|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: AHCCCS Medicaid |
$17,015.96
|
| Rate for Payer: Allwell Medicaid |
$17,015.96
|
| Rate for Payer: AZCH Complete Medicaid |
$17,015.96
|
| Rate for Payer: Banner UC Health Medicaid |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: AHCCCS Medicaid |
$34,264.79
|
| Rate for Payer: Allwell Medicaid |
$34,264.79
|
| Rate for Payer: AZCH Complete Medicaid |
$34,264.79
|
| Rate for Payer: Banner UC Health Medicaid |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: AHCCCS Medicaid |
$8,983.53
|
| Rate for Payer: Allwell Medicaid |
$8,983.53
|
| Rate for Payer: AZCH Complete Medicaid |
$8,983.53
|
| Rate for Payer: Banner UC Health Medicaid |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: AHCCCS Medicaid |
$8,983.53
|
| Rate for Payer: Allwell Medicaid |
$8,983.53
|
| Rate for Payer: AZCH Complete Medicaid |
$8,983.53
|
| Rate for Payer: Banner UC Health Medicaid |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: AHCCCS Medicaid |
$11,330.42
|
| Rate for Payer: Allwell Medicaid |
$11,330.42
|
| Rate for Payer: AZCH Complete Medicaid |
$11,330.42
|
| Rate for Payer: Banner UC Health Medicaid |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$11,330.42
|
|
|
Service Code
|
APR-DRG 0262
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$11,330.42 |
| Max. Negotiated Rate |
$11,330.42 |
| Rate for Payer: AHCCCS Medicaid |
$11,330.42
|
| Rate for Payer: Allwell Medicaid |
$11,330.42
|
| Rate for Payer: AZCH Complete Medicaid |
$11,330.42
|
| Rate for Payer: Banner UC Health Medicaid |
$11,330.42
|
| Rate for Payer: Mercy Care Medicaid |
$11,330.42
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0264
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: AHCCCS Medicaid |
$17,015.96
|
| Rate for Payer: Allwell Medicaid |
$17,015.96
|
| Rate for Payer: AZCH Complete Medicaid |
$17,015.96
|
| Rate for Payer: Banner UC Health Medicaid |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: AHCCCS Medicaid |
$34,264.79
|
| Rate for Payer: Allwell Medicaid |
$34,264.79
|
| Rate for Payer: AZCH Complete Medicaid |
$34,264.79
|
| Rate for Payer: Banner UC Health Medicaid |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$17,015.96
|
|
|
Service Code
|
APR-DRG 0263
|
| Hospital Charge Code |
APRDRG0263
|
| Min. Negotiated Rate |
$17,015.96 |
| Max. Negotiated Rate |
$17,015.96 |
| Rate for Payer: AHCCCS Medicaid |
$17,015.96
|
| Rate for Payer: Allwell Medicaid |
$17,015.96
|
| Rate for Payer: AZCH Complete Medicaid |
$17,015.96
|
| Rate for Payer: Banner UC Health Medicaid |
$17,015.96
|
| Rate for Payer: Mercy Care Medicaid |
$17,015.96
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$34,264.79
|
|
|
Service Code
|
APR-DRG 0264
|
| Hospital Charge Code |
APRDRG0261
|
| Min. Negotiated Rate |
$34,264.79 |
| Max. Negotiated Rate |
$34,264.79 |
| Rate for Payer: AHCCCS Medicaid |
$34,264.79
|
| Rate for Payer: Allwell Medicaid |
$34,264.79
|
| Rate for Payer: AZCH Complete Medicaid |
$34,264.79
|
| Rate for Payer: Banner UC Health Medicaid |
$34,264.79
|
| Rate for Payer: Mercy Care Medicaid |
$34,264.79
|
|
|
Other Nervous System And Related Procedures
|
Facility
|
IP
|
$8,983.53
|
|
|
Service Code
|
APR-DRG 0261
|
| Hospital Charge Code |
APRDRG0262
|
| Min. Negotiated Rate |
$8,983.53 |
| Max. Negotiated Rate |
$8,983.53 |
| Rate for Payer: AHCCCS Medicaid |
$8,983.53
|
| Rate for Payer: Allwell Medicaid |
$8,983.53
|
| Rate for Payer: AZCH Complete Medicaid |
$8,983.53
|
| Rate for Payer: Banner UC Health Medicaid |
$8,983.53
|
| Rate for Payer: Mercy Care Medicaid |
$8,983.53
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: AHCCCS Medicaid |
$2,896.78
|
| Rate for Payer: Allwell Medicaid |
$2,896.78
|
| Rate for Payer: AZCH Complete Medicaid |
$2,896.78
|
| Rate for Payer: Banner UC Health Medicaid |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4251
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: AHCCCS Medicaid |
$5,180.54
|
| Rate for Payer: Allwell Medicaid |
$5,180.54
|
| Rate for Payer: AZCH Complete Medicaid |
$5,180.54
|
| Rate for Payer: Banner UC Health Medicaid |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$10,942.54
|
|
|
Service Code
|
APR-DRG 4254
|
| Hospital Charge Code |
APRDRG4251
|
| Min. Negotiated Rate |
$10,942.54 |
| Max. Negotiated Rate |
$10,942.54 |
| Rate for Payer: AHCCCS Medicaid |
$10,942.54
|
| Rate for Payer: Allwell Medicaid |
$10,942.54
|
| Rate for Payer: AZCH Complete Medicaid |
$10,942.54
|
| Rate for Payer: Banner UC Health Medicaid |
$10,942.54
|
| Rate for Payer: Mercy Care Medicaid |
$10,942.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$3,677.44
|
|
|
Service Code
|
APR-DRG 4252
|
| Hospital Charge Code |
APRDRG4254
|
| Min. Negotiated Rate |
$3,677.44 |
| Max. Negotiated Rate |
$3,677.44 |
| Rate for Payer: AHCCCS Medicaid |
$3,677.44
|
| Rate for Payer: Allwell Medicaid |
$3,677.44
|
| Rate for Payer: AZCH Complete Medicaid |
$3,677.44
|
| Rate for Payer: Banner UC Health Medicaid |
$3,677.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,677.44
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4253
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: AHCCCS Medicaid |
$2,896.78
|
| Rate for Payer: Allwell Medicaid |
$2,896.78
|
| Rate for Payer: AZCH Complete Medicaid |
$2,896.78
|
| Rate for Payer: Banner UC Health Medicaid |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$3,677.44
|
|
|
Service Code
|
APR-DRG 4252
|
| Hospital Charge Code |
APRDRG4251
|
| Min. Negotiated Rate |
$3,677.44 |
| Max. Negotiated Rate |
$3,677.44 |
| Rate for Payer: AHCCCS Medicaid |
$3,677.44
|
| Rate for Payer: Allwell Medicaid |
$3,677.44
|
| Rate for Payer: AZCH Complete Medicaid |
$3,677.44
|
| Rate for Payer: Banner UC Health Medicaid |
$3,677.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,677.44
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4254
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: AHCCCS Medicaid |
$5,180.54
|
| Rate for Payer: Allwell Medicaid |
$5,180.54
|
| Rate for Payer: AZCH Complete Medicaid |
$5,180.54
|
| Rate for Payer: Banner UC Health Medicaid |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4251
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: AHCCCS Medicaid |
$2,896.78
|
| Rate for Payer: Allwell Medicaid |
$2,896.78
|
| Rate for Payer: AZCH Complete Medicaid |
$2,896.78
|
| Rate for Payer: Banner UC Health Medicaid |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: AHCCCS Medicaid |
$5,180.54
|
| Rate for Payer: Allwell Medicaid |
$5,180.54
|
| Rate for Payer: AZCH Complete Medicaid |
$5,180.54
|
| Rate for Payer: Banner UC Health Medicaid |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$10,942.54
|
|
|
Service Code
|
APR-DRG 4254
|
| Hospital Charge Code |
APRDRG4253
|
| Min. Negotiated Rate |
$10,942.54 |
| Max. Negotiated Rate |
$10,942.54 |
| Rate for Payer: AHCCCS Medicaid |
$10,942.54
|
| Rate for Payer: Allwell Medicaid |
$10,942.54
|
| Rate for Payer: AZCH Complete Medicaid |
$10,942.54
|
| Rate for Payer: Banner UC Health Medicaid |
$10,942.54
|
| Rate for Payer: Mercy Care Medicaid |
$10,942.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$2,896.78
|
|
|
Service Code
|
APR-DRG 4251
|
| Hospital Charge Code |
APRDRG4254
|
| Min. Negotiated Rate |
$2,896.78 |
| Max. Negotiated Rate |
$2,896.78 |
| Rate for Payer: AHCCCS Medicaid |
$2,896.78
|
| Rate for Payer: Allwell Medicaid |
$2,896.78
|
| Rate for Payer: AZCH Complete Medicaid |
$2,896.78
|
| Rate for Payer: Banner UC Health Medicaid |
$2,896.78
|
| Rate for Payer: Mercy Care Medicaid |
$2,896.78
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$10,942.54
|
|
|
Service Code
|
APR-DRG 4254
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$10,942.54 |
| Max. Negotiated Rate |
$10,942.54 |
| Rate for Payer: AHCCCS Medicaid |
$10,942.54
|
| Rate for Payer: Allwell Medicaid |
$10,942.54
|
| Rate for Payer: AZCH Complete Medicaid |
$10,942.54
|
| Rate for Payer: Banner UC Health Medicaid |
$10,942.54
|
| Rate for Payer: Mercy Care Medicaid |
$10,942.54
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$3,677.44
|
|
|
Service Code
|
APR-DRG 4252
|
| Hospital Charge Code |
APRDRG4252
|
| Min. Negotiated Rate |
$3,677.44 |
| Max. Negotiated Rate |
$3,677.44 |
| Rate for Payer: AHCCCS Medicaid |
$3,677.44
|
| Rate for Payer: Allwell Medicaid |
$3,677.44
|
| Rate for Payer: AZCH Complete Medicaid |
$3,677.44
|
| Rate for Payer: Banner UC Health Medicaid |
$3,677.44
|
| Rate for Payer: Mercy Care Medicaid |
$3,677.44
|
|
|
Other Non-Hypovolemic Electrolyte Disorders
|
Facility
|
IP
|
$5,180.54
|
|
|
Service Code
|
APR-DRG 4253
|
| Hospital Charge Code |
APRDRG4253
|
| Min. Negotiated Rate |
$5,180.54 |
| Max. Negotiated Rate |
$5,180.54 |
| Rate for Payer: AHCCCS Medicaid |
$5,180.54
|
| Rate for Payer: Allwell Medicaid |
$5,180.54
|
| Rate for Payer: AZCH Complete Medicaid |
$5,180.54
|
| Rate for Payer: Banner UC Health Medicaid |
$5,180.54
|
| Rate for Payer: Mercy Care Medicaid |
$5,180.54
|
|
