|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6123
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: AHCCCS Medicaid |
$50,039.98
|
| Rate for Payer: Allwell Medicaid |
$50,039.98
|
| Rate for Payer: AZCH Complete Medicaid |
$50,039.98
|
| Rate for Payer: Banner UC Health Medicaid |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$33,076.62
|
|
|
Service Code
|
APR-DRG 6123
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$33,076.62 |
| Max. Negotiated Rate |
$33,076.62 |
| Rate for Payer: AHCCCS Medicaid |
$33,076.62
|
| Rate for Payer: Allwell Medicaid |
$33,076.62
|
| Rate for Payer: AZCH Complete Medicaid |
$33,076.62
|
| Rate for Payer: Banner UC Health Medicaid |
$33,076.62
|
| Rate for Payer: Mercy Care Medicaid |
$33,076.62
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$15,807.45
|
|
|
Service Code
|
APR-DRG 6121
|
| Hospital Charge Code |
APRDRG6122
|
| Min. Negotiated Rate |
$15,807.45 |
| Max. Negotiated Rate |
$15,807.45 |
| Rate for Payer: AHCCCS Medicaid |
$15,807.45
|
| Rate for Payer: Allwell Medicaid |
$15,807.45
|
| Rate for Payer: AZCH Complete Medicaid |
$15,807.45
|
| Rate for Payer: Banner UC Health Medicaid |
$15,807.45
|
| Rate for Payer: Mercy Care Medicaid |
$15,807.45
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$15,807.45
|
|
|
Service Code
|
APR-DRG 6121
|
| Hospital Charge Code |
APRDRG6123
|
| Min. Negotiated Rate |
$15,807.45 |
| Max. Negotiated Rate |
$15,807.45 |
| Rate for Payer: AHCCCS Medicaid |
$15,807.45
|
| Rate for Payer: Allwell Medicaid |
$15,807.45
|
| Rate for Payer: AZCH Complete Medicaid |
$15,807.45
|
| Rate for Payer: Banner UC Health Medicaid |
$15,807.45
|
| Rate for Payer: Mercy Care Medicaid |
$15,807.45
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: AHCCCS Medicaid |
$50,039.98
|
| Rate for Payer: Allwell Medicaid |
$50,039.98
|
| Rate for Payer: AZCH Complete Medicaid |
$50,039.98
|
| Rate for Payer: Banner UC Health Medicaid |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$24,091.69
|
|
|
Service Code
|
APR-DRG 6122
|
| Hospital Charge Code |
APRDRG6121
|
| Min. Negotiated Rate |
$24,091.69 |
| Max. Negotiated Rate |
$24,091.69 |
| Rate for Payer: AHCCCS Medicaid |
$24,091.69
|
| Rate for Payer: Allwell Medicaid |
$24,091.69
|
| Rate for Payer: AZCH Complete Medicaid |
$24,091.69
|
| Rate for Payer: Banner UC Health Medicaid |
$24,091.69
|
| Rate for Payer: Mercy Care Medicaid |
$24,091.69
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$24,091.69
|
|
|
Service Code
|
APR-DRG 6122
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$24,091.69 |
| Max. Negotiated Rate |
$24,091.69 |
| Rate for Payer: AHCCCS Medicaid |
$24,091.69
|
| Rate for Payer: Allwell Medicaid |
$24,091.69
|
| Rate for Payer: AZCH Complete Medicaid |
$24,091.69
|
| Rate for Payer: Banner UC Health Medicaid |
$24,091.69
|
| Rate for Payer: Mercy Care Medicaid |
$24,091.69
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$33,076.62
|
|
|
Service Code
|
APR-DRG 6123
|
| Hospital Charge Code |
APRDRG6122
|
| Min. Negotiated Rate |
$33,076.62 |
| Max. Negotiated Rate |
$33,076.62 |
| Rate for Payer: AHCCCS Medicaid |
$33,076.62
|
| Rate for Payer: Allwell Medicaid |
$33,076.62
|
| Rate for Payer: AZCH Complete Medicaid |
$33,076.62
|
| Rate for Payer: Banner UC Health Medicaid |
$33,076.62
|
| Rate for Payer: Mercy Care Medicaid |
$33,076.62
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$33,076.62
|
|
|
Service Code
|
APR-DRG 6123
|
| Hospital Charge Code |
APRDRG6121
|
| Min. Negotiated Rate |
$33,076.62 |
| Max. Negotiated Rate |
$33,076.62 |
| Rate for Payer: AHCCCS Medicaid |
$33,076.62
|
| Rate for Payer: Allwell Medicaid |
$33,076.62
|
| Rate for Payer: AZCH Complete Medicaid |
$33,076.62
|
| Rate for Payer: Banner UC Health Medicaid |
$33,076.62
|
| Rate for Payer: Mercy Care Medicaid |
$33,076.62
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6122
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: AHCCCS Medicaid |
$50,039.98
|
| Rate for Payer: Allwell Medicaid |
$50,039.98
|
| Rate for Payer: AZCH Complete Medicaid |
$50,039.98
|
| Rate for Payer: Banner UC Health Medicaid |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$24,091.69
|
|
|
Service Code
|
APR-DRG 6122
|
| Hospital Charge Code |
APRDRG6122
|
| Min. Negotiated Rate |
$24,091.69 |
| Max. Negotiated Rate |
$24,091.69 |
| Rate for Payer: AHCCCS Medicaid |
$24,091.69
|
| Rate for Payer: Allwell Medicaid |
$24,091.69
|
| Rate for Payer: AZCH Complete Medicaid |
$24,091.69
|
| Rate for Payer: Banner UC Health Medicaid |
$24,091.69
|
| Rate for Payer: Mercy Care Medicaid |
$24,091.69
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$138,340.63
|
|
|
Service Code
|
APR-DRG 6094
|
| Hospital Charge Code |
APRDRG6092
|
| Min. Negotiated Rate |
$138,340.63 |
| Max. Negotiated Rate |
$138,340.63 |
| Rate for Payer: AHCCCS Medicaid |
$138,340.63
|
| Rate for Payer: Allwell Medicaid |
$138,340.63
|
| Rate for Payer: AZCH Complete Medicaid |
$138,340.63
|
| Rate for Payer: Banner UC Health Medicaid |
$138,340.63
|
| Rate for Payer: Mercy Care Medicaid |
$138,340.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6091
|
| Hospital Charge Code |
APRDRG6092
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6091
|
| Hospital Charge Code |
APRDRG6094
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6092
|
| Hospital Charge Code |
APRDRG6094
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6092
|
| Hospital Charge Code |
APRDRG6093
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$138,340.63
|
|
|
Service Code
|
APR-DRG 6094
|
| Hospital Charge Code |
APRDRG6094
|
| Min. Negotiated Rate |
$138,340.63 |
| Max. Negotiated Rate |
$138,340.63 |
| Rate for Payer: AHCCCS Medicaid |
$138,340.63
|
| Rate for Payer: Allwell Medicaid |
$138,340.63
|
| Rate for Payer: AZCH Complete Medicaid |
$138,340.63
|
| Rate for Payer: Banner UC Health Medicaid |
$138,340.63
|
| Rate for Payer: Mercy Care Medicaid |
$138,340.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$55,323.63
|
|
|
Service Code
|
APR-DRG 6093
|
| Hospital Charge Code |
APRDRG6094
|
| Min. Negotiated Rate |
$55,323.63 |
| Max. Negotiated Rate |
$55,323.63 |
| Rate for Payer: AHCCCS Medicaid |
$55,323.63
|
| Rate for Payer: Allwell Medicaid |
$55,323.63
|
| Rate for Payer: AZCH Complete Medicaid |
$55,323.63
|
| Rate for Payer: Banner UC Health Medicaid |
$55,323.63
|
| Rate for Payer: Mercy Care Medicaid |
$55,323.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6091
|
| Hospital Charge Code |
APRDRG6093
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6092
|
| Hospital Charge Code |
APRDRG6091
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$55,323.63
|
|
|
Service Code
|
APR-DRG 6093
|
| Hospital Charge Code |
APRDRG6093
|
| Min. Negotiated Rate |
$55,323.63 |
| Max. Negotiated Rate |
$55,323.63 |
| Rate for Payer: AHCCCS Medicaid |
$55,323.63
|
| Rate for Payer: Allwell Medicaid |
$55,323.63
|
| Rate for Payer: AZCH Complete Medicaid |
$55,323.63
|
| Rate for Payer: Banner UC Health Medicaid |
$55,323.63
|
| Rate for Payer: Mercy Care Medicaid |
$55,323.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$55,323.63
|
|
|
Service Code
|
APR-DRG 6093
|
| Hospital Charge Code |
APRDRG6091
|
| Min. Negotiated Rate |
$55,323.63 |
| Max. Negotiated Rate |
$55,323.63 |
| Rate for Payer: AHCCCS Medicaid |
$55,323.63
|
| Rate for Payer: Allwell Medicaid |
$55,323.63
|
| Rate for Payer: AZCH Complete Medicaid |
$55,323.63
|
| Rate for Payer: Banner UC Health Medicaid |
$55,323.63
|
| Rate for Payer: Mercy Care Medicaid |
$55,323.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6091
|
| Hospital Charge Code |
APRDRG6091
|
| Min. Negotiated Rate |
$37,504.56 |
| Max. Negotiated Rate |
$37,504.56 |
| Rate for Payer: AHCCCS Medicaid |
$37,504.56
|
| Rate for Payer: Allwell Medicaid |
$37,504.56
|
| Rate for Payer: AZCH Complete Medicaid |
$37,504.56
|
| Rate for Payer: Banner UC Health Medicaid |
$37,504.56
|
| Rate for Payer: Mercy Care Medicaid |
$37,504.56
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$138,340.63
|
|
|
Service Code
|
APR-DRG 6094
|
| Hospital Charge Code |
APRDRG6093
|
| Min. Negotiated Rate |
$138,340.63 |
| Max. Negotiated Rate |
$138,340.63 |
| Rate for Payer: AHCCCS Medicaid |
$138,340.63
|
| Rate for Payer: Allwell Medicaid |
$138,340.63
|
| Rate for Payer: AZCH Complete Medicaid |
$138,340.63
|
| Rate for Payer: Banner UC Health Medicaid |
$138,340.63
|
| Rate for Payer: Mercy Care Medicaid |
$138,340.63
|
|
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
Facility
|
IP
|
$55,323.63
|
|
|
Service Code
|
APR-DRG 6093
|
| Hospital Charge Code |
APRDRG6092
|
| Min. Negotiated Rate |
$55,323.63 |
| Max. Negotiated Rate |
$55,323.63 |
| Rate for Payer: AHCCCS Medicaid |
$55,323.63
|
| Rate for Payer: Allwell Medicaid |
$55,323.63
|
| Rate for Payer: AZCH Complete Medicaid |
$55,323.63
|
| Rate for Payer: Banner UC Health Medicaid |
$55,323.63
|
| Rate for Payer: Mercy Care Medicaid |
$55,323.63
|
|
