|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$3,840.87
|
|
|
Service Code
|
APR-DRG 8152
|
| Hospital Charge Code |
APRDRG8154
|
| Min. Negotiated Rate |
$3,840.87 |
| Max. Negotiated Rate |
$3,840.87 |
| Rate for Payer: AHCCCS Medicaid |
$3,840.87
|
| Rate for Payer: Allwell Medicaid |
$3,840.87
|
| Rate for Payer: AZCH Complete Medicaid |
$3,840.87
|
| Rate for Payer: Banner UC Health Medicaid |
$3,840.87
|
| Rate for Payer: Mercy Care Medicaid |
$3,840.87
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$2,978.14
|
|
|
Service Code
|
APR-DRG 8151
|
| Hospital Charge Code |
APRDRG8152
|
| Min. Negotiated Rate |
$2,978.14 |
| Max. Negotiated Rate |
$2,978.14 |
| Rate for Payer: AHCCCS Medicaid |
$2,978.14
|
| Rate for Payer: Allwell Medicaid |
$2,978.14
|
| Rate for Payer: AZCH Complete Medicaid |
$2,978.14
|
| Rate for Payer: Banner UC Health Medicaid |
$2,978.14
|
| Rate for Payer: Mercy Care Medicaid |
$2,978.14
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$6,475.32
|
|
|
Service Code
|
APR-DRG 8153
|
| Hospital Charge Code |
APRDRG8151
|
| Min. Negotiated Rate |
$6,475.32 |
| Max. Negotiated Rate |
$6,475.32 |
| Rate for Payer: AHCCCS Medicaid |
$6,475.32
|
| Rate for Payer: Allwell Medicaid |
$6,475.32
|
| Rate for Payer: AZCH Complete Medicaid |
$6,475.32
|
| Rate for Payer: Banner UC Health Medicaid |
$6,475.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,475.32
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$16,898.13
|
|
|
Service Code
|
APR-DRG 8154
|
| Hospital Charge Code |
APRDRG8154
|
| Min. Negotiated Rate |
$16,898.13 |
| Max. Negotiated Rate |
$16,898.13 |
| Rate for Payer: AHCCCS Medicaid |
$16,898.13
|
| Rate for Payer: Allwell Medicaid |
$16,898.13
|
| Rate for Payer: AZCH Complete Medicaid |
$16,898.13
|
| Rate for Payer: Banner UC Health Medicaid |
$16,898.13
|
| Rate for Payer: Mercy Care Medicaid |
$16,898.13
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$2,978.14
|
|
|
Service Code
|
APR-DRG 8151
|
| Hospital Charge Code |
APRDRG8154
|
| Min. Negotiated Rate |
$2,978.14 |
| Max. Negotiated Rate |
$2,978.14 |
| Rate for Payer: AHCCCS Medicaid |
$2,978.14
|
| Rate for Payer: Allwell Medicaid |
$2,978.14
|
| Rate for Payer: AZCH Complete Medicaid |
$2,978.14
|
| Rate for Payer: Banner UC Health Medicaid |
$2,978.14
|
| Rate for Payer: Mercy Care Medicaid |
$2,978.14
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$6,475.32
|
|
|
Service Code
|
APR-DRG 8153
|
| Hospital Charge Code |
APRDRG8153
|
| Min. Negotiated Rate |
$6,475.32 |
| Max. Negotiated Rate |
$6,475.32 |
| Rate for Payer: AHCCCS Medicaid |
$6,475.32
|
| Rate for Payer: Allwell Medicaid |
$6,475.32
|
| Rate for Payer: AZCH Complete Medicaid |
$6,475.32
|
| Rate for Payer: Banner UC Health Medicaid |
$6,475.32
|
| Rate for Payer: Mercy Care Medicaid |
$6,475.32
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$3,840.87
|
|
|
Service Code
|
APR-DRG 8152
|
| Hospital Charge Code |
APRDRG8153
|
| Min. Negotiated Rate |
$3,840.87 |
| Max. Negotiated Rate |
$3,840.87 |
| Rate for Payer: AHCCCS Medicaid |
$3,840.87
|
| Rate for Payer: Allwell Medicaid |
$3,840.87
|
| Rate for Payer: AZCH Complete Medicaid |
$3,840.87
|
| Rate for Payer: Banner UC Health Medicaid |
$3,840.87
|
| Rate for Payer: Mercy Care Medicaid |
$3,840.87
|
|
|
Other Injury, Poisoning And Toxic Effect Diagnoses
|
Facility
|
IP
|
$2,978.14
|
|
|
Service Code
|
APR-DRG 8151
|
| Hospital Charge Code |
APRDRG8153
|
| Min. Negotiated Rate |
$2,978.14 |
| Max. Negotiated Rate |
$2,978.14 |
| Rate for Payer: AHCCCS Medicaid |
$2,978.14
|
| Rate for Payer: Allwell Medicaid |
$2,978.14
|
| Rate for Payer: AZCH Complete Medicaid |
$2,978.14
|
| Rate for Payer: Banner UC Health Medicaid |
$2,978.14
|
| Rate for Payer: Mercy Care Medicaid |
$2,978.14
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$3,485.26
|
|
|
Service Code
|
APR-DRG 4681
|
| Hospital Charge Code |
APRDRG4682
|
| Min. Negotiated Rate |
$3,485.26 |
| Max. Negotiated Rate |
$3,485.26 |
| Rate for Payer: AHCCCS Medicaid |
$3,485.26
|
| Rate for Payer: Allwell Medicaid |
$3,485.26
|
| Rate for Payer: AZCH Complete Medicaid |
$3,485.26
|
| Rate for Payer: Banner UC Health Medicaid |
$3,485.26
|
| Rate for Payer: Mercy Care Medicaid |
$3,485.26
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$6,754.48
|
|
|
Service Code
|
APR-DRG 4683
|
| Hospital Charge Code |
APRDRG4683
|
| Min. Negotiated Rate |
$6,754.48 |
| Max. Negotiated Rate |
$6,754.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,754.48
|
| Rate for Payer: Allwell Medicaid |
$6,754.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,754.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,754.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,754.48
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$11,770.19
|
|
|
Service Code
|
APR-DRG 4684
|
| Hospital Charge Code |
APRDRG4682
|
| Min. Negotiated Rate |
$11,770.19 |
| Max. Negotiated Rate |
$11,770.19 |
| Rate for Payer: AHCCCS Medicaid |
$11,770.19
|
| Rate for Payer: Allwell Medicaid |
$11,770.19
|
| Rate for Payer: AZCH Complete Medicaid |
$11,770.19
|
| Rate for Payer: Banner UC Health Medicaid |
$11,770.19
|
| Rate for Payer: Mercy Care Medicaid |
$11,770.19
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$3,485.26
|
|
|
Service Code
|
APR-DRG 4681
|
| Hospital Charge Code |
APRDRG4683
|
| Min. Negotiated Rate |
$3,485.26 |
| Max. Negotiated Rate |
$3,485.26 |
| Rate for Payer: AHCCCS Medicaid |
$3,485.26
|
| Rate for Payer: Allwell Medicaid |
$3,485.26
|
| Rate for Payer: AZCH Complete Medicaid |
$3,485.26
|
| Rate for Payer: Banner UC Health Medicaid |
$3,485.26
|
| Rate for Payer: Mercy Care Medicaid |
$3,485.26
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$4,490.36
|
|
|
Service Code
|
APR-DRG 4682
|
| Hospital Charge Code |
APRDRG4684
|
| Min. Negotiated Rate |
$4,490.36 |
| Max. Negotiated Rate |
$4,490.36 |
| Rate for Payer: AHCCCS Medicaid |
$4,490.36
|
| Rate for Payer: Allwell Medicaid |
$4,490.36
|
| Rate for Payer: AZCH Complete Medicaid |
$4,490.36
|
| Rate for Payer: Banner UC Health Medicaid |
$4,490.36
|
| Rate for Payer: Mercy Care Medicaid |
$4,490.36
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$3,485.26
|
|
|
Service Code
|
APR-DRG 4681
|
| Hospital Charge Code |
APRDRG4684
|
| Min. Negotiated Rate |
$3,485.26 |
| Max. Negotiated Rate |
$3,485.26 |
| Rate for Payer: AHCCCS Medicaid |
$3,485.26
|
| Rate for Payer: Allwell Medicaid |
$3,485.26
|
| Rate for Payer: AZCH Complete Medicaid |
$3,485.26
|
| Rate for Payer: Banner UC Health Medicaid |
$3,485.26
|
| Rate for Payer: Mercy Care Medicaid |
$3,485.26
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$6,754.48
|
|
|
Service Code
|
APR-DRG 4683
|
| Hospital Charge Code |
APRDRG4682
|
| Min. Negotiated Rate |
$6,754.48 |
| Max. Negotiated Rate |
$6,754.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,754.48
|
| Rate for Payer: Allwell Medicaid |
$6,754.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,754.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,754.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,754.48
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$11,770.19
|
|
|
Service Code
|
APR-DRG 4684
|
| Hospital Charge Code |
APRDRG4681
|
| Min. Negotiated Rate |
$11,770.19 |
| Max. Negotiated Rate |
$11,770.19 |
| Rate for Payer: AHCCCS Medicaid |
$11,770.19
|
| Rate for Payer: Allwell Medicaid |
$11,770.19
|
| Rate for Payer: AZCH Complete Medicaid |
$11,770.19
|
| Rate for Payer: Banner UC Health Medicaid |
$11,770.19
|
| Rate for Payer: Mercy Care Medicaid |
$11,770.19
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$11,770.19
|
|
|
Service Code
|
APR-DRG 4684
|
| Hospital Charge Code |
APRDRG4684
|
| Min. Negotiated Rate |
$11,770.19 |
| Max. Negotiated Rate |
$11,770.19 |
| Rate for Payer: AHCCCS Medicaid |
$11,770.19
|
| Rate for Payer: Allwell Medicaid |
$11,770.19
|
| Rate for Payer: AZCH Complete Medicaid |
$11,770.19
|
| Rate for Payer: Banner UC Health Medicaid |
$11,770.19
|
| Rate for Payer: Mercy Care Medicaid |
$11,770.19
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$4,490.36
|
|
|
Service Code
|
APR-DRG 4682
|
| Hospital Charge Code |
APRDRG4682
|
| Min. Negotiated Rate |
$4,490.36 |
| Max. Negotiated Rate |
$4,490.36 |
| Rate for Payer: AHCCCS Medicaid |
$4,490.36
|
| Rate for Payer: Allwell Medicaid |
$4,490.36
|
| Rate for Payer: AZCH Complete Medicaid |
$4,490.36
|
| Rate for Payer: Banner UC Health Medicaid |
$4,490.36
|
| Rate for Payer: Mercy Care Medicaid |
$4,490.36
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$6,754.48
|
|
|
Service Code
|
APR-DRG 4683
|
| Hospital Charge Code |
APRDRG4681
|
| Min. Negotiated Rate |
$6,754.48 |
| Max. Negotiated Rate |
$6,754.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,754.48
|
| Rate for Payer: Allwell Medicaid |
$6,754.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,754.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,754.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,754.48
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$6,754.48
|
|
|
Service Code
|
APR-DRG 4683
|
| Hospital Charge Code |
APRDRG4684
|
| Min. Negotiated Rate |
$6,754.48 |
| Max. Negotiated Rate |
$6,754.48 |
| Rate for Payer: AHCCCS Medicaid |
$6,754.48
|
| Rate for Payer: Allwell Medicaid |
$6,754.48
|
| Rate for Payer: AZCH Complete Medicaid |
$6,754.48
|
| Rate for Payer: Banner UC Health Medicaid |
$6,754.48
|
| Rate for Payer: Mercy Care Medicaid |
$6,754.48
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$4,490.36
|
|
|
Service Code
|
APR-DRG 4682
|
| Hospital Charge Code |
APRDRG4681
|
| Min. Negotiated Rate |
$4,490.36 |
| Max. Negotiated Rate |
$4,490.36 |
| Rate for Payer: AHCCCS Medicaid |
$4,490.36
|
| Rate for Payer: Allwell Medicaid |
$4,490.36
|
| Rate for Payer: AZCH Complete Medicaid |
$4,490.36
|
| Rate for Payer: Banner UC Health Medicaid |
$4,490.36
|
| Rate for Payer: Mercy Care Medicaid |
$4,490.36
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$3,485.26
|
|
|
Service Code
|
APR-DRG 4681
|
| Hospital Charge Code |
APRDRG4681
|
| Min. Negotiated Rate |
$3,485.26 |
| Max. Negotiated Rate |
$3,485.26 |
| Rate for Payer: AHCCCS Medicaid |
$3,485.26
|
| Rate for Payer: Allwell Medicaid |
$3,485.26
|
| Rate for Payer: AZCH Complete Medicaid |
$3,485.26
|
| Rate for Payer: Banner UC Health Medicaid |
$3,485.26
|
| Rate for Payer: Mercy Care Medicaid |
$3,485.26
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$4,490.36
|
|
|
Service Code
|
APR-DRG 4682
|
| Hospital Charge Code |
APRDRG4683
|
| Min. Negotiated Rate |
$4,490.36 |
| Max. Negotiated Rate |
$4,490.36 |
| Rate for Payer: AHCCCS Medicaid |
$4,490.36
|
| Rate for Payer: Allwell Medicaid |
$4,490.36
|
| Rate for Payer: AZCH Complete Medicaid |
$4,490.36
|
| Rate for Payer: Banner UC Health Medicaid |
$4,490.36
|
| Rate for Payer: Mercy Care Medicaid |
$4,490.36
|
|
|
Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms
|
Facility
|
IP
|
$11,770.19
|
|
|
Service Code
|
APR-DRG 4684
|
| Hospital Charge Code |
APRDRG4683
|
| Min. Negotiated Rate |
$11,770.19 |
| Max. Negotiated Rate |
$11,770.19 |
| Rate for Payer: AHCCCS Medicaid |
$11,770.19
|
| Rate for Payer: Allwell Medicaid |
$11,770.19
|
| Rate for Payer: AZCH Complete Medicaid |
$11,770.19
|
| Rate for Payer: Banner UC Health Medicaid |
$11,770.19
|
| Rate for Payer: Mercy Care Medicaid |
$11,770.19
|
|
|
Other Kidney, Urinary Tract And Related Procedures
|
Facility
|
IP
|
$9,990.04
|
|
|
Service Code
|
APR-DRG 4472
|
| Hospital Charge Code |
APRDRG4472
|
| Min. Negotiated Rate |
$9,990.04 |
| Max. Negotiated Rate |
$9,990.04 |
| Rate for Payer: AHCCCS Medicaid |
$9,990.04
|
| Rate for Payer: Allwell Medicaid |
$9,990.04
|
| Rate for Payer: AZCH Complete Medicaid |
$9,990.04
|
| Rate for Payer: Banner UC Health Medicaid |
$9,990.04
|
| Rate for Payer: Mercy Care Medicaid |
$9,990.04
|
|
