|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,320.32
|
|
|
Service Code
|
APR-DRG 6633
|
| Hospital Charge Code |
APRDRG6631
|
| Min. Negotiated Rate |
$6,320.32 |
| Max. Negotiated Rate |
$6,320.32 |
| Rate for Payer: AHCCCS Medicaid |
$6,320.32
|
| Rate for Payer: Allwell Medicaid |
$6,320.32
|
| Rate for Payer: AZCH Complete Medicaid |
$6,320.32
|
| Rate for Payer: Banner UC Health Medicaid |
$6,320.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,320.32
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,320.32
|
|
|
Service Code
|
APR-DRG 6633
|
| Hospital Charge Code |
APRDRG6634
|
| Min. Negotiated Rate |
$6,320.32 |
| Max. Negotiated Rate |
$6,320.32 |
| Rate for Payer: AHCCCS Medicaid |
$6,320.32
|
| Rate for Payer: Allwell Medicaid |
$6,320.32
|
| Rate for Payer: AZCH Complete Medicaid |
$6,320.32
|
| Rate for Payer: Banner UC Health Medicaid |
$6,320.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,320.32
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$3,436.86
|
|
|
Service Code
|
APR-DRG 6631
|
| Hospital Charge Code |
APRDRG6634
|
| Min. Negotiated Rate |
$3,436.86 |
| Max. Negotiated Rate |
$3,436.86 |
| Rate for Payer: AHCCCS Medicaid |
$3,436.86
|
| Rate for Payer: Allwell Medicaid |
$3,436.86
|
| Rate for Payer: AZCH Complete Medicaid |
$3,436.86
|
| Rate for Payer: Banner UC Health Medicaid |
$3,436.86
|
| Rate for Payer: Mercy Care Medicaid |
$3,436.86
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$11,114.38
|
|
|
Service Code
|
APR-DRG 6634
|
| Hospital Charge Code |
APRDRG6632
|
| Min. Negotiated Rate |
$11,114.38 |
| Max. Negotiated Rate |
$11,114.38 |
| Rate for Payer: AHCCCS Medicaid |
$11,114.38
|
| Rate for Payer: Allwell Medicaid |
$11,114.38
|
| Rate for Payer: AZCH Complete Medicaid |
$11,114.38
|
| Rate for Payer: Banner UC Health Medicaid |
$11,114.38
|
| Rate for Payer: Mercy Care Medicaid |
$11,114.38
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$11,114.38
|
|
|
Service Code
|
APR-DRG 6634
|
| Hospital Charge Code |
APRDRG6634
|
| Min. Negotiated Rate |
$11,114.38 |
| Max. Negotiated Rate |
$11,114.38 |
| Rate for Payer: AHCCCS Medicaid |
$11,114.38
|
| Rate for Payer: Allwell Medicaid |
$11,114.38
|
| Rate for Payer: AZCH Complete Medicaid |
$11,114.38
|
| Rate for Payer: Banner UC Health Medicaid |
$11,114.38
|
| Rate for Payer: Mercy Care Medicaid |
$11,114.38
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$11,114.38
|
|
|
Service Code
|
APR-DRG 6634
|
| Hospital Charge Code |
APRDRG6631
|
| Min. Negotiated Rate |
$11,114.38 |
| Max. Negotiated Rate |
$11,114.38 |
| Rate for Payer: AHCCCS Medicaid |
$11,114.38
|
| Rate for Payer: Allwell Medicaid |
$11,114.38
|
| Rate for Payer: AZCH Complete Medicaid |
$11,114.38
|
| Rate for Payer: Banner UC Health Medicaid |
$11,114.38
|
| Rate for Payer: Mercy Care Medicaid |
$11,114.38
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$4,459.50
|
|
|
Service Code
|
APR-DRG 6632
|
| Hospital Charge Code |
APRDRG6633
|
| Min. Negotiated Rate |
$4,459.50 |
| Max. Negotiated Rate |
$4,459.50 |
| Rate for Payer: AHCCCS Medicaid |
$4,459.50
|
| Rate for Payer: Allwell Medicaid |
$4,459.50
|
| Rate for Payer: AZCH Complete Medicaid |
$4,459.50
|
| Rate for Payer: Banner UC Health Medicaid |
$4,459.50
|
| Rate for Payer: Mercy Care Medicaid |
$4,459.50
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$4,459.50
|
|
|
Service Code
|
APR-DRG 6632
|
| Hospital Charge Code |
APRDRG6634
|
| Min. Negotiated Rate |
$4,459.50 |
| Max. Negotiated Rate |
$4,459.50 |
| Rate for Payer: AHCCCS Medicaid |
$4,459.50
|
| Rate for Payer: Allwell Medicaid |
$4,459.50
|
| Rate for Payer: AZCH Complete Medicaid |
$4,459.50
|
| Rate for Payer: Banner UC Health Medicaid |
$4,459.50
|
| Rate for Payer: Mercy Care Medicaid |
$4,459.50
|
|
|
Other Anemia And Disorders Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$3,436.86
|
|
|
Service Code
|
APR-DRG 6631
|
| Hospital Charge Code |
APRDRG6632
|
| Min. Negotiated Rate |
$3,436.86 |
| Max. Negotiated Rate |
$3,436.86 |
| Rate for Payer: AHCCCS Medicaid |
$3,436.86
|
| Rate for Payer: Allwell Medicaid |
$3,436.86
|
| Rate for Payer: AZCH Complete Medicaid |
$3,436.86
|
| Rate for Payer: Banner UC Health Medicaid |
$3,436.86
|
| Rate for Payer: Mercy Care Medicaid |
$3,436.86
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: AHCCCS Medicaid |
$13,908.76
|
| Rate for Payer: Allwell Medicaid |
$13,908.76
|
| Rate for Payer: AZCH Complete Medicaid |
$13,908.76
|
| Rate for Payer: Banner UC Health Medicaid |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: AHCCCS Medicaid |
$4,319.92
|
| Rate for Payer: Allwell Medicaid |
$4,319.92
|
| Rate for Payer: AZCH Complete Medicaid |
$4,319.92
|
| Rate for Payer: Banner UC Health Medicaid |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: AHCCCS Medicaid |
$13,908.76
|
| Rate for Payer: Allwell Medicaid |
$13,908.76
|
| Rate for Payer: AZCH Complete Medicaid |
$13,908.76
|
| Rate for Payer: Banner UC Health Medicaid |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: AHCCCS Medicaid |
$4,319.92
|
| Rate for Payer: Allwell Medicaid |
$4,319.92
|
| Rate for Payer: AZCH Complete Medicaid |
$4,319.92
|
| Rate for Payer: Banner UC Health Medicaid |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: AHCCCS Medicaid |
$7,085.54
|
| Rate for Payer: Allwell Medicaid |
$7,085.54
|
| Rate for Payer: AZCH Complete Medicaid |
$7,085.54
|
| Rate for Payer: Banner UC Health Medicaid |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: AHCCCS Medicaid |
$13,908.76
|
| Rate for Payer: Allwell Medicaid |
$13,908.76
|
| Rate for Payer: AZCH Complete Medicaid |
$13,908.76
|
| Rate for Payer: Banner UC Health Medicaid |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: AHCCCS Medicaid |
$7,085.54
|
| Rate for Payer: Allwell Medicaid |
$7,085.54
|
| Rate for Payer: AZCH Complete Medicaid |
$7,085.54
|
| Rate for Payer: Banner UC Health Medicaid |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$13,908.76
|
|
|
Service Code
|
APR-DRG 3474
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$13,908.76 |
| Max. Negotiated Rate |
$13,908.76 |
| Rate for Payer: AHCCCS Medicaid |
$13,908.76
|
| Rate for Payer: Allwell Medicaid |
$13,908.76
|
| Rate for Payer: AZCH Complete Medicaid |
$13,908.76
|
| Rate for Payer: Banner UC Health Medicaid |
$13,908.76
|
| Rate for Payer: Mercy Care Medicaid |
$13,908.76
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: AHCCCS Medicaid |
$4,319.92
|
| Rate for Payer: Allwell Medicaid |
$4,319.92
|
| Rate for Payer: AZCH Complete Medicaid |
$4,319.92
|
| Rate for Payer: Banner UC Health Medicaid |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: AHCCCS Medicaid |
$5,293.47
|
| Rate for Payer: Allwell Medicaid |
$5,293.47
|
| Rate for Payer: AZCH Complete Medicaid |
$5,293.47
|
| Rate for Payer: Banner UC Health Medicaid |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: AHCCCS Medicaid |
$7,085.54
|
| Rate for Payer: Allwell Medicaid |
$7,085.54
|
| Rate for Payer: AZCH Complete Medicaid |
$7,085.54
|
| Rate for Payer: Banner UC Health Medicaid |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: AHCCCS Medicaid |
$5,293.47
|
| Rate for Payer: Allwell Medicaid |
$5,293.47
|
| Rate for Payer: AZCH Complete Medicaid |
$5,293.47
|
| Rate for Payer: Banner UC Health Medicaid |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$4,319.92
|
|
|
Service Code
|
APR-DRG 3471
|
| Hospital Charge Code |
APRDRG3473
|
| Min. Negotiated Rate |
$4,319.92 |
| Max. Negotiated Rate |
$4,319.92 |
| Rate for Payer: AHCCCS Medicaid |
$4,319.92
|
| Rate for Payer: Allwell Medicaid |
$4,319.92
|
| Rate for Payer: AZCH Complete Medicaid |
$4,319.92
|
| Rate for Payer: Banner UC Health Medicaid |
$4,319.92
|
| Rate for Payer: Mercy Care Medicaid |
$4,319.92
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3471
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: AHCCCS Medicaid |
$5,293.47
|
| Rate for Payer: Allwell Medicaid |
$5,293.47
|
| Rate for Payer: AZCH Complete Medicaid |
$5,293.47
|
| Rate for Payer: Banner UC Health Medicaid |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$5,293.47
|
|
|
Service Code
|
APR-DRG 3472
|
| Hospital Charge Code |
APRDRG3474
|
| Min. Negotiated Rate |
$5,293.47 |
| Max. Negotiated Rate |
$5,293.47 |
| Rate for Payer: AHCCCS Medicaid |
$5,293.47
|
| Rate for Payer: Allwell Medicaid |
$5,293.47
|
| Rate for Payer: AZCH Complete Medicaid |
$5,293.47
|
| Rate for Payer: Banner UC Health Medicaid |
$5,293.47
|
| Rate for Payer: Mercy Care Medicaid |
$5,293.47
|
|
|
Other Back And Neck Disorders, Fractures And Injuries
|
Facility
|
IP
|
$7,085.54
|
|
|
Service Code
|
APR-DRG 3473
|
| Hospital Charge Code |
APRDRG3472
|
| Min. Negotiated Rate |
$7,085.54 |
| Max. Negotiated Rate |
$7,085.54 |
| Rate for Payer: AHCCCS Medicaid |
$7,085.54
|
| Rate for Payer: Allwell Medicaid |
$7,085.54
|
| Rate for Payer: AZCH Complete Medicaid |
$7,085.54
|
| Rate for Payer: Banner UC Health Medicaid |
$7,085.54
|
| Rate for Payer: Mercy Care Medicaid |
$7,085.54
|
|
