|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1822
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$31,432.54
|
|
|
Service Code
|
APR-DRG 1824
|
| Hospital Charge Code |
APRDRG1823
|
| Min. Negotiated Rate |
$31,432.54 |
| Max. Negotiated Rate |
$31,432.54 |
| Rate for Payer: AHCCCS Medicaid |
$31,432.54
|
| Rate for Payer: Allwell Medicaid |
$31,432.54
|
| Rate for Payer: AZCH Complete Medicaid |
$31,432.54
|
| Rate for Payer: Banner UC Health Medicaid |
$31,432.54
|
| Rate for Payer: Mercy Care Medicaid |
$31,432.54
|
|
|
Other Peripheral Vascular Procedures
|
Facility
|
IP
|
$12,827.20
|
|
|
Service Code
|
APR-DRG 1821
|
| Hospital Charge Code |
APRDRG1823
|
| Min. Negotiated Rate |
$12,827.20 |
| Max. Negotiated Rate |
$12,827.20 |
| Rate for Payer: AHCCCS Medicaid |
$12,827.20
|
| Rate for Payer: Allwell Medicaid |
$12,827.20
|
| Rate for Payer: AZCH Complete Medicaid |
$12,827.20
|
| Rate for Payer: Banner UC Health Medicaid |
$12,827.20
|
| Rate for Payer: Mercy Care Medicaid |
$12,827.20
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$5,743.76
|
|
|
Service Code
|
APR-DRG 1393
|
| Hospital Charge Code |
APRDRG1391
|
| Min. Negotiated Rate |
$5,743.76 |
| Max. Negotiated Rate |
$5,743.76 |
| Rate for Payer: AHCCCS Medicaid |
$5,743.76
|
| Rate for Payer: Allwell Medicaid |
$5,743.76
|
| Rate for Payer: AZCH Complete Medicaid |
$5,743.76
|
| Rate for Payer: Banner UC Health Medicaid |
$5,743.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,743.76
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$9,200.97
|
|
|
Service Code
|
APR-DRG 1394
|
| Hospital Charge Code |
APRDRG1392
|
| Min. Negotiated Rate |
$9,200.97 |
| Max. Negotiated Rate |
$9,200.97 |
| Rate for Payer: AHCCCS Medicaid |
$9,200.97
|
| Rate for Payer: Allwell Medicaid |
$9,200.97
|
| Rate for Payer: AZCH Complete Medicaid |
$9,200.97
|
| Rate for Payer: Banner UC Health Medicaid |
$9,200.97
|
| Rate for Payer: Mercy Care Medicaid |
$9,200.97
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$2,979.55
|
|
|
Service Code
|
APR-DRG 1391
|
| Hospital Charge Code |
APRDRG1394
|
| Min. Negotiated Rate |
$2,979.55 |
| Max. Negotiated Rate |
$2,979.55 |
| Rate for Payer: AHCCCS Medicaid |
$2,979.55
|
| Rate for Payer: Allwell Medicaid |
$2,979.55
|
| Rate for Payer: AZCH Complete Medicaid |
$2,979.55
|
| Rate for Payer: Banner UC Health Medicaid |
$2,979.55
|
| Rate for Payer: Mercy Care Medicaid |
$2,979.55
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$4,013.41
|
|
|
Service Code
|
APR-DRG 1392
|
| Hospital Charge Code |
APRDRG1393
|
| Min. Negotiated Rate |
$4,013.41 |
| Max. Negotiated Rate |
$4,013.41 |
| Rate for Payer: AHCCCS Medicaid |
$4,013.41
|
| Rate for Payer: Allwell Medicaid |
$4,013.41
|
| Rate for Payer: AZCH Complete Medicaid |
$4,013.41
|
| Rate for Payer: Banner UC Health Medicaid |
$4,013.41
|
| Rate for Payer: Mercy Care Medicaid |
$4,013.41
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$4,013.41
|
|
|
Service Code
|
APR-DRG 1392
|
| Hospital Charge Code |
APRDRG1394
|
| Min. Negotiated Rate |
$4,013.41 |
| Max. Negotiated Rate |
$4,013.41 |
| Rate for Payer: AHCCCS Medicaid |
$4,013.41
|
| Rate for Payer: Allwell Medicaid |
$4,013.41
|
| Rate for Payer: AZCH Complete Medicaid |
$4,013.41
|
| Rate for Payer: Banner UC Health Medicaid |
$4,013.41
|
| Rate for Payer: Mercy Care Medicaid |
$4,013.41
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$2,979.55
|
|
|
Service Code
|
APR-DRG 1391
|
| Hospital Charge Code |
APRDRG1392
|
| Min. Negotiated Rate |
$2,979.55 |
| Max. Negotiated Rate |
$2,979.55 |
| Rate for Payer: AHCCCS Medicaid |
$2,979.55
|
| Rate for Payer: Allwell Medicaid |
$2,979.55
|
| Rate for Payer: AZCH Complete Medicaid |
$2,979.55
|
| Rate for Payer: Banner UC Health Medicaid |
$2,979.55
|
| Rate for Payer: Mercy Care Medicaid |
$2,979.55
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$4,013.41
|
|
|
Service Code
|
APR-DRG 1392
|
| Hospital Charge Code |
APRDRG1391
|
| Min. Negotiated Rate |
$4,013.41 |
| Max. Negotiated Rate |
$4,013.41 |
| Rate for Payer: AHCCCS Medicaid |
$4,013.41
|
| Rate for Payer: Allwell Medicaid |
$4,013.41
|
| Rate for Payer: AZCH Complete Medicaid |
$4,013.41
|
| Rate for Payer: Banner UC Health Medicaid |
$4,013.41
|
| Rate for Payer: Mercy Care Medicaid |
$4,013.41
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$5,743.76
|
|
|
Service Code
|
APR-DRG 1393
|
| Hospital Charge Code |
APRDRG1394
|
| Min. Negotiated Rate |
$5,743.76 |
| Max. Negotiated Rate |
$5,743.76 |
| Rate for Payer: AHCCCS Medicaid |
$5,743.76
|
| Rate for Payer: Allwell Medicaid |
$5,743.76
|
| Rate for Payer: AZCH Complete Medicaid |
$5,743.76
|
| Rate for Payer: Banner UC Health Medicaid |
$5,743.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,743.76
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$2,979.55
|
|
|
Service Code
|
APR-DRG 1391
|
| Hospital Charge Code |
APRDRG1393
|
| Min. Negotiated Rate |
$2,979.55 |
| Max. Negotiated Rate |
$2,979.55 |
| Rate for Payer: AHCCCS Medicaid |
$2,979.55
|
| Rate for Payer: Allwell Medicaid |
$2,979.55
|
| Rate for Payer: AZCH Complete Medicaid |
$2,979.55
|
| Rate for Payer: Banner UC Health Medicaid |
$2,979.55
|
| Rate for Payer: Mercy Care Medicaid |
$2,979.55
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$5,743.76
|
|
|
Service Code
|
APR-DRG 1393
|
| Hospital Charge Code |
APRDRG1393
|
| Min. Negotiated Rate |
$5,743.76 |
| Max. Negotiated Rate |
$5,743.76 |
| Rate for Payer: AHCCCS Medicaid |
$5,743.76
|
| Rate for Payer: Allwell Medicaid |
$5,743.76
|
| Rate for Payer: AZCH Complete Medicaid |
$5,743.76
|
| Rate for Payer: Banner UC Health Medicaid |
$5,743.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,743.76
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$2,979.55
|
|
|
Service Code
|
APR-DRG 1391
|
| Hospital Charge Code |
APRDRG1391
|
| Min. Negotiated Rate |
$2,979.55 |
| Max. Negotiated Rate |
$2,979.55 |
| Rate for Payer: AHCCCS Medicaid |
$2,979.55
|
| Rate for Payer: Allwell Medicaid |
$2,979.55
|
| Rate for Payer: AZCH Complete Medicaid |
$2,979.55
|
| Rate for Payer: Banner UC Health Medicaid |
$2,979.55
|
| Rate for Payer: Mercy Care Medicaid |
$2,979.55
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$5,743.76
|
|
|
Service Code
|
APR-DRG 1393
|
| Hospital Charge Code |
APRDRG1392
|
| Min. Negotiated Rate |
$5,743.76 |
| Max. Negotiated Rate |
$5,743.76 |
| Rate for Payer: AHCCCS Medicaid |
$5,743.76
|
| Rate for Payer: Allwell Medicaid |
$5,743.76
|
| Rate for Payer: AZCH Complete Medicaid |
$5,743.76
|
| Rate for Payer: Banner UC Health Medicaid |
$5,743.76
|
| Rate for Payer: Mercy Care Medicaid |
$5,743.76
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$9,200.97
|
|
|
Service Code
|
APR-DRG 1394
|
| Hospital Charge Code |
APRDRG1391
|
| Min. Negotiated Rate |
$9,200.97 |
| Max. Negotiated Rate |
$9,200.97 |
| Rate for Payer: AHCCCS Medicaid |
$9,200.97
|
| Rate for Payer: Allwell Medicaid |
$9,200.97
|
| Rate for Payer: AZCH Complete Medicaid |
$9,200.97
|
| Rate for Payer: Banner UC Health Medicaid |
$9,200.97
|
| Rate for Payer: Mercy Care Medicaid |
$9,200.97
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$9,200.97
|
|
|
Service Code
|
APR-DRG 1394
|
| Hospital Charge Code |
APRDRG1393
|
| Min. Negotiated Rate |
$9,200.97 |
| Max. Negotiated Rate |
$9,200.97 |
| Rate for Payer: AHCCCS Medicaid |
$9,200.97
|
| Rate for Payer: Allwell Medicaid |
$9,200.97
|
| Rate for Payer: AZCH Complete Medicaid |
$9,200.97
|
| Rate for Payer: Banner UC Health Medicaid |
$9,200.97
|
| Rate for Payer: Mercy Care Medicaid |
$9,200.97
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$9,200.97
|
|
|
Service Code
|
APR-DRG 1394
|
| Hospital Charge Code |
APRDRG1394
|
| Min. Negotiated Rate |
$9,200.97 |
| Max. Negotiated Rate |
$9,200.97 |
| Rate for Payer: AHCCCS Medicaid |
$9,200.97
|
| Rate for Payer: Allwell Medicaid |
$9,200.97
|
| Rate for Payer: AZCH Complete Medicaid |
$9,200.97
|
| Rate for Payer: Banner UC Health Medicaid |
$9,200.97
|
| Rate for Payer: Mercy Care Medicaid |
$9,200.97
|
|
|
Other Pneumonia
|
Facility
|
IP
|
$4,013.41
|
|
|
Service Code
|
APR-DRG 1392
|
| Hospital Charge Code |
APRDRG1392
|
| Min. Negotiated Rate |
$4,013.41 |
| Max. Negotiated Rate |
$4,013.41 |
| Rate for Payer: AHCCCS Medicaid |
$4,013.41
|
| Rate for Payer: Allwell Medicaid |
$4,013.41
|
| Rate for Payer: AZCH Complete Medicaid |
$4,013.41
|
| Rate for Payer: Banner UC Health Medicaid |
$4,013.41
|
| Rate for Payer: Mercy Care Medicaid |
$4,013.41
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$35,614.99
|
|
|
Service Code
|
APR-DRG 4054
|
| Hospital Charge Code |
APRDRG4052
|
| Min. Negotiated Rate |
$35,614.99 |
| Max. Negotiated Rate |
$35,614.99 |
| Rate for Payer: AHCCCS Medicaid |
$35,614.99
|
| Rate for Payer: Allwell Medicaid |
$35,614.99
|
| Rate for Payer: AZCH Complete Medicaid |
$35,614.99
|
| Rate for Payer: Banner UC Health Medicaid |
$35,614.99
|
| Rate for Payer: Mercy Care Medicaid |
$35,614.99
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$9,049.46
|
|
|
Service Code
|
APR-DRG 4051
|
| Hospital Charge Code |
APRDRG4051
|
| Min. Negotiated Rate |
$9,049.46 |
| Max. Negotiated Rate |
$9,049.46 |
| Rate for Payer: AHCCCS Medicaid |
$9,049.46
|
| Rate for Payer: Allwell Medicaid |
$9,049.46
|
| Rate for Payer: AZCH Complete Medicaid |
$9,049.46
|
| Rate for Payer: Banner UC Health Medicaid |
$9,049.46
|
| Rate for Payer: Mercy Care Medicaid |
$9,049.46
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$9,049.46
|
|
|
Service Code
|
APR-DRG 4051
|
| Hospital Charge Code |
APRDRG4053
|
| Min. Negotiated Rate |
$9,049.46 |
| Max. Negotiated Rate |
$9,049.46 |
| Rate for Payer: AHCCCS Medicaid |
$9,049.46
|
| Rate for Payer: Allwell Medicaid |
$9,049.46
|
| Rate for Payer: AZCH Complete Medicaid |
$9,049.46
|
| Rate for Payer: Banner UC Health Medicaid |
$9,049.46
|
| Rate for Payer: Mercy Care Medicaid |
$9,049.46
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$35,614.99
|
|
|
Service Code
|
APR-DRG 4054
|
| Hospital Charge Code |
APRDRG4053
|
| Min. Negotiated Rate |
$35,614.99 |
| Max. Negotiated Rate |
$35,614.99 |
| Rate for Payer: AHCCCS Medicaid |
$35,614.99
|
| Rate for Payer: Allwell Medicaid |
$35,614.99
|
| Rate for Payer: AZCH Complete Medicaid |
$35,614.99
|
| Rate for Payer: Banner UC Health Medicaid |
$35,614.99
|
| Rate for Payer: Mercy Care Medicaid |
$35,614.99
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$10,736.33
|
|
|
Service Code
|
APR-DRG 4052
|
| Hospital Charge Code |
APRDRG4053
|
| Min. Negotiated Rate |
$10,736.33 |
| Max. Negotiated Rate |
$10,736.33 |
| Rate for Payer: AHCCCS Medicaid |
$10,736.33
|
| Rate for Payer: Allwell Medicaid |
$10,736.33
|
| Rate for Payer: AZCH Complete Medicaid |
$10,736.33
|
| Rate for Payer: Banner UC Health Medicaid |
$10,736.33
|
| Rate for Payer: Mercy Care Medicaid |
$10,736.33
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$10,736.33
|
|
|
Service Code
|
APR-DRG 4052
|
| Hospital Charge Code |
APRDRG4052
|
| Min. Negotiated Rate |
$10,736.33 |
| Max. Negotiated Rate |
$10,736.33 |
| Rate for Payer: AHCCCS Medicaid |
$10,736.33
|
| Rate for Payer: Allwell Medicaid |
$10,736.33
|
| Rate for Payer: AZCH Complete Medicaid |
$10,736.33
|
| Rate for Payer: Banner UC Health Medicaid |
$10,736.33
|
| Rate for Payer: Mercy Care Medicaid |
$10,736.33
|
|
