|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6232
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: AHCCCS Medicaid |
$13,704.65
|
| Rate for Payer: Allwell Medicaid |
$13,704.65
|
| Rate for Payer: AZCH Complete Medicaid |
$13,704.65
|
| Rate for Payer: Banner UC Health Medicaid |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: AHCCCS Medicaid |
$25,929.36
|
| Rate for Payer: Allwell Medicaid |
$25,929.36
|
| Rate for Payer: AZCH Complete Medicaid |
$25,929.36
|
| Rate for Payer: Banner UC Health Medicaid |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: AHCCCS Medicaid |
$25,929.36
|
| Rate for Payer: Allwell Medicaid |
$25,929.36
|
| Rate for Payer: AZCH Complete Medicaid |
$25,929.36
|
| Rate for Payer: Banner UC Health Medicaid |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$7,804.48
|
|
|
Service Code
|
APR-DRG 6231
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$7,804.48 |
| Max. Negotiated Rate |
$7,804.48 |
| Rate for Payer: AHCCCS Medicaid |
$7,804.48
|
| Rate for Payer: Allwell Medicaid |
$7,804.48
|
| Rate for Payer: AZCH Complete Medicaid |
$7,804.48
|
| Rate for Payer: Banner UC Health Medicaid |
$7,804.48
|
| Rate for Payer: Mercy Care Medicaid |
$7,804.48
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6233
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: AHCCCS Medicaid |
$13,704.65
|
| Rate for Payer: Allwell Medicaid |
$13,704.65
|
| Rate for Payer: AZCH Complete Medicaid |
$13,704.65
|
| Rate for Payer: Banner UC Health Medicaid |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: AHCCCS Medicaid |
$13,704.65
|
| Rate for Payer: Allwell Medicaid |
$13,704.65
|
| Rate for Payer: AZCH Complete Medicaid |
$13,704.65
|
| Rate for Payer: Banner UC Health Medicaid |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$42,547.63
|
|
|
Service Code
|
APR-DRG 6234
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$42,547.63 |
| Max. Negotiated Rate |
$42,547.63 |
| Rate for Payer: AHCCCS Medicaid |
$42,547.63
|
| Rate for Payer: Allwell Medicaid |
$42,547.63
|
| Rate for Payer: AZCH Complete Medicaid |
$42,547.63
|
| Rate for Payer: Banner UC Health Medicaid |
$42,547.63
|
| Rate for Payer: Mercy Care Medicaid |
$42,547.63
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6212
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: AHCCCS Medicaid |
$14,645.93
|
| Rate for Payer: Allwell Medicaid |
$14,645.93
|
| Rate for Payer: AZCH Complete Medicaid |
$14,645.93
|
| Rate for Payer: Banner UC Health Medicaid |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$5,088.66
|
|
|
Service Code
|
APR-DRG 6211
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$5,088.66 |
| Max. Negotiated Rate |
$5,088.66 |
| Rate for Payer: AHCCCS Medicaid |
$5,088.66
|
| Rate for Payer: Allwell Medicaid |
$5,088.66
|
| Rate for Payer: AZCH Complete Medicaid |
$5,088.66
|
| Rate for Payer: Banner UC Health Medicaid |
$5,088.66
|
| Rate for Payer: Mercy Care Medicaid |
$5,088.66
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6213
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: AHCCCS Medicaid |
$14,645.93
|
| Rate for Payer: Allwell Medicaid |
$14,645.93
|
| Rate for Payer: AZCH Complete Medicaid |
$14,645.93
|
| Rate for Payer: Banner UC Health Medicaid |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: AHCCCS Medicaid |
$14,645.93
|
| Rate for Payer: Allwell Medicaid |
$14,645.93
|
| Rate for Payer: AZCH Complete Medicaid |
$14,645.93
|
| Rate for Payer: Banner UC Health Medicaid |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$47,287.69
|
|
|
Service Code
|
APR-DRG 6214
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$47,287.69 |
| Max. Negotiated Rate |
$47,287.69 |
| Rate for Payer: AHCCCS Medicaid |
$47,287.69
|
| Rate for Payer: Allwell Medicaid |
$47,287.69
|
| Rate for Payer: AZCH Complete Medicaid |
$47,287.69
|
| Rate for Payer: Banner UC Health Medicaid |
$47,287.69
|
| Rate for Payer: Mercy Care Medicaid |
$47,287.69
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: AHCCCS Medicaid |
$14,645.93
|
| Rate for Payer: Allwell Medicaid |
$14,645.93
|
| Rate for Payer: AZCH Complete Medicaid |
$14,645.93
|
| Rate for Payer: Banner UC Health Medicaid |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: AHCCCS Medicaid |
$27,217.83
|
| Rate for Payer: Allwell Medicaid |
$27,217.83
|
| Rate for Payer: AZCH Complete Medicaid |
$27,217.83
|
| Rate for Payer: Banner UC Health Medicaid |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6212
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: AHCCCS Medicaid |
$27,217.83
|
| Rate for Payer: Allwell Medicaid |
$27,217.83
|
| Rate for Payer: AZCH Complete Medicaid |
$27,217.83
|
| Rate for Payer: Banner UC Health Medicaid |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$5,088.66
|
|
|
Service Code
|
APR-DRG 6211
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$5,088.66 |
| Max. Negotiated Rate |
$5,088.66 |
| Rate for Payer: AHCCCS Medicaid |
$5,088.66
|
| Rate for Payer: Allwell Medicaid |
$5,088.66
|
| Rate for Payer: AZCH Complete Medicaid |
$5,088.66
|
| Rate for Payer: Banner UC Health Medicaid |
$5,088.66
|
| Rate for Payer: Mercy Care Medicaid |
$5,088.66
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: AHCCCS Medicaid |
$27,217.83
|
| Rate for Payer: Allwell Medicaid |
$27,217.83
|
| Rate for Payer: AZCH Complete Medicaid |
$27,217.83
|
| Rate for Payer: Banner UC Health Medicaid |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$47,287.69
|
|
|
Service Code
|
APR-DRG 6214
|
| Hospital Charge Code |
APRDRG6212
|
| Min. Negotiated Rate |
$47,287.69 |
| Max. Negotiated Rate |
$47,287.69 |
| Rate for Payer: AHCCCS Medicaid |
$47,287.69
|
| Rate for Payer: Allwell Medicaid |
$47,287.69
|
| Rate for Payer: AZCH Complete Medicaid |
$47,287.69
|
| Rate for Payer: Banner UC Health Medicaid |
$47,287.69
|
| Rate for Payer: Mercy Care Medicaid |
$47,287.69
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$47,287.69
|
|
|
Service Code
|
APR-DRG 6214
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$47,287.69 |
| Max. Negotiated Rate |
$47,287.69 |
| Rate for Payer: AHCCCS Medicaid |
$47,287.69
|
| Rate for Payer: Allwell Medicaid |
$47,287.69
|
| Rate for Payer: AZCH Complete Medicaid |
$47,287.69
|
| Rate for Payer: Banner UC Health Medicaid |
$47,287.69
|
| Rate for Payer: Mercy Care Medicaid |
$47,287.69
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6213
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: AHCCCS Medicaid |
$27,217.83
|
| Rate for Payer: Allwell Medicaid |
$27,217.83
|
| Rate for Payer: AZCH Complete Medicaid |
$27,217.83
|
| Rate for Payer: Banner UC Health Medicaid |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$5,088.66
|
|
|
Service Code
|
APR-DRG 6211
|
| Hospital Charge Code |
APRDRG6212
|
| Min. Negotiated Rate |
$5,088.66 |
| Max. Negotiated Rate |
$5,088.66 |
| Rate for Payer: AHCCCS Medicaid |
$5,088.66
|
| Rate for Payer: Allwell Medicaid |
$5,088.66
|
| Rate for Payer: AZCH Complete Medicaid |
$5,088.66
|
| Rate for Payer: Banner UC Health Medicaid |
$5,088.66
|
| Rate for Payer: Mercy Care Medicaid |
$5,088.66
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$47,287.69
|
|
|
Service Code
|
APR-DRG 6214
|
| Hospital Charge Code |
APRDRG6213
|
| Min. Negotiated Rate |
$47,287.69 |
| Max. Negotiated Rate |
$47,287.69 |
| Rate for Payer: AHCCCS Medicaid |
$47,287.69
|
| Rate for Payer: Allwell Medicaid |
$47,287.69
|
| Rate for Payer: AZCH Complete Medicaid |
$47,287.69
|
| Rate for Payer: Banner UC Health Medicaid |
$47,287.69
|
| Rate for Payer: Mercy Care Medicaid |
$47,287.69
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$5,088.66
|
|
|
Service Code
|
APR-DRG 6211
|
| Hospital Charge Code |
APRDRG6213
|
| Min. Negotiated Rate |
$5,088.66 |
| Max. Negotiated Rate |
$5,088.66 |
| Rate for Payer: AHCCCS Medicaid |
$5,088.66
|
| Rate for Payer: Allwell Medicaid |
$5,088.66
|
| Rate for Payer: AZCH Complete Medicaid |
$5,088.66
|
| Rate for Payer: Banner UC Health Medicaid |
$5,088.66
|
| Rate for Payer: Mercy Care Medicaid |
$5,088.66
|
|
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
Facility
|
IP
|
$13,673.09
|
|
|
Service Code
|
APR-DRG 6252
|
| Hospital Charge Code |
APRDRG6252
|
| Min. Negotiated Rate |
$13,673.09 |
| Max. Negotiated Rate |
$13,673.09 |
| Rate for Payer: AHCCCS Medicaid |
$13,673.09
|
| Rate for Payer: Allwell Medicaid |
$13,673.09
|
| Rate for Payer: AZCH Complete Medicaid |
$13,673.09
|
| Rate for Payer: Banner UC Health Medicaid |
$13,673.09
|
| Rate for Payer: Mercy Care Medicaid |
$13,673.09
|
|
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
Facility
|
IP
|
$22,888.08
|
|
|
Service Code
|
APR-DRG 6253
|
| Hospital Charge Code |
APRDRG6253
|
| Min. Negotiated Rate |
$22,888.08 |
| Max. Negotiated Rate |
$22,888.08 |
| Rate for Payer: AHCCCS Medicaid |
$22,888.08
|
| Rate for Payer: Allwell Medicaid |
$22,888.08
|
| Rate for Payer: AZCH Complete Medicaid |
$22,888.08
|
| Rate for Payer: Banner UC Health Medicaid |
$22,888.08
|
| Rate for Payer: Mercy Care Medicaid |
$22,888.08
|
|
