|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$16,566.37
|
|
|
Service Code
|
APR-DRG 6142
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$16,566.37 |
| Max. Negotiated Rate |
$16,566.37 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,566.37
|
| Rate for Payer: Mercy Care Medicaid |
$16,566.37
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,566.37
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$28,286.76
|
|
|
Service Code
|
APR-DRG 6143
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$28,286.76 |
| Max. Negotiated Rate |
$28,286.76 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$28,286.76
|
| Rate for Payer: Mercy Care Medicaid |
$28,286.76
|
| Rate for Payer: NaphCare Correctional Healthcare |
$28,286.76
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6143
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6142
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$39,212.47
|
|
|
Service Code
|
APR-DRG 6144
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$39,212.47 |
| Max. Negotiated Rate |
$39,212.47 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$39,212.47
|
| Rate for Payer: Mercy Care Medicaid |
$39,212.47
|
| Rate for Payer: NaphCare Correctional Healthcare |
$39,212.47
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6144
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
Facility
|
IP
|
$8,510.79
|
|
|
Service Code
|
APR-DRG 6141
|
| Hospital Charge Code |
APRDRG6141
|
| Min. Negotiated Rate |
$8,510.79 |
| Max. Negotiated Rate |
$8,510.79 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,510.79
|
| Rate for Payer: Mercy Care Medicaid |
$8,510.79
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,510.79
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$24,091.69
|
|
|
Service Code
|
APR-DRG 6122
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$24,091.69 |
| Max. Negotiated Rate |
$24,091.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$24,091.69
|
| Rate for Payer: Mercy Care Medicaid |
$24,091.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$24,091.69
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6122
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$15,807.45
|
|
|
Service Code
|
APR-DRG 6121
|
| Hospital Charge Code |
APRDRG6121
|
| Min. Negotiated Rate |
$15,807.45 |
| Max. Negotiated Rate |
$15,807.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,807.45
|
| Rate for Payer: Mercy Care Medicaid |
$15,807.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,807.45
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6123
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$33,076.62
|
|
|
Service Code
|
APR-DRG 6123
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$33,076.62 |
| Max. Negotiated Rate |
$33,076.62 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,076.62
|
| Rate for Payer: Mercy Care Medicaid |
$33,076.62
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,076.62
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$33,076.62
|
|
|
Service Code
|
APR-DRG 6123
|
| Hospital Charge Code |
APRDRG6123
|
| Min. Negotiated Rate |
$33,076.62 |
| Max. Negotiated Rate |
$33,076.62 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$33,076.62
|
| Rate for Payer: Mercy Care Medicaid |
$33,076.62
|
| Rate for Payer: NaphCare Correctional Healthcare |
$33,076.62
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$50,039.98
|
|
|
Service Code
|
APR-DRG 6124
|
| Hospital Charge Code |
APRDRG6121
|
| Min. Negotiated Rate |
$50,039.98 |
| Max. Negotiated Rate |
$50,039.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$50,039.98
|
| Rate for Payer: Mercy Care Medicaid |
$50,039.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$50,039.98
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$15,807.45
|
|
|
Service Code
|
APR-DRG 6121
|
| Hospital Charge Code |
APRDRG6124
|
| Min. Negotiated Rate |
$15,807.45 |
| Max. Negotiated Rate |
$15,807.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,807.45
|
| Rate for Payer: Mercy Care Medicaid |
$15,807.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,807.45
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$24,091.69
|
|
|
Service Code
|
APR-DRG 6122
|
| Hospital Charge Code |
APRDRG6121
|
| Min. Negotiated Rate |
$24,091.69 |
| Max. Negotiated Rate |
$24,091.69 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$24,091.69
|
| Rate for Payer: Mercy Care Medicaid |
$24,091.69
|
| Rate for Payer: NaphCare Correctional Healthcare |
$24,091.69
|
|
|
Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition
|
Facility
|
IP
|
$15,807.45
|
|
|
Service Code
|
APR-DRG 6121
|
| Hospital Charge Code |
APRDRG6123
|
| Min. Negotiated Rate |
$15,807.45 |
| Max. Negotiated Rate |
$15,807.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$15,807.45
|
| Rate for Payer: Mercy Care Medicaid |
$15,807.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$15,807.45
|
|
