Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$20,407.23
|
|
Service Code
|
APR-DRG 6223
|
Hospital Charge Code |
APRDRG6221
|
Min. Negotiated Rate |
$20,407.23 |
Max. Negotiated Rate |
$20,407.23 |
Rate for Payer: AHCCCS Medicaid |
$20,407.23
|
Rate for Payer: Allwell Medicaid |
$20,407.23
|
Rate for Payer: AZCH Complete Medicaid |
$20,407.23
|
Rate for Payer: Banner UC Health Medicaid |
$20,407.23
|
Rate for Payer: Mercy Care Medicaid |
$20,407.23
|
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$36,513.48
|
|
Service Code
|
APR-DRG 6224
|
Hospital Charge Code |
APRDRG6224
|
Min. Negotiated Rate |
$36,513.48 |
Max. Negotiated Rate |
$36,513.48 |
Rate for Payer: AHCCCS Medicaid |
$36,513.48
|
Rate for Payer: Allwell Medicaid |
$36,513.48
|
Rate for Payer: AZCH Complete Medicaid |
$36,513.48
|
Rate for Payer: Banner UC Health Medicaid |
$36,513.48
|
Rate for Payer: Mercy Care Medicaid |
$36,513.48
|
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$10,227.11
|
|
Service Code
|
APR-DRG 6221
|
Hospital Charge Code |
APRDRG6223
|
Min. Negotiated Rate |
$10,227.11 |
Max. Negotiated Rate |
$10,227.11 |
Rate for Payer: AHCCCS Medicaid |
$10,227.11
|
Rate for Payer: Allwell Medicaid |
$10,227.11
|
Rate for Payer: AZCH Complete Medicaid |
$10,227.11
|
Rate for Payer: Banner UC Health Medicaid |
$10,227.11
|
Rate for Payer: Mercy Care Medicaid |
$10,227.11
|
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$36,513.48
|
|
Service Code
|
APR-DRG 6224
|
Hospital Charge Code |
APRDRG6221
|
Min. Negotiated Rate |
$36,513.48 |
Max. Negotiated Rate |
$36,513.48 |
Rate for Payer: AHCCCS Medicaid |
$36,513.48
|
Rate for Payer: Allwell Medicaid |
$36,513.48
|
Rate for Payer: AZCH Complete Medicaid |
$36,513.48
|
Rate for Payer: Banner UC Health Medicaid |
$36,513.48
|
Rate for Payer: Mercy Care Medicaid |
$36,513.48
|
|
Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$36,513.48
|
|
Service Code
|
APR-DRG 6224
|
Hospital Charge Code |
APRDRG6223
|
Min. Negotiated Rate |
$36,513.48 |
Max. Negotiated Rate |
$36,513.48 |
Rate for Payer: AHCCCS Medicaid |
$36,513.48
|
Rate for Payer: Allwell Medicaid |
$36,513.48
|
Rate for Payer: AZCH Complete Medicaid |
$36,513.48
|
Rate for Payer: Banner UC Health Medicaid |
$36,513.48
|
Rate for Payer: Mercy Care Medicaid |
$36,513.48
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
Service Code
|
APR-DRG 6402
|
Hospital Charge Code |
APRDRG6404
|
Min. Negotiated Rate |
$1,007.21 |
Max. Negotiated Rate |
$1,007.21 |
Rate for Payer: AHCCCS Medicaid |
$1,007.21
|
Rate for Payer: Allwell Medicaid |
$1,007.21
|
Rate for Payer: AZCH Complete Medicaid |
$1,007.21
|
Rate for Payer: Banner UC Health Medicaid |
$1,007.21
|
Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
Service Code
|
APR-DRG 6401
|
Hospital Charge Code |
APRDRG6401
|
Min. Negotiated Rate |
$692.28 |
Max. Negotiated Rate |
$692.28 |
Rate for Payer: AHCCCS Medicaid |
$692.28
|
Rate for Payer: Allwell Medicaid |
$692.28
|
Rate for Payer: AZCH Complete Medicaid |
$692.28
|
Rate for Payer: Banner UC Health Medicaid |
$692.28
|
Rate for Payer: Mercy Care Medicaid |
$692.28
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
Service Code
|
APR-DRG 6402
|
Hospital Charge Code |
APRDRG6401
|
Min. Negotiated Rate |
$1,007.21 |
Max. Negotiated Rate |
$1,007.21 |
Rate for Payer: AHCCCS Medicaid |
$1,007.21
|
Rate for Payer: Allwell Medicaid |
$1,007.21
|
Rate for Payer: AZCH Complete Medicaid |
$1,007.21
|
Rate for Payer: Banner UC Health Medicaid |
$1,007.21
|
Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$17,536.40
|
|
Service Code
|
APR-DRG 6404
|
Hospital Charge Code |
APRDRG6402
|
Min. Negotiated Rate |
$17,536.40 |
Max. Negotiated Rate |
$17,536.40 |
Rate for Payer: AHCCCS Medicaid |
$17,536.40
|
Rate for Payer: Allwell Medicaid |
$17,536.40
|
Rate for Payer: AZCH Complete Medicaid |
$17,536.40
|
Rate for Payer: Banner UC Health Medicaid |
$17,536.40
|
Rate for Payer: Mercy Care Medicaid |
$17,536.40
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
Service Code
|
APR-DRG 6403
|
Hospital Charge Code |
APRDRG6404
|
Min. Negotiated Rate |
$2,353.20 |
Max. Negotiated Rate |
$2,353.20 |
Rate for Payer: AHCCCS Medicaid |
$2,353.20
|
Rate for Payer: Allwell Medicaid |
$2,353.20
|
Rate for Payer: AZCH Complete Medicaid |
$2,353.20
|
Rate for Payer: Banner UC Health Medicaid |
$2,353.20
|
Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
Service Code
|
APR-DRG 6403
|
Hospital Charge Code |
APRDRG6402
|
Min. Negotiated Rate |
$2,353.20 |
Max. Negotiated Rate |
$2,353.20 |
Rate for Payer: AHCCCS Medicaid |
$2,353.20
|
Rate for Payer: Allwell Medicaid |
$2,353.20
|
Rate for Payer: AZCH Complete Medicaid |
$2,353.20
|
Rate for Payer: Banner UC Health Medicaid |
$2,353.20
|
Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
Service Code
|
APR-DRG 6401
|
Hospital Charge Code |
APRDRG6404
|
Min. Negotiated Rate |
$692.28 |
Max. Negotiated Rate |
$692.28 |
Rate for Payer: AHCCCS Medicaid |
$692.28
|
Rate for Payer: Allwell Medicaid |
$692.28
|
Rate for Payer: AZCH Complete Medicaid |
$692.28
|
Rate for Payer: Banner UC Health Medicaid |
$692.28
|
Rate for Payer: Mercy Care Medicaid |
$692.28
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$17,536.40
|
|
Service Code
|
APR-DRG 6404
|
Hospital Charge Code |
APRDRG6401
|
Min. Negotiated Rate |
$17,536.40 |
Max. Negotiated Rate |
$17,536.40 |
Rate for Payer: AHCCCS Medicaid |
$17,536.40
|
Rate for Payer: Allwell Medicaid |
$17,536.40
|
Rate for Payer: AZCH Complete Medicaid |
$17,536.40
|
Rate for Payer: Banner UC Health Medicaid |
$17,536.40
|
Rate for Payer: Mercy Care Medicaid |
$17,536.40
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
Service Code
|
APR-DRG 6401
|
Hospital Charge Code |
APRDRG6402
|
Min. Negotiated Rate |
$692.28 |
Max. Negotiated Rate |
$692.28 |
Rate for Payer: AHCCCS Medicaid |
$692.28
|
Rate for Payer: Allwell Medicaid |
$692.28
|
Rate for Payer: AZCH Complete Medicaid |
$692.28
|
Rate for Payer: Banner UC Health Medicaid |
$692.28
|
Rate for Payer: Mercy Care Medicaid |
$692.28
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$17,536.40
|
|
Service Code
|
APR-DRG 6404
|
Hospital Charge Code |
APRDRG6404
|
Min. Negotiated Rate |
$17,536.40 |
Max. Negotiated Rate |
$17,536.40 |
Rate for Payer: AHCCCS Medicaid |
$17,536.40
|
Rate for Payer: Allwell Medicaid |
$17,536.40
|
Rate for Payer: AZCH Complete Medicaid |
$17,536.40
|
Rate for Payer: Banner UC Health Medicaid |
$17,536.40
|
Rate for Payer: Mercy Care Medicaid |
$17,536.40
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
Service Code
|
APR-DRG 6401
|
Hospital Charge Code |
APRDRG6403
|
Min. Negotiated Rate |
$692.28 |
Max. Negotiated Rate |
$692.28 |
Rate for Payer: AHCCCS Medicaid |
$692.28
|
Rate for Payer: Allwell Medicaid |
$692.28
|
Rate for Payer: AZCH Complete Medicaid |
$692.28
|
Rate for Payer: Banner UC Health Medicaid |
$692.28
|
Rate for Payer: Mercy Care Medicaid |
$692.28
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
Service Code
|
APR-DRG 6403
|
Hospital Charge Code |
APRDRG6401
|
Min. Negotiated Rate |
$2,353.20 |
Max. Negotiated Rate |
$2,353.20 |
Rate for Payer: AHCCCS Medicaid |
$2,353.20
|
Rate for Payer: Allwell Medicaid |
$2,353.20
|
Rate for Payer: AZCH Complete Medicaid |
$2,353.20
|
Rate for Payer: Banner UC Health Medicaid |
$2,353.20
|
Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$17,536.40
|
|
Service Code
|
APR-DRG 6404
|
Hospital Charge Code |
APRDRG6403
|
Min. Negotiated Rate |
$17,536.40 |
Max. Negotiated Rate |
$17,536.40 |
Rate for Payer: AHCCCS Medicaid |
$17,536.40
|
Rate for Payer: Allwell Medicaid |
$17,536.40
|
Rate for Payer: AZCH Complete Medicaid |
$17,536.40
|
Rate for Payer: Banner UC Health Medicaid |
$17,536.40
|
Rate for Payer: Mercy Care Medicaid |
$17,536.40
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
Service Code
|
APR-DRG 6402
|
Hospital Charge Code |
APRDRG6403
|
Min. Negotiated Rate |
$1,007.21 |
Max. Negotiated Rate |
$1,007.21 |
Rate for Payer: AHCCCS Medicaid |
$1,007.21
|
Rate for Payer: Allwell Medicaid |
$1,007.21
|
Rate for Payer: AZCH Complete Medicaid |
$1,007.21
|
Rate for Payer: Banner UC Health Medicaid |
$1,007.21
|
Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
Service Code
|
APR-DRG 6403
|
Hospital Charge Code |
APRDRG6403
|
Min. Negotiated Rate |
$2,353.20 |
Max. Negotiated Rate |
$2,353.20 |
Rate for Payer: AHCCCS Medicaid |
$2,353.20
|
Rate for Payer: Allwell Medicaid |
$2,353.20
|
Rate for Payer: AZCH Complete Medicaid |
$2,353.20
|
Rate for Payer: Banner UC Health Medicaid |
$2,353.20
|
Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
Service Code
|
APR-DRG 6402
|
Hospital Charge Code |
APRDRG6402
|
Min. Negotiated Rate |
$1,007.21 |
Max. Negotiated Rate |
$1,007.21 |
Rate for Payer: AHCCCS Medicaid |
$1,007.21
|
Rate for Payer: Allwell Medicaid |
$1,007.21
|
Rate for Payer: AZCH Complete Medicaid |
$1,007.21
|
Rate for Payer: Banner UC Health Medicaid |
$1,007.21
|
Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
Service Code
|
APR-DRG 6364
|
Hospital Charge Code |
APRDRG6363
|
Min. Negotiated Rate |
$29,347.98 |
Max. Negotiated Rate |
$29,347.98 |
Rate for Payer: AHCCCS Medicaid |
$29,347.98
|
Rate for Payer: Allwell Medicaid |
$29,347.98
|
Rate for Payer: AZCH Complete Medicaid |
$29,347.98
|
Rate for Payer: Banner UC Health Medicaid |
$29,347.98
|
Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
Service Code
|
APR-DRG 6362
|
Hospital Charge Code |
APRDRG6363
|
Min. Negotiated Rate |
$8,089.25 |
Max. Negotiated Rate |
$8,089.25 |
Rate for Payer: AHCCCS Medicaid |
$8,089.25
|
Rate for Payer: Allwell Medicaid |
$8,089.25
|
Rate for Payer: AZCH Complete Medicaid |
$8,089.25
|
Rate for Payer: Banner UC Health Medicaid |
$8,089.25
|
Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
Service Code
|
APR-DRG 6364
|
Hospital Charge Code |
APRDRG6364
|
Min. Negotiated Rate |
$29,347.98 |
Max. Negotiated Rate |
$29,347.98 |
Rate for Payer: AHCCCS Medicaid |
$29,347.98
|
Rate for Payer: Allwell Medicaid |
$29,347.98
|
Rate for Payer: AZCH Complete Medicaid |
$29,347.98
|
Rate for Payer: Banner UC Health Medicaid |
$29,347.98
|
Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
Service Code
|
APR-DRG 6362
|
Hospital Charge Code |
APRDRG6362
|
Min. Negotiated Rate |
$8,089.25 |
Max. Negotiated Rate |
$8,089.25 |
Rate for Payer: AHCCCS Medicaid |
$8,089.25
|
Rate for Payer: Allwell Medicaid |
$8,089.25
|
Rate for Payer: AZCH Complete Medicaid |
$8,089.25
|
Rate for Payer: Banner UC Health Medicaid |
$8,089.25
|
Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
|