|
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
|
$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
|
$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
|
$37,504.56
|
|
|
Service Code
|
APR-DRG 6092
|
| 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 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 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
|
$138,340.63
|
|
|
Service Code
|
APR-DRG 6094
|
| Hospital Charge Code |
APRDRG6091
|
| 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
|
$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 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: AHCCCS Medicaid |
$126,083.66
|
| Rate for Payer: Allwell Medicaid |
$126,083.66
|
| Rate for Payer: AZCH Complete Medicaid |
$126,083.66
|
| Rate for Payer: Banner UC Health Medicaid |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: AHCCCS Medicaid |
$206,843.56
|
| Rate for Payer: Allwell Medicaid |
$206,843.56
|
| Rate for Payer: AZCH Complete Medicaid |
$206,843.56
|
| Rate for Payer: Banner UC Health Medicaid |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: AHCCCS Medicaid |
$126,083.66
|
| Rate for Payer: Allwell Medicaid |
$126,083.66
|
| Rate for Payer: AZCH Complete Medicaid |
$126,083.66
|
| Rate for Payer: Banner UC Health Medicaid |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: AHCCCS Medicaid |
$126,083.66
|
| Rate for Payer: Allwell Medicaid |
$126,083.66
|
| Rate for Payer: AZCH Complete Medicaid |
$126,083.66
|
| Rate for Payer: Banner UC Health Medicaid |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: AHCCCS Medicaid |
$206,843.56
|
| Rate for Payer: Allwell Medicaid |
$206,843.56
|
| Rate for Payer: AZCH Complete Medicaid |
$206,843.56
|
| Rate for Payer: Banner UC Health Medicaid |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: AHCCCS Medicaid |
$206,843.56
|
| Rate for Payer: Allwell Medicaid |
$206,843.56
|
| Rate for Payer: AZCH Complete Medicaid |
$206,843.56
|
| Rate for Payer: Banner UC Health Medicaid |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: AHCCCS Medicaid |
$206,843.56
|
| Rate for Payer: Allwell Medicaid |
$206,843.56
|
| Rate for Payer: AZCH Complete Medicaid |
$206,843.56
|
| Rate for Payer: Banner UC Health Medicaid |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: AHCCCS Medicaid |
$60,868.89
|
| Rate for Payer: Allwell Medicaid |
$60,868.89
|
| Rate for Payer: AZCH Complete Medicaid |
$60,868.89
|
| Rate for Payer: Banner UC Health Medicaid |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: AHCCCS Medicaid |
$126,083.66
|
| Rate for Payer: Allwell Medicaid |
$126,083.66
|
| Rate for Payer: AZCH Complete Medicaid |
$126,083.66
|
| Rate for Payer: Banner UC Health Medicaid |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
|
