|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$41,263.36
|
|
|
Service Code
|
APR-DRG 6083
|
| Hospital Charge Code |
APRDRG6083
|
| Min. Negotiated Rate |
$41,263.36 |
| Max. Negotiated Rate |
$41,263.36 |
| Rate for Payer: AHCCCS Medicaid |
$41,263.36
|
| Rate for Payer: Allwell Medicaid |
$41,263.36
|
| Rate for Payer: AZCH Complete Medicaid |
$41,263.36
|
| Rate for Payer: Banner UC Health Medicaid |
$41,263.36
|
| Rate for Payer: Mercy Care Medicaid |
$41,263.36
|
|
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$10,373.00
|
|
|
Service Code
|
APR-DRG 6081
|
| Hospital Charge Code |
APRDRG6082
|
| Min. Negotiated Rate |
$10,373.00 |
| Max. Negotiated Rate |
$10,373.00 |
| Rate for Payer: AHCCCS Medicaid |
$10,373.00
|
| Rate for Payer: Allwell Medicaid |
$10,373.00
|
| Rate for Payer: AZCH Complete Medicaid |
$10,373.00
|
| Rate for Payer: Banner UC Health Medicaid |
$10,373.00
|
| Rate for Payer: Mercy Care Medicaid |
$10,373.00
|
|
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$67,001.94
|
|
|
Service Code
|
APR-DRG 6084
|
| Hospital Charge Code |
APRDRG6081
|
| Min. Negotiated Rate |
$67,001.94 |
| Max. Negotiated Rate |
$67,001.94 |
| Rate for Payer: AHCCCS Medicaid |
$67,001.94
|
| Rate for Payer: Allwell Medicaid |
$67,001.94
|
| Rate for Payer: AZCH Complete Medicaid |
$67,001.94
|
| Rate for Payer: Banner UC Health Medicaid |
$67,001.94
|
| Rate for Payer: Mercy Care Medicaid |
$67,001.94
|
|
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$41,263.36
|
|
|
Service Code
|
APR-DRG 6083
|
| Hospital Charge Code |
APRDRG6082
|
| Min. Negotiated Rate |
$41,263.36 |
| Max. Negotiated Rate |
$41,263.36 |
| Rate for Payer: AHCCCS Medicaid |
$41,263.36
|
| Rate for Payer: Allwell Medicaid |
$41,263.36
|
| Rate for Payer: AZCH Complete Medicaid |
$41,263.36
|
| Rate for Payer: Banner UC Health Medicaid |
$41,263.36
|
| Rate for Payer: Mercy Care Medicaid |
$41,263.36
|
|
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$41,263.36
|
|
|
Service Code
|
APR-DRG 6083
|
| Hospital Charge Code |
APRDRG6081
|
| Min. Negotiated Rate |
$41,263.36 |
| Max. Negotiated Rate |
$41,263.36 |
| Rate for Payer: AHCCCS Medicaid |
$41,263.36
|
| Rate for Payer: Allwell Medicaid |
$41,263.36
|
| Rate for Payer: AZCH Complete Medicaid |
$41,263.36
|
| Rate for Payer: Banner UC Health Medicaid |
$41,263.36
|
| Rate for Payer: Mercy Care Medicaid |
$41,263.36
|
|
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
Facility
|
IP
|
$28,194.88
|
|
|
Service Code
|
APR-DRG 6082
|
| Hospital Charge Code |
APRDRG6081
|
| Min. Negotiated Rate |
$28,194.88 |
| Max. Negotiated Rate |
$28,194.88 |
| Rate for Payer: AHCCCS Medicaid |
$28,194.88
|
| Rate for Payer: Allwell Medicaid |
$28,194.88
|
| Rate for Payer: AZCH Complete Medicaid |
$28,194.88
|
| Rate for Payer: Banner UC Health Medicaid |
$28,194.88
|
| Rate for Payer: Mercy Care Medicaid |
$28,194.88
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$38,935.42
|
|
|
Service Code
|
APR-DRG 6072
|
| Hospital Charge Code |
APRDRG6072
|
| Min. Negotiated Rate |
$38,935.42 |
| Max. Negotiated Rate |
$38,935.42 |
| Rate for Payer: AHCCCS Medicaid |
$38,935.42
|
| Rate for Payer: Allwell Medicaid |
$38,935.42
|
| Rate for Payer: AZCH Complete Medicaid |
$38,935.42
|
| Rate for Payer: Banner UC Health Medicaid |
$38,935.42
|
| Rate for Payer: Mercy Care Medicaid |
$38,935.42
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$22,200.71
|
|
|
Service Code
|
APR-DRG 6071
|
| Hospital Charge Code |
APRDRG6074
|
| Min. Negotiated Rate |
$22,200.71 |
| Max. Negotiated Rate |
$22,200.71 |
| Rate for Payer: AHCCCS Medicaid |
$22,200.71
|
| Rate for Payer: Allwell Medicaid |
$22,200.71
|
| Rate for Payer: AZCH Complete Medicaid |
$22,200.71
|
| Rate for Payer: Banner UC Health Medicaid |
$22,200.71
|
| Rate for Payer: Mercy Care Medicaid |
$22,200.71
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$48,520.75
|
|
|
Service Code
|
APR-DRG 6073
|
| Hospital Charge Code |
APRDRG6071
|
| Min. Negotiated Rate |
$48,520.75 |
| Max. Negotiated Rate |
$48,520.75 |
| Rate for Payer: AHCCCS Medicaid |
$48,520.75
|
| Rate for Payer: Allwell Medicaid |
$48,520.75
|
| Rate for Payer: AZCH Complete Medicaid |
$48,520.75
|
| Rate for Payer: Banner UC Health Medicaid |
$48,520.75
|
| Rate for Payer: Mercy Care Medicaid |
$48,520.75
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$75,637.57
|
|
|
Service Code
|
APR-DRG 6074
|
| Hospital Charge Code |
APRDRG6074
|
| Min. Negotiated Rate |
$75,637.57 |
| Max. Negotiated Rate |
$75,637.57 |
| Rate for Payer: AHCCCS Medicaid |
$75,637.57
|
| Rate for Payer: Allwell Medicaid |
$75,637.57
|
| Rate for Payer: AZCH Complete Medicaid |
$75,637.57
|
| Rate for Payer: Banner UC Health Medicaid |
$75,637.57
|
| Rate for Payer: Mercy Care Medicaid |
$75,637.57
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$22,200.71
|
|
|
Service Code
|
APR-DRG 6071
|
| Hospital Charge Code |
APRDRG6071
|
| Min. Negotiated Rate |
$22,200.71 |
| Max. Negotiated Rate |
$22,200.71 |
| Rate for Payer: AHCCCS Medicaid |
$22,200.71
|
| Rate for Payer: Allwell Medicaid |
$22,200.71
|
| Rate for Payer: AZCH Complete Medicaid |
$22,200.71
|
| Rate for Payer: Banner UC Health Medicaid |
$22,200.71
|
| Rate for Payer: Mercy Care Medicaid |
$22,200.71
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$48,520.75
|
|
|
Service Code
|
APR-DRG 6073
|
| Hospital Charge Code |
APRDRG6074
|
| Min. Negotiated Rate |
$48,520.75 |
| Max. Negotiated Rate |
$48,520.75 |
| Rate for Payer: AHCCCS Medicaid |
$48,520.75
|
| Rate for Payer: Allwell Medicaid |
$48,520.75
|
| Rate for Payer: AZCH Complete Medicaid |
$48,520.75
|
| Rate for Payer: Banner UC Health Medicaid |
$48,520.75
|
| Rate for Payer: Mercy Care Medicaid |
$48,520.75
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$75,637.57
|
|
|
Service Code
|
APR-DRG 6074
|
| Hospital Charge Code |
APRDRG6071
|
| Min. Negotiated Rate |
$75,637.57 |
| Max. Negotiated Rate |
$75,637.57 |
| Rate for Payer: AHCCCS Medicaid |
$75,637.57
|
| Rate for Payer: Allwell Medicaid |
$75,637.57
|
| Rate for Payer: AZCH Complete Medicaid |
$75,637.57
|
| Rate for Payer: Banner UC Health Medicaid |
$75,637.57
|
| Rate for Payer: Mercy Care Medicaid |
$75,637.57
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$75,637.57
|
|
|
Service Code
|
APR-DRG 6074
|
| Hospital Charge Code |
APRDRG6073
|
| Min. Negotiated Rate |
$75,637.57 |
| Max. Negotiated Rate |
$75,637.57 |
| Rate for Payer: AHCCCS Medicaid |
$75,637.57
|
| Rate for Payer: Allwell Medicaid |
$75,637.57
|
| Rate for Payer: AZCH Complete Medicaid |
$75,637.57
|
| Rate for Payer: Banner UC Health Medicaid |
$75,637.57
|
| Rate for Payer: Mercy Care Medicaid |
$75,637.57
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$48,520.75
|
|
|
Service Code
|
APR-DRG 6073
|
| Hospital Charge Code |
APRDRG6073
|
| Min. Negotiated Rate |
$48,520.75 |
| Max. Negotiated Rate |
$48,520.75 |
| Rate for Payer: AHCCCS Medicaid |
$48,520.75
|
| Rate for Payer: Allwell Medicaid |
$48,520.75
|
| Rate for Payer: AZCH Complete Medicaid |
$48,520.75
|
| Rate for Payer: Banner UC Health Medicaid |
$48,520.75
|
| Rate for Payer: Mercy Care Medicaid |
$48,520.75
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$38,935.42
|
|
|
Service Code
|
APR-DRG 6072
|
| Hospital Charge Code |
APRDRG6073
|
| Min. Negotiated Rate |
$38,935.42 |
| Max. Negotiated Rate |
$38,935.42 |
| Rate for Payer: AHCCCS Medicaid |
$38,935.42
|
| Rate for Payer: Allwell Medicaid |
$38,935.42
|
| Rate for Payer: AZCH Complete Medicaid |
$38,935.42
|
| Rate for Payer: Banner UC Health Medicaid |
$38,935.42
|
| Rate for Payer: Mercy Care Medicaid |
$38,935.42
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$38,935.42
|
|
|
Service Code
|
APR-DRG 6072
|
| Hospital Charge Code |
APRDRG6074
|
| Min. Negotiated Rate |
$38,935.42 |
| Max. Negotiated Rate |
$38,935.42 |
| Rate for Payer: AHCCCS Medicaid |
$38,935.42
|
| Rate for Payer: Allwell Medicaid |
$38,935.42
|
| Rate for Payer: AZCH Complete Medicaid |
$38,935.42
|
| Rate for Payer: Banner UC Health Medicaid |
$38,935.42
|
| Rate for Payer: Mercy Care Medicaid |
$38,935.42
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$75,637.57
|
|
|
Service Code
|
APR-DRG 6074
|
| Hospital Charge Code |
APRDRG6072
|
| Min. Negotiated Rate |
$75,637.57 |
| Max. Negotiated Rate |
$75,637.57 |
| Rate for Payer: AHCCCS Medicaid |
$75,637.57
|
| Rate for Payer: Allwell Medicaid |
$75,637.57
|
| Rate for Payer: AZCH Complete Medicaid |
$75,637.57
|
| Rate for Payer: Banner UC Health Medicaid |
$75,637.57
|
| Rate for Payer: Mercy Care Medicaid |
$75,637.57
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$48,520.75
|
|
|
Service Code
|
APR-DRG 6073
|
| Hospital Charge Code |
APRDRG6072
|
| Min. Negotiated Rate |
$48,520.75 |
| Max. Negotiated Rate |
$48,520.75 |
| Rate for Payer: AHCCCS Medicaid |
$48,520.75
|
| Rate for Payer: Allwell Medicaid |
$48,520.75
|
| Rate for Payer: AZCH Complete Medicaid |
$48,520.75
|
| Rate for Payer: Banner UC Health Medicaid |
$48,520.75
|
| Rate for Payer: Mercy Care Medicaid |
$48,520.75
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$38,935.42
|
|
|
Service Code
|
APR-DRG 6072
|
| Hospital Charge Code |
APRDRG6071
|
| Min. Negotiated Rate |
$38,935.42 |
| Max. Negotiated Rate |
$38,935.42 |
| Rate for Payer: AHCCCS Medicaid |
$38,935.42
|
| Rate for Payer: Allwell Medicaid |
$38,935.42
|
| Rate for Payer: AZCH Complete Medicaid |
$38,935.42
|
| Rate for Payer: Banner UC Health Medicaid |
$38,935.42
|
| Rate for Payer: Mercy Care Medicaid |
$38,935.42
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$22,200.71
|
|
|
Service Code
|
APR-DRG 6071
|
| Hospital Charge Code |
APRDRG6072
|
| Min. Negotiated Rate |
$22,200.71 |
| Max. Negotiated Rate |
$22,200.71 |
| Rate for Payer: AHCCCS Medicaid |
$22,200.71
|
| Rate for Payer: Allwell Medicaid |
$22,200.71
|
| Rate for Payer: AZCH Complete Medicaid |
$22,200.71
|
| Rate for Payer: Banner UC Health Medicaid |
$22,200.71
|
| Rate for Payer: Mercy Care Medicaid |
$22,200.71
|
|
|
Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly
|
Facility
|
IP
|
$22,200.71
|
|
|
Service Code
|
APR-DRG 6071
|
| Hospital Charge Code |
APRDRG6073
|
| Min. Negotiated Rate |
$22,200.71 |
| Max. Negotiated Rate |
$22,200.71 |
| Rate for Payer: AHCCCS Medicaid |
$22,200.71
|
| Rate for Payer: Allwell Medicaid |
$22,200.71
|
| Rate for Payer: AZCH Complete Medicaid |
$22,200.71
|
| Rate for Payer: Banner UC Health Medicaid |
$22,200.71
|
| Rate for Payer: Mercy Care Medicaid |
$22,200.71
|
|
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$50,289.68
|
|
|
Service Code
|
APR-DRG 6134
|
| Hospital Charge Code |
APRDRG6131
|
| Min. Negotiated Rate |
$50,289.68 |
| Max. Negotiated Rate |
$50,289.68 |
| Rate for Payer: AHCCCS Medicaid |
$50,289.68
|
| Rate for Payer: Allwell Medicaid |
$50,289.68
|
| Rate for Payer: AZCH Complete Medicaid |
$50,289.68
|
| Rate for Payer: Banner UC Health Medicaid |
$50,289.68
|
| Rate for Payer: Mercy Care Medicaid |
$50,289.68
|
|
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$31,431.14
|
|
|
Service Code
|
APR-DRG 6133
|
| Hospital Charge Code |
APRDRG6132
|
| Min. Negotiated Rate |
$31,431.14 |
| Max. Negotiated Rate |
$31,431.14 |
| Rate for Payer: AHCCCS Medicaid |
$31,431.14
|
| Rate for Payer: Allwell Medicaid |
$31,431.14
|
| Rate for Payer: AZCH Complete Medicaid |
$31,431.14
|
| Rate for Payer: Banner UC Health Medicaid |
$31,431.14
|
| Rate for Payer: Mercy Care Medicaid |
$31,431.14
|
|
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,628.20
|
|
|
Service Code
|
APR-DRG 6131
|
| Hospital Charge Code |
APRDRG6131
|
| Min. Negotiated Rate |
$13,628.20 |
| Max. Negotiated Rate |
$13,628.20 |
| Rate for Payer: AHCCCS Medicaid |
$13,628.20
|
| Rate for Payer: Allwell Medicaid |
$13,628.20
|
| Rate for Payer: AZCH Complete Medicaid |
$13,628.20
|
| Rate for Payer: Banner UC Health Medicaid |
$13,628.20
|
| Rate for Payer: Mercy Care Medicaid |
$13,628.20
|
|