|
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
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6361
|
| 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 |
APRDRG6362
|
| 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
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: AHCCCS Medicaid |
$16,258.45
|
| Rate for Payer: Allwell Medicaid |
$16,258.45
|
| Rate for Payer: AZCH Complete Medicaid |
$16,258.45
|
| Rate for Payer: Banner UC Health Medicaid |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6364
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: AHCCCS Medicaid |
$16,258.45
|
| Rate for Payer: Allwell Medicaid |
$16,258.45
|
| Rate for Payer: AZCH Complete Medicaid |
$16,258.45
|
| Rate for Payer: Banner UC Health Medicaid |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: AHCCCS Medicaid |
$16,258.45
|
| Rate for Payer: Allwell Medicaid |
$16,258.45
|
| Rate for Payer: AZCH Complete Medicaid |
$16,258.45
|
| Rate for Payer: Banner UC Health Medicaid |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
|
|
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
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6361
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: AHCCCS Medicaid |
$16,258.45
|
| Rate for Payer: Allwell Medicaid |
$16,258.45
|
| Rate for Payer: AZCH Complete Medicaid |
$16,258.45
|
| Rate for Payer: Banner UC Health Medicaid |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6364
|
| 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
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: AHCCCS Medicaid |
$4,584.35
|
| Rate for Payer: Allwell Medicaid |
$4,584.35
|
| Rate for Payer: AZCH Complete Medicaid |
$4,584.35
|
| Rate for Payer: Banner UC Health Medicaid |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: AHCCCS Medicaid |
$4,584.35
|
| Rate for Payer: Allwell Medicaid |
$4,584.35
|
| Rate for Payer: AZCH Complete Medicaid |
$4,584.35
|
| Rate for Payer: Banner UC Health Medicaid |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$7,082.04
|
|
|
Service Code
|
APR-DRG 6332
|
| Hospital Charge Code |
APRDRG6331
|
| Min. Negotiated Rate |
$7,082.04 |
| Max. Negotiated Rate |
$7,082.04 |
| Rate for Payer: AHCCCS Medicaid |
$7,082.04
|
| Rate for Payer: Allwell Medicaid |
$7,082.04
|
| Rate for Payer: AZCH Complete Medicaid |
$7,082.04
|
| Rate for Payer: Banner UC Health Medicaid |
$7,082.04
|
| Rate for Payer: Mercy Care Medicaid |
$7,082.04
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$1,907.11
|
|
|
Service Code
|
APR-DRG 6331
|
| Hospital Charge Code |
APRDRG6332
|
| Min. Negotiated Rate |
$1,907.11 |
| Max. Negotiated Rate |
$1,907.11 |
| Rate for Payer: AHCCCS Medicaid |
$1,907.11
|
| Rate for Payer: Allwell Medicaid |
$1,907.11
|
| Rate for Payer: AZCH Complete Medicaid |
$1,907.11
|
| Rate for Payer: Banner UC Health Medicaid |
$1,907.11
|
| Rate for Payer: Mercy Care Medicaid |
$1,907.11
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$46,523.16
|
|
|
Service Code
|
APR-DRG 6334
|
| Hospital Charge Code |
APRDRG6331
|
| Min. Negotiated Rate |
$46,523.16 |
| Max. Negotiated Rate |
$46,523.16 |
| Rate for Payer: AHCCCS Medicaid |
$46,523.16
|
| Rate for Payer: Allwell Medicaid |
$46,523.16
|
| Rate for Payer: AZCH Complete Medicaid |
$46,523.16
|
| Rate for Payer: Banner UC Health Medicaid |
$46,523.16
|
| Rate for Payer: Mercy Care Medicaid |
$46,523.16
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$7,082.04
|
|
|
Service Code
|
APR-DRG 6332
|
| Hospital Charge Code |
APRDRG6334
|
| Min. Negotiated Rate |
$7,082.04 |
| Max. Negotiated Rate |
$7,082.04 |
| Rate for Payer: AHCCCS Medicaid |
$7,082.04
|
| Rate for Payer: Allwell Medicaid |
$7,082.04
|
| Rate for Payer: AZCH Complete Medicaid |
$7,082.04
|
| Rate for Payer: Banner UC Health Medicaid |
$7,082.04
|
| Rate for Payer: Mercy Care Medicaid |
$7,082.04
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$7,082.04
|
|
|
Service Code
|
APR-DRG 6332
|
| Hospital Charge Code |
APRDRG6332
|
| Min. Negotiated Rate |
$7,082.04 |
| Max. Negotiated Rate |
$7,082.04 |
| Rate for Payer: AHCCCS Medicaid |
$7,082.04
|
| Rate for Payer: Allwell Medicaid |
$7,082.04
|
| Rate for Payer: AZCH Complete Medicaid |
$7,082.04
|
| Rate for Payer: Banner UC Health Medicaid |
$7,082.04
|
| Rate for Payer: Mercy Care Medicaid |
$7,082.04
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$46,523.16
|
|
|
Service Code
|
APR-DRG 6334
|
| Hospital Charge Code |
APRDRG6332
|
| Min. Negotiated Rate |
$46,523.16 |
| Max. Negotiated Rate |
$46,523.16 |
| Rate for Payer: AHCCCS Medicaid |
$46,523.16
|
| Rate for Payer: Allwell Medicaid |
$46,523.16
|
| Rate for Payer: AZCH Complete Medicaid |
$46,523.16
|
| Rate for Payer: Banner UC Health Medicaid |
$46,523.16
|
| Rate for Payer: Mercy Care Medicaid |
$46,523.16
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$46,523.16
|
|
|
Service Code
|
APR-DRG 6334
|
| Hospital Charge Code |
APRDRG6334
|
| Min. Negotiated Rate |
$46,523.16 |
| Max. Negotiated Rate |
$46,523.16 |
| Rate for Payer: AHCCCS Medicaid |
$46,523.16
|
| Rate for Payer: Allwell Medicaid |
$46,523.16
|
| Rate for Payer: AZCH Complete Medicaid |
$46,523.16
|
| Rate for Payer: Banner UC Health Medicaid |
$46,523.16
|
| Rate for Payer: Mercy Care Medicaid |
$46,523.16
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$19,568.36
|
|
|
Service Code
|
APR-DRG 6333
|
| Hospital Charge Code |
APRDRG6332
|
| Min. Negotiated Rate |
$19,568.36 |
| Max. Negotiated Rate |
$19,568.36 |
| Rate for Payer: AHCCCS Medicaid |
$19,568.36
|
| Rate for Payer: Allwell Medicaid |
$19,568.36
|
| Rate for Payer: AZCH Complete Medicaid |
$19,568.36
|
| Rate for Payer: Banner UC Health Medicaid |
$19,568.36
|
| Rate for Payer: Mercy Care Medicaid |
$19,568.36
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$46,523.16
|
|
|
Service Code
|
APR-DRG 6334
|
| Hospital Charge Code |
APRDRG6333
|
| Min. Negotiated Rate |
$46,523.16 |
| Max. Negotiated Rate |
$46,523.16 |
| Rate for Payer: AHCCCS Medicaid |
$46,523.16
|
| Rate for Payer: Allwell Medicaid |
$46,523.16
|
| Rate for Payer: AZCH Complete Medicaid |
$46,523.16
|
| Rate for Payer: Banner UC Health Medicaid |
$46,523.16
|
| Rate for Payer: Mercy Care Medicaid |
$46,523.16
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$7,082.04
|
|
|
Service Code
|
APR-DRG 6332
|
| Hospital Charge Code |
APRDRG6333
|
| Min. Negotiated Rate |
$7,082.04 |
| Max. Negotiated Rate |
$7,082.04 |
| Rate for Payer: AHCCCS Medicaid |
$7,082.04
|
| Rate for Payer: Allwell Medicaid |
$7,082.04
|
| Rate for Payer: AZCH Complete Medicaid |
$7,082.04
|
| Rate for Payer: Banner UC Health Medicaid |
$7,082.04
|
| Rate for Payer: Mercy Care Medicaid |
$7,082.04
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$19,568.36
|
|
|
Service Code
|
APR-DRG 6333
|
| Hospital Charge Code |
APRDRG6331
|
| Min. Negotiated Rate |
$19,568.36 |
| Max. Negotiated Rate |
$19,568.36 |
| Rate for Payer: AHCCCS Medicaid |
$19,568.36
|
| Rate for Payer: Allwell Medicaid |
$19,568.36
|
| Rate for Payer: AZCH Complete Medicaid |
$19,568.36
|
| Rate for Payer: Banner UC Health Medicaid |
$19,568.36
|
| Rate for Payer: Mercy Care Medicaid |
$19,568.36
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$1,907.11
|
|
|
Service Code
|
APR-DRG 6331
|
| Hospital Charge Code |
APRDRG6333
|
| Min. Negotiated Rate |
$1,907.11 |
| Max. Negotiated Rate |
$1,907.11 |
| Rate for Payer: AHCCCS Medicaid |
$1,907.11
|
| Rate for Payer: Allwell Medicaid |
$1,907.11
|
| Rate for Payer: AZCH Complete Medicaid |
$1,907.11
|
| Rate for Payer: Banner UC Health Medicaid |
$1,907.11
|
| Rate for Payer: Mercy Care Medicaid |
$1,907.11
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$1,907.11
|
|
|
Service Code
|
APR-DRG 6331
|
| Hospital Charge Code |
APRDRG6331
|
| Min. Negotiated Rate |
$1,907.11 |
| Max. Negotiated Rate |
$1,907.11 |
| Rate for Payer: AHCCCS Medicaid |
$1,907.11
|
| Rate for Payer: Allwell Medicaid |
$1,907.11
|
| Rate for Payer: AZCH Complete Medicaid |
$1,907.11
|
| Rate for Payer: Banner UC Health Medicaid |
$1,907.11
|
| Rate for Payer: Mercy Care Medicaid |
$1,907.11
|
|
