Payer: Allwell Medicaid |
$16,206.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,206.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,206.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,206.55
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$5,019.92
|
|
|
Service Code
|
APR-DRG 2522
|
| Hospital Charge Code |
APRDRG2523
|
| Min. Negotiated Rate |
$5,019.92 |
| Max. Negotiated Rate |
$5,019.92 |
| Rate for Payer: AHCCCS Medicaid |
$5,019.92
|
| Rate for Payer: Allwell Medicaid |
$5,019.92
|
| Rate for Payer: AZCH Complete Medicaid |
$5,019.92
|
| Rate for Payer: Banner UC Health Medicaid |
$5,019.92
|
| Rate for Payer: Mercy Care Medicaid |
$5,019.92
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$5,019.92
|
|
|
Service Code
|
APR-DRG 2522
|
| Hospital Charge Code |
APRDRG2524
|
| Min. Negotiated Rate |
$5,019.92 |
| Max. Negotiated Rate |
$5,019.92 |
| Rate for Payer: AHCCCS Medicaid |
$5,019.92
|
| Rate for Payer: Allwell Medicaid |
$5,019.92
|
| Rate for Payer: AZCH Complete Medicaid |
$5,019.92
|
| Rate for Payer: Banner UC Health Medicaid |
$5,019.92
|
| Rate for Payer: Mercy Care Medicaid |
$5,019.92
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$3,976.24
|
|
|
Service Code
|
APR-DRG 2521
|
| Hospital Charge Code |
APRDRG2521
|
| Min. Negotiated Rate |
$3,976.24 |
| Max. Negotiated Rate |
$3,976.24 |
| Rate for Payer: AHCCCS Medicaid |
$3,976.24
|
| Rate for Payer: Allwell Medicaid |
$3,976.24
|
| Rate for Payer: AZCH Complete Medicaid |
$3,976.24
|
| Rate for Payer: Banner UC Health Medicaid |
$3,976.24
|
| Rate for Payer: Mercy Care Medicaid |
$3,976.24
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$3,976.24
|
|
|
Service Code
|
APR-DRG 2521
|
| Hospital Charge Code |
APRDRG2524
|
| Min. Negotiated Rate |
$3,976.24 |
| Max. Negotiated Rate |
$3,976.24 |
| Rate for Payer: AHCCCS Medicaid |
$3,976.24
|
| Rate for Payer: Allwell Medicaid |
$3,976.24
|
| Rate for Payer: AZCH Complete Medicaid |
$3,976.24
|
| Rate for Payer: Banner UC Health Medicaid |
$3,976.24
|
| Rate for Payer: Mercy Care Medicaid |
$3,976.24
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$3,976.24
|
|
|
Service Code
|
APR-DRG 2521
|
| Hospital Charge Code |
APRDRG2523
|
| Min. Negotiated Rate |
$3,976.24 |
| Max. Negotiated Rate |
$3,976.24 |
| Rate for Payer: AHCCCS Medicaid |
$3,976.24
|
| Rate for Payer: Allwell Medicaid |
$3,976.24
|
| Rate for Payer: AZCH Complete Medicaid |
$3,976.24
|
| Rate for Payer: Banner UC Health Medicaid |
$3,976.24
|
| Rate for Payer: Mercy Care Medicaid |
$3,976.24
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$16,206.55
|
|
|
Service Code
|
APR-DRG 2524
|
| Hospital Charge Code |
APRDRG2522
|
| Min. Negotiated Rate |
$16,206.55 |
| Max. Negotiated Rate |
$16,206.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,206.55
|
| Rate for Payer: Allwell Medicaid |
$16,206.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,206.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,206.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,206.55
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$7,653.68
|
|
|
Service Code
|
APR-DRG 2523
|
| Hospital Charge Code |
APRDRG2524
|
| Min. Negotiated Rate |
$7,653.68 |
| Max. Negotiated Rate |
$7,653.68 |
| Rate for Payer: AHCCCS Medicaid |
$7,653.68
|
| Rate for Payer: Allwell Medicaid |
$7,653.68
|
| Rate for Payer: AZCH Complete Medicaid |
$7,653.68
|
| Rate for Payer: Banner UC Health Medicaid |
$7,653.68
|
| Rate for Payer: Mercy Care Medicaid |
$7,653.68
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$3,976.24
|
|
|
Service Code
|
APR-DRG 2521
|
| Hospital Charge Code |
APRDRG2522
|
| Min. Negotiated Rate |
$3,976.24 |
| Max. Negotiated Rate |
$3,976.24 |
| Rate for Payer: AHCCCS Medicaid |
$3,976.24
|
| Rate for Payer: Allwell Medicaid |
$3,976.24
|
| Rate for Payer: AZCH Complete Medicaid |
$3,976.24
|
| Rate for Payer: Banner UC Health Medicaid |
$3,976.24
|
| Rate for Payer: Mercy Care Medicaid |
$3,976.24
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$7,653.68
|
|
|
Service Code
|
APR-DRG 2523
|
| Hospital Charge Code |
APRDRG2523
|
| Min. Negotiated Rate |
$7,653.68 |
| Max. Negotiated Rate |
$7,653.68 |
| Rate for Payer: AHCCCS Medicaid |
$7,653.68
|
| Rate for Payer: Allwell Medicaid |
$7,653.68
|
| Rate for Payer: AZCH Complete Medicaid |
$7,653.68
|
| Rate for Payer: Banner UC Health Medicaid |
$7,653.68
|
| Rate for Payer: Mercy Care Medicaid |
$7,653.68
|
|
|
Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure
|
Facility
|
IP
|
$5,019.92
|
|
|
Service Code
|
APR-DRG 2522
|
| Hospital Charge Code |
APRDRG2522
|
| Min. Negotiated Rate |
$5,019.92 |
| Max. Negotiated Rate |
$5,019.92 |
| Rate for Payer: AHCCCS Medicaid |
$5,019.92
|
| Rate for Payer: Allwell Medicaid |
$5,019.92
|
| Rate for Payer: AZCH Complete Medicaid |
$5,019.92
|
| Rate for Payer: Banner UC Health Medicaid |
$5,019.92
|
| Rate for Payer: Mercy Care Medicaid |
$5,019.92
|
|
