|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$7,528.13
|
|
|
Service Code
|
APR-DRG 2063
|
| Hospital Charge Code |
APRDRG2063
|
| Min. Negotiated Rate |
$7,528.13 |
| Max. Negotiated Rate |
$7,528.13 |
| Rate for Payer: AHCCCS Medicaid |
$7,528.13
|
| Rate for Payer: Allwell Medicaid |
$7,528.13
|
| Rate for Payer: AZCH Complete Medicaid |
$7,528.13
|
| Rate for Payer: Banner UC Health Medicaid |
$7,528.13
|
| Rate for Payer: Mercy Care Medicaid |
$7,528.13
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$7,528.13
|
|
|
Service Code
|
APR-DRG 2063
|
| Hospital Charge Code |
APRDRG2062
|
| Min. Negotiated Rate |
$7,528.13 |
| Max. Negotiated Rate |
$7,528.13 |
| Rate for Payer: AHCCCS Medicaid |
$7,528.13
|
| Rate for Payer: Allwell Medicaid |
$7,528.13
|
| Rate for Payer: AZCH Complete Medicaid |
$7,528.13
|
| Rate for Payer: Banner UC Health Medicaid |
$7,528.13
|
| Rate for Payer: Mercy Care Medicaid |
$7,528.13
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$5,165.81
|
|
|
Service Code
|
APR-DRG 2062
|
| Hospital Charge Code |
APRDRG2064
|
| Min. Negotiated Rate |
$5,165.81 |
| Max. Negotiated Rate |
$5,165.81 |
| Rate for Payer: AHCCCS Medicaid |
$5,165.81
|
| Rate for Payer: Allwell Medicaid |
$5,165.81
|
| Rate for Payer: AZCH Complete Medicaid |
$5,165.81
|
| Rate for Payer: Banner UC Health Medicaid |
$5,165.81
|
| Rate for Payer: Mercy Care Medicaid |
$5,165.81
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$5,014.31
|
|
|
Service Code
|
APR-DRG 2061
|
| Hospital Charge Code |
APRDRG2062
|
| Min. Negotiated Rate |
$5,014.31 |
| Max. Negotiated Rate |
$5,014.31 |
| Rate for Payer: AHCCCS Medicaid |
$5,014.31
|
| Rate for Payer: Allwell Medicaid |
$5,014.31
|
| Rate for Payer: AZCH Complete Medicaid |
$5,014.31
|
| Rate for Payer: Banner UC Health Medicaid |
$5,014.31
|
| Rate for Payer: Mercy Care Medicaid |
$5,014.31
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$5,014.31
|
|
|
Service Code
|
APR-DRG 2061
|
| Hospital Charge Code |
APRDRG2063
|
| Min. Negotiated Rate |
$5,014.31 |
| Max. Negotiated Rate |
$5,014.31 |
| Rate for Payer: AHCCCS Medicaid |
$5,014.31
|
| Rate for Payer: Allwell Medicaid |
$5,014.31
|
| Rate for Payer: AZCH Complete Medicaid |
$5,014.31
|
| Rate for Payer: Banner UC Health Medicaid |
$5,014.31
|
| Rate for Payer: Mercy Care Medicaid |
$5,014.31
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$7,528.13
|
|
|
Service Code
|
APR-DRG 2063
|
| Hospital Charge Code |
APRDRG2061
|
| Min. Negotiated Rate |
$7,528.13 |
| Max. Negotiated Rate |
$7,528.13 |
| Rate for Payer: AHCCCS Medicaid |
$7,528.13
|
| Rate for Payer: Allwell Medicaid |
$7,528.13
|
| Rate for Payer: AZCH Complete Medicaid |
$7,528.13
|
| Rate for Payer: Banner UC Health Medicaid |
$7,528.13
|
| Rate for Payer: Mercy Care Medicaid |
$7,528.13
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$5,014.31
|
|
|
Service Code
|
APR-DRG 2061
|
| Hospital Charge Code |
APRDRG2064
|
| Min. Negotiated Rate |
$5,014.31 |
| Max. Negotiated Rate |
$5,014.31 |
| Rate for Payer: AHCCCS Medicaid |
$5,014.31
|
| Rate for Payer: Allwell Medicaid |
$5,014.31
|
| Rate for Payer: AZCH Complete Medicaid |
$5,014.31
|
| Rate for Payer: Banner UC Health Medicaid |
$5,014.31
|
| Rate for Payer: Mercy Care Medicaid |
$5,014.31
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$5,165.81
|
|
|
Service Code
|
APR-DRG 2062
|
| Hospital Charge Code |
APRDRG2062
|
| Min. Negotiated Rate |
$5,165.81 |
| Max. Negotiated Rate |
$5,165.81 |
| Rate for Payer: AHCCCS Medicaid |
$5,165.81
|
| Rate for Payer: Allwell Medicaid |
$5,165.81
|
| Rate for Payer: AZCH Complete Medicaid |
$5,165.81
|
| Rate for Payer: Banner UC Health Medicaid |
$5,165.81
|
| Rate for Payer: Mercy Care Medicaid |
$5,165.81
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$16,159.55
|
|
|
Service Code
|
APR-DRG 2064
|
| Hospital Charge Code |
APRDRG2063
|
| Min. Negotiated Rate |
$16,159.55 |
| Max. Negotiated Rate |
$16,159.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,159.55
|
| Rate for Payer: Allwell Medicaid |
$16,159.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,159.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,159.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,159.55
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$16,159.55
|
|
|
Service Code
|
APR-DRG 2064
|
| Hospital Charge Code |
APRDRG2064
|
| Min. Negotiated Rate |
$16,159.55 |
| Max. Negotiated Rate |
$16,159.55 |
| Rate for Payer: AHCCCS Medicaid |
$16,159.55
|
| Rate for Payer: Allwell Medicaid |
$16,159.55
|
| Rate for Payer: AZCH Complete Medicaid |
$16,159.55
|
| Rate for Payer: Banner UC Health Medicaid |
$16,159.55
|
| Rate for Payer: Mercy Care Medicaid |
$16,159.55
|
|
|
Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure
|
Facility
|
IP
|
$7,528.13
|
|
|
Service Code
|
APR-DRG 2063
|
| Hospital Charge Code |
APRDRG2064
|
| Min. Negotiated Rate |
$7,528.13 |
| Max. Negotiated Rate |
$7,528.13 |
| Rate for Payer: AHCCCS Medicaid |
$7,528.13
|
| Rate for Payer: Allwell Medicaid |
$7,528.13
|
| Rate for Payer: AZCH Complete Medicaid |
$7,528.13
|
| Rate for Payer: Banner UC Health Medicaid |
$7,528.13
|
| Rate for Payer: Mercy Care Medicaid |
$7,528.13
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$4,237.16
|
|
|
Service Code
|
APR-DRG 4662
|
| Hospital Charge Code |
APRDRG4663
|
| Min. Negotiated Rate |
$4,237.16 |
| Max. Negotiated Rate |
$4,237.16 |
| Rate for Payer: AHCCCS Medicaid |
$4,237.16
|
| Rate for Payer: Allwell Medicaid |
$4,237.16
|
| Rate for Payer: AZCH Complete Medicaid |
$4,237.16
|
| Rate for Payer: Banner UC Health Medicaid |
$4,237.16
|
| Rate for Payer: Mercy Care Medicaid |
$4,237.16
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$4,237.16
|
|
|
Service Code
|
APR-DRG 4662
|
| Hospital Charge Code |
APRDRG4662
|
| Min. Negotiated Rate |
$4,237.16 |
| Max. Negotiated Rate |
$4,237.16 |
| Rate for Payer: AHCCCS Medicaid |
$4,237.16
|
| Rate for Payer: Allwell Medicaid |
$4,237.16
|
| Rate for Payer: AZCH Complete Medicaid |
$4,237.16
|
| Rate for Payer: Banner UC Health Medicaid |
$4,237.16
|
| Rate for Payer: Mercy Care Medicaid |
$4,237.16
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$3,150.69
|
|
|
Service Code
|
APR-DRG 4661
|
| Hospital Charge Code |
APRDRG4663
|
| Min. Negotiated Rate |
$3,150.69 |
| Max. Negotiated Rate |
$3,150.69 |
| Rate for Payer: AHCCCS Medicaid |
$3,150.69
|
| Rate for Payer: Allwell Medicaid |
$3,150.69
|
| Rate for Payer: AZCH Complete Medicaid |
$3,150.69
|
| Rate for Payer: Banner UC Health Medicaid |
$3,150.69
|
| Rate for Payer: Mercy Care Medicaid |
$3,150.69
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$11,058.97
|
|
|
Service Code
|
APR-DRG 4664
|
| Hospital Charge Code |
APRDRG4663
|
| Min. Negotiated Rate |
$11,058.97 |
| Max. Negotiated Rate |
$11,058.97 |
| Rate for Payer: AHCCCS Medicaid |
$11,058.97
|
| Rate for Payer: Allwell Medicaid |
$11,058.97
|
| Rate for Payer: AZCH Complete Medicaid |
$11,058.97
|
| Rate for Payer: Banner UC Health Medicaid |
$11,058.97
|
| Rate for Payer: Mercy Care Medicaid |
$11,058.97
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$3,150.69
|
|
|
Service Code
|
APR-DRG 4661
|
| Hospital Charge Code |
APRDRG4664
|
| Min. Negotiated Rate |
$3,150.69 |
| Max. Negotiated Rate |
$3,150.69 |
| Rate for Payer: AHCCCS Medicaid |
$3,150.69
|
| Rate for Payer: Allwell Medicaid |
$3,150.69
|
| Rate for Payer: AZCH Complete Medicaid |
$3,150.69
|
| Rate for Payer: Banner UC Health Medicaid |
$3,150.69
|
| Rate for Payer: Mercy Care Medicaid |
$3,150.69
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$3,150.69
|
|
|
Service Code
|
APR-DRG 4661
|
| Hospital Charge Code |
APRDRG4662
|
| Min. Negotiated Rate |
$3,150.69 |
| Max. Negotiated Rate |
$3,150.69 |
| Rate for Payer: AHCCCS Medicaid |
$3,150.69
|
| Rate for Payer: Allwell Medicaid |
$3,150.69
|
| Rate for Payer: AZCH Complete Medicaid |
$3,150.69
|
| Rate for Payer: Banner UC Health Medicaid |
$3,150.69
|
| Rate for Payer: Mercy Care Medicaid |
$3,150.69
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$6,481.64
|
|
|
Service Code
|
APR-DRG 4663
|
| Hospital Charge Code |
APRDRG4662
|
| Min. Negotiated Rate |
$6,481.64 |
| Max. Negotiated Rate |
$6,481.64 |
| Rate for Payer: AHCCCS Medicaid |
$6,481.64
|
| Rate for Payer: Allwell Medicaid |
$6,481.64
|
| Rate for Payer: AZCH Complete Medicaid |
$6,481.64
|
| Rate for Payer: Banner UC Health Medicaid |
$6,481.64
|
| Rate for Payer: Mercy Care Medicaid |
$6,481.64
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$11,058.97
|
|
|
Service Code
|
APR-DRG 4664
|
| Hospital Charge Code |
APRDRG4662
|
| Min. Negotiated Rate |
$11,058.97 |
| Max. Negotiated Rate |
$11,058.97 |
| Rate for Payer: AHCCCS Medicaid |
$11,058.97
|
| Rate for Payer: Allwell Medicaid |
$11,058.97
|
| Rate for Payer: AZCH Complete Medicaid |
$11,058.97
|
| Rate for Payer: Banner UC Health Medicaid |
$11,058.97
|
| Rate for Payer: Mercy Care Medicaid |
$11,058.97
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$11,058.97
|
|
|
Service Code
|
APR-DRG 4664
|
| Hospital Charge Code |
APRDRG4664
|
| Min. Negotiated Rate |
$11,058.97 |
| Max. Negotiated Rate |
$11,058.97 |
| Rate for Payer: AHCCCS Medicaid |
$11,058.97
|
| Rate for Payer: Allwell Medicaid |
$11,058.97
|
| Rate for Payer: AZCH Complete Medicaid |
$11,058.97
|
| Rate for Payer: Banner UC Health Medicaid |
$11,058.97
|
| Rate for Payer: Mercy Care Medicaid |
$11,058.97
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$4,237.16
|
|
|
Service Code
|
APR-DRG 4662
|
| Hospital Charge Code |
APRDRG4664
|
| Min. Negotiated Rate |
$4,237.16 |
| Max. Negotiated Rate |
$4,237.16 |
| Rate for Payer: AHCCCS Medicaid |
$4,237.16
|
| Rate for Payer: Allwell Medicaid |
$4,237.16
|
| Rate for Payer: AZCH Complete Medicaid |
$4,237.16
|
| Rate for Payer: Banner UC Health Medicaid |
$4,237.16
|
| Rate for Payer: Mercy Care Medicaid |
$4,237.16
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$3,150.69
|
|
|
Service Code
|
APR-DRG 4661
|
| Hospital Charge Code |
APRDRG4661
|
| Min. Negotiated Rate |
$3,150.69 |
| Max. Negotiated Rate |
$3,150.69 |
| Rate for Payer: AHCCCS Medicaid |
$3,150.69
|
| Rate for Payer: Allwell Medicaid |
$3,150.69
|
| Rate for Payer: AZCH Complete Medicaid |
$3,150.69
|
| Rate for Payer: Banner UC Health Medicaid |
$3,150.69
|
| Rate for Payer: Mercy Care Medicaid |
$3,150.69
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$6,481.64
|
|
|
Service Code
|
APR-DRG 4663
|
| Hospital Charge Code |
APRDRG4664
|
| Min. Negotiated Rate |
$6,481.64 |
| Max. Negotiated Rate |
$6,481.64 |
| Rate for Payer: AHCCCS Medicaid |
$6,481.64
|
| Rate for Payer: Allwell Medicaid |
$6,481.64
|
| Rate for Payer: AZCH Complete Medicaid |
$6,481.64
|
| Rate for Payer: Banner UC Health Medicaid |
$6,481.64
|
| Rate for Payer: Mercy Care Medicaid |
$6,481.64
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$6,481.64
|
|
|
Service Code
|
APR-DRG 4663
|
| Hospital Charge Code |
APRDRG4661
|
| Min. Negotiated Rate |
$6,481.64 |
| Max. Negotiated Rate |
$6,481.64 |
| Rate for Payer: AHCCCS Medicaid |
$6,481.64
|
| Rate for Payer: Allwell Medicaid |
$6,481.64
|
| Rate for Payer: AZCH Complete Medicaid |
$6,481.64
|
| Rate for Payer: Banner UC Health Medicaid |
$6,481.64
|
| Rate for Payer: Mercy Care Medicaid |
$6,481.64
|
|
|
Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure
|
Facility
|
IP
|
$4,237.16
|
|
|
Service Code
|
APR-DRG 4662
|
| Hospital Charge Code |
APRDRG4661
|
| Min. Negotiated Rate |
$4,237.16 |
| Max. Negotiated Rate |
$4,237.16 |
| Rate for Payer: AHCCCS Medicaid |
$4,237.16
|
| Rate for Payer: Allwell Medicaid |
$4,237.16
|
| Rate for Payer: AZCH Complete Medicaid |
$4,237.16
|
| Rate for Payer: Banner UC Health Medicaid |
$4,237.16
|
| Rate for Payer: Mercy Care Medicaid |
$4,237.16
|
|
