|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$16,158.15
|
|
|
Service Code
|
APR-DRG 4053
|
| Hospital Charge Code |
APRDRG4054
|
| Min. Negotiated Rate |
$16,158.15 |
| Max. Negotiated Rate |
$16,158.15 |
| Rate for Payer: AHCCCS Medicaid |
$16,158.15
|
| Rate for Payer: Allwell Medicaid |
$16,158.15
|
| Rate for Payer: AZCH Complete Medicaid |
$16,158.15
|
| Rate for Payer: Banner UC Health Medicaid |
$16,158.15
|
| Rate for Payer: Mercy Care Medicaid |
$16,158.15
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$35,614.99
|
|
|
Service Code
|
APR-DRG 4054
|
| Hospital Charge Code |
APRDRG4054
|
| 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 |
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
|
$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
|
$35,614.99
|
|
|
Service Code
|
APR-DRG 4054
|
| Hospital Charge Code |
APRDRG4051
|
| 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 |
APRDRG4054
|
| 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 |
APRDRG4054
|
| 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
|
$16,158.15
|
|
|
Service Code
|
APR-DRG 4053
|
| Hospital Charge Code |
APRDRG4051
|
| Min. Negotiated Rate |
$16,158.15 |
| Max. Negotiated Rate |
$16,158.15 |
| Rate for Payer: AHCCCS Medicaid |
$16,158.15
|
| Rate for Payer: Allwell Medicaid |
$16,158.15
|
| Rate for Payer: AZCH Complete Medicaid |
$16,158.15
|
| Rate for Payer: Banner UC Health Medicaid |
$16,158.15
|
| Rate for Payer: Mercy Care Medicaid |
$16,158.15
|
|
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
Facility
|
IP
|
$9,049.46
|
|
|
Service Code
|
APR-DRG 4051
|
| Hospital Charge Code |
APRDRG4052
|
| 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 Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6511
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: AHCCCS Medicaid |
$6,963.50
|
| Rate for Payer: Allwell Medicaid |
$6,963.50
|
| Rate for Payer: AZCH Complete Medicaid |
$6,963.50
|
| Rate for Payer: Banner UC Health Medicaid |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: AHCCCS Medicaid |
$46,387.79
|
| Rate for Payer: Allwell Medicaid |
$46,387.79
|
| Rate for Payer: AZCH Complete Medicaid |
$46,387.79
|
| Rate for Payer: Banner UC Health Medicaid |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: AHCCCS Medicaid |
$17,262.16
|
| Rate for Payer: Allwell Medicaid |
$17,262.16
|
| Rate for Payer: AZCH Complete Medicaid |
$17,262.16
|
| Rate for Payer: Banner UC Health Medicaid |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: AHCCCS Medicaid |
$6,963.50
|
| Rate for Payer: Allwell Medicaid |
$6,963.50
|
| Rate for Payer: AZCH Complete Medicaid |
$6,963.50
|
| Rate for Payer: Banner UC Health Medicaid |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: AHCCCS Medicaid |
$46,387.79
|
| Rate for Payer: Allwell Medicaid |
$46,387.79
|
| Rate for Payer: AZCH Complete Medicaid |
$46,387.79
|
| Rate for Payer: Banner UC Health Medicaid |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: AHCCCS Medicaid |
$17,262.16
|
| Rate for Payer: Allwell Medicaid |
$17,262.16
|
| Rate for Payer: AZCH Complete Medicaid |
$17,262.16
|
| Rate for Payer: Banner UC Health Medicaid |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6511
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: AHCCCS Medicaid |
$46,387.79
|
| Rate for Payer: Allwell Medicaid |
$46,387.79
|
| Rate for Payer: AZCH Complete Medicaid |
$46,387.79
|
| Rate for Payer: Banner UC Health Medicaid |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$46,387.79
|
|
|
Service Code
|
APR-DRG 6514
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$46,387.79 |
| Max. Negotiated Rate |
$46,387.79 |
| Rate for Payer: AHCCCS Medicaid |
$46,387.79
|
| Rate for Payer: Allwell Medicaid |
$46,387.79
|
| Rate for Payer: AZCH Complete Medicaid |
$46,387.79
|
| Rate for Payer: Banner UC Health Medicaid |
$46,387.79
|
| Rate for Payer: Mercy Care Medicaid |
$46,387.79
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: AHCCCS Medicaid |
$6,963.50
|
| Rate for Payer: Allwell Medicaid |
$6,963.50
|
| Rate for Payer: AZCH Complete Medicaid |
$6,963.50
|
| Rate for Payer: Banner UC Health Medicaid |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: AHCCCS Medicaid |
$9,886.93
|
| Rate for Payer: Allwell Medicaid |
$9,886.93
|
| Rate for Payer: AZCH Complete Medicaid |
$9,886.93
|
| Rate for Payer: Banner UC Health Medicaid |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6513
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: AHCCCS Medicaid |
$9,886.93
|
| Rate for Payer: Allwell Medicaid |
$9,886.93
|
| Rate for Payer: AZCH Complete Medicaid |
$9,886.93
|
| Rate for Payer: Banner UC Health Medicaid |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$9,886.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$9,886.93 |
| Max. Negotiated Rate |
$9,886.93 |
| Rate for Payer: AHCCCS Medicaid |
$9,886.93
|
| Rate for Payer: Allwell Medicaid |
$9,886.93
|
| Rate for Payer: AZCH Complete Medicaid |
$9,886.93
|
| Rate for Payer: Banner UC Health Medicaid |
$9,886.93
|
| Rate for Payer: Mercy Care Medicaid |
$9,886.93
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$6,963.50
|
|
|
Service Code
|
APR-DRG 6511
|
| Hospital Charge Code |
APRDRG6512
|
| Min. Negotiated Rate |
$6,963.50 |
| Max. Negotiated Rate |
$6,963.50 |
| Rate for Payer: AHCCCS Medicaid |
$6,963.50
|
| Rate for Payer: Allwell Medicaid |
$6,963.50
|
| Rate for Payer: AZCH Complete Medicaid |
$6,963.50
|
| Rate for Payer: Banner UC Health Medicaid |
$6,963.50
|
| Rate for Payer: Mercy Care Medicaid |
$6,963.50
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6514
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: AHCCCS Medicaid |
$17,262.16
|
| Rate for Payer: Allwell Medicaid |
$17,262.16
|
| Rate for Payer: AZCH Complete Medicaid |
$17,262.16
|
| Rate for Payer: Banner UC Health Medicaid |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
|
|
Other Procedures Of Blood And Blood-Forming Organs
|
Facility
|
IP
|
$17,262.16
|
|
|
Service Code
|
APR-DRG 6513
|
| Hospital Charge Code |
APRDRG6511
|
| Min. Negotiated Rate |
$17,262.16 |
| Max. Negotiated Rate |
$17,262.16 |
| Rate for Payer: AHCCCS Medicaid |
$17,262.16
|
| Rate for Payer: Allwell Medicaid |
$17,262.16
|
| Rate for Payer: AZCH Complete Medicaid |
$17,262.16
|
| Rate for Payer: Banner UC Health Medicaid |
$17,262.16
|
| Rate for Payer: Mercy Care Medicaid |
$17,262.16
|
|
