|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$12,664.48
|
|
|
Service Code
|
APR-DRG 6111
|
| Hospital Charge Code |
APRDRG6111
|
| Min. Negotiated Rate |
$12,664.48 |
| Max. Negotiated Rate |
$12,664.48 |
| Rate for Payer: AHCCCS Medicaid |
$12,664.48
|
| Rate for Payer: Allwell Medicaid |
$12,664.48
|
| Rate for Payer: AZCH Complete Medicaid |
$12,664.48
|
| Rate for Payer: Banner UC Health Medicaid |
$12,664.48
|
| Rate for Payer: Mercy Care Medicaid |
$12,664.48
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$35,147.15
|
|
|
Service Code
|
APR-DRG 6113
|
| Hospital Charge Code |
APRDRG6114
|
| Min. Negotiated Rate |
$35,147.15 |
| Max. Negotiated Rate |
$35,147.15 |
| Rate for Payer: AHCCCS Medicaid |
$35,147.15
|
| Rate for Payer: Allwell Medicaid |
$35,147.15
|
| Rate for Payer: AZCH Complete Medicaid |
$35,147.15
|
| Rate for Payer: Banner UC Health Medicaid |
$35,147.15
|
| Rate for Payer: Mercy Care Medicaid |
$35,147.15
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$35,147.15
|
|
|
Service Code
|
APR-DRG 6113
|
| Hospital Charge Code |
APRDRG6113
|
| Min. Negotiated Rate |
$35,147.15 |
| Max. Negotiated Rate |
$35,147.15 |
| Rate for Payer: AHCCCS Medicaid |
$35,147.15
|
| Rate for Payer: Allwell Medicaid |
$35,147.15
|
| Rate for Payer: AZCH Complete Medicaid |
$35,147.15
|
| Rate for Payer: Banner UC Health Medicaid |
$35,147.15
|
| Rate for Payer: Mercy Care Medicaid |
$35,147.15
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$20,541.20
|
|
|
Service Code
|
APR-DRG 6112
|
| Hospital Charge Code |
APRDRG6112
|
| Min. Negotiated Rate |
$20,541.20 |
| Max. Negotiated Rate |
$20,541.20 |
| Rate for Payer: AHCCCS Medicaid |
$20,541.20
|
| Rate for Payer: Allwell Medicaid |
$20,541.20
|
| Rate for Payer: AZCH Complete Medicaid |
$20,541.20
|
| Rate for Payer: Banner UC Health Medicaid |
$20,541.20
|
| Rate for Payer: Mercy Care Medicaid |
$20,541.20
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$35,147.15
|
|
|
Service Code
|
APR-DRG 6113
|
| Hospital Charge Code |
APRDRG6111
|
| Min. Negotiated Rate |
$35,147.15 |
| Max. Negotiated Rate |
$35,147.15 |
| Rate for Payer: AHCCCS Medicaid |
$35,147.15
|
| Rate for Payer: Allwell Medicaid |
$35,147.15
|
| Rate for Payer: AZCH Complete Medicaid |
$35,147.15
|
| Rate for Payer: Banner UC Health Medicaid |
$35,147.15
|
| Rate for Payer: Mercy Care Medicaid |
$35,147.15
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$60,961.48
|
|
|
Service Code
|
APR-DRG 6114
|
| Hospital Charge Code |
APRDRG6111
|
| Min. Negotiated Rate |
$60,961.48 |
| Max. Negotiated Rate |
$60,961.48 |
| Rate for Payer: AHCCCS Medicaid |
$60,961.48
|
| Rate for Payer: Allwell Medicaid |
$60,961.48
|
| Rate for Payer: AZCH Complete Medicaid |
$60,961.48
|
| Rate for Payer: Banner UC Health Medicaid |
$60,961.48
|
| Rate for Payer: Mercy Care Medicaid |
$60,961.48
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$60,961.48
|
|
|
Service Code
|
APR-DRG 6114
|
| Hospital Charge Code |
APRDRG6112
|
| Min. Negotiated Rate |
$60,961.48 |
| Max. Negotiated Rate |
$60,961.48 |
| Rate for Payer: AHCCCS Medicaid |
$60,961.48
|
| Rate for Payer: Allwell Medicaid |
$60,961.48
|
| Rate for Payer: AZCH Complete Medicaid |
$60,961.48
|
| Rate for Payer: Banner UC Health Medicaid |
$60,961.48
|
| Rate for Payer: Mercy Care Medicaid |
$60,961.48
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$12,664.48
|
|
|
Service Code
|
APR-DRG 6111
|
| Hospital Charge Code |
APRDRG6114
|
| Min. Negotiated Rate |
$12,664.48 |
| Max. Negotiated Rate |
$12,664.48 |
| Rate for Payer: AHCCCS Medicaid |
$12,664.48
|
| Rate for Payer: Allwell Medicaid |
$12,664.48
|
| Rate for Payer: AZCH Complete Medicaid |
$12,664.48
|
| Rate for Payer: Banner UC Health Medicaid |
$12,664.48
|
| Rate for Payer: Mercy Care Medicaid |
$12,664.48
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$20,541.20
|
|
|
Service Code
|
APR-DRG 6112
|
| Hospital Charge Code |
APRDRG6114
|
| Min. Negotiated Rate |
$20,541.20 |
| Max. Negotiated Rate |
$20,541.20 |
| Rate for Payer: AHCCCS Medicaid |
$20,541.20
|
| Rate for Payer: Allwell Medicaid |
$20,541.20
|
| Rate for Payer: AZCH Complete Medicaid |
$20,541.20
|
| Rate for Payer: Banner UC Health Medicaid |
$20,541.20
|
| Rate for Payer: Mercy Care Medicaid |
$20,541.20
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$35,147.15
|
|
|
Service Code
|
APR-DRG 6113
|
| Hospital Charge Code |
APRDRG6112
|
| Min. Negotiated Rate |
$35,147.15 |
| Max. Negotiated Rate |
$35,147.15 |
| Rate for Payer: AHCCCS Medicaid |
$35,147.15
|
| Rate for Payer: Allwell Medicaid |
$35,147.15
|
| Rate for Payer: AZCH Complete Medicaid |
$35,147.15
|
| Rate for Payer: Banner UC Health Medicaid |
$35,147.15
|
| Rate for Payer: Mercy Care Medicaid |
$35,147.15
|
|
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
Facility
|
IP
|
$60,961.48
|
|
|
Service Code
|
APR-DRG 6114
|
| Hospital Charge Code |
APRDRG6114
|
| Min. Negotiated Rate |
$60,961.48 |
| Max. Negotiated Rate |
$60,961.48 |
| Rate for Payer: AHCCCS Medicaid |
$60,961.48
|
| Rate for Payer: Allwell Medicaid |
$60,961.48
|
| Rate for Payer: AZCH Complete Medicaid |
$60,961.48
|
| Rate for Payer: Banner UC Health Medicaid |
$60,961.48
|
| Rate for Payer: Mercy Care Medicaid |
$60,961.48
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: AHCCCS Medicaid |
$28,286.76
|
| Rate for Payer: Allwell Medicaid |
$28,286.76
|
| Rate for Payer: AZCH Complete Medicaid |
$28,286.76
|
| Rate for Payer: Banner UC Health Medicaid |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: AHCCCS Medicaid |
$16,566.37
|
| Rate for Payer: Allwell Medicaid |
$16,566.37
|
| Rate for Payer: AZCH Complete Medicaid |
$16,566.37
|
| Rate for Payer: Banner UC Health Medicaid |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: AHCCCS Medicaid |
$16,566.37
|
| Rate for Payer: Allwell Medicaid |
$16,566.37
|
| Rate for Payer: AZCH Complete Medicaid |
$16,566.37
|
| Rate for Payer: Banner UC Health Medicaid |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: AHCCCS Medicaid |
$39,212.47
|
| Rate for Payer: Allwell Medicaid |
$39,212.47
|
| Rate for Payer: AZCH Complete Medicaid |
$39,212.47
|
| Rate for Payer: Banner UC Health Medicaid |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: AHCCCS Medicaid |
$28,286.76
|
| Rate for Payer: Allwell Medicaid |
$28,286.76
|
| Rate for Payer: AZCH Complete Medicaid |
$28,286.76
|
| Rate for Payer: Banner UC Health Medicaid |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: AHCCCS Medicaid |
$16,566.37
|
| Rate for Payer: Allwell Medicaid |
$16,566.37
|
| Rate for Payer: AZCH Complete Medicaid |
$16,566.37
|
| Rate for Payer: Banner UC Health Medicaid |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: AHCCCS Medicaid |
$8,510.79
|
| Rate for Payer: Allwell Medicaid |
$8,510.79
|
| Rate for Payer: AZCH Complete Medicaid |
$8,510.79
|
| Rate for Payer: Banner UC Health Medicaid |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: AHCCCS Medicaid |
$39,212.47
|
| Rate for Payer: Allwell Medicaid |
$39,212.47
|
| Rate for Payer: AZCH Complete Medicaid |
$39,212.47
|
| Rate for Payer: Banner UC Health Medicaid |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: AHCCCS Medicaid |
$39,212.47
|
| Rate for Payer: Allwell Medicaid |
$39,212.47
|
| Rate for Payer: AZCH Complete Medicaid |
$39,212.47
|
| Rate for Payer: Banner UC Health Medicaid |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: AHCCCS Medicaid |
$28,286.76
|
| Rate for Payer: Allwell Medicaid |
$28,286.76
|
| Rate for Payer: AZCH Complete Medicaid |
$28,286.76
|
| Rate for Payer: Banner UC Health Medicaid |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: AHCCCS Medicaid |
$8,510.79
|
| Rate for Payer: Allwell Medicaid |
$8,510.79
|
| Rate for Payer: AZCH Complete Medicaid |
$8,510.79
|
| Rate for Payer: Banner UC Health Medicaid |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: AHCCCS Medicaid |
$16,566.37
|
| Rate for Payer: Allwell Medicaid |
$16,566.37
|
| Rate for Payer: AZCH Complete Medicaid |
$16,566.37
|
| Rate for Payer: Banner UC Health Medicaid |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: AHCCCS Medicaid |
$8,510.79
|
| Rate for Payer: Allwell Medicaid |
$8,510.79
|
| Rate for Payer: AZCH Complete Medicaid |
$8,510.79
|
| Rate for Payer: Banner UC Health Medicaid |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: AHCCCS Medicaid |
$8,510.79
|
| Rate for Payer: Allwell Medicaid |
$8,510.79
|
| Rate for Payer: AZCH Complete Medicaid |
$8,510.79
|
| Rate for Payer: Banner UC Health Medicaid |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
|
