|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
| Rate for Payer: NaphCare Correctional Healthcare |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
| Rate for Payer: NaphCare Correctional Healthcare |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5882
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$126,083.66
|
|
|
Service Code
|
APR-DRG 5883
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$126,083.66 |
| Max. Negotiated Rate |
$126,083.66 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$126,083.66
|
| Rate for Payer: Mercy Care Medicaid |
$126,083.66
|
| Rate for Payer: NaphCare Correctional Healthcare |
$126,083.66
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5882
|
| Hospital Charge Code |
APRDRG5881
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$60,868.89
|
|
|
Service Code
|
APR-DRG 5881
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$60,868.89 |
| Max. Negotiated Rate |
$60,868.89 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$60,868.89
|
| Rate for Payer: Mercy Care Medicaid |
$60,868.89
|
| Rate for Payer: NaphCare Correctional Healthcare |
$60,868.89
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5884
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$206,843.56
|
|
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
Facility
|
IP
|
$206,843.56
|
|
|
Service Code
|
APR-DRG 5884
|
| Hospital Charge Code |
APRDRG5883
|
| Min. Negotiated Rate |
$206,843.56 |
| Max. Negotiated Rate |
$206,843.56 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$206,843.56
|
| Rate for Payer: Mercy Care Medicaid |
$206,843.56
|
| Rate for Payer: NaphCare Correctional Healthcare |
$206,843.56
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$16,892.52
|
|
|
Service Code
|
APR-DRG 6264
|
| Hospital Charge Code |
APRDRG6262
|
| Min. Negotiated Rate |
$16,892.52 |
| Max. Negotiated Rate |
$16,892.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,892.52
|
| Rate for Payer: Mercy Care Medicaid |
$16,892.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,892.52
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$4,627.84
|
|
|
Service Code
|
APR-DRG 6263
|
| Hospital Charge Code |
APRDRG6262
|
| Min. Negotiated Rate |
$4,627.84 |
| Max. Negotiated Rate |
$4,627.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,627.84
|
| Rate for Payer: Mercy Care Medicaid |
$4,627.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,627.84
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,226.05
|
|
|
Service Code
|
APR-DRG 6261
|
| Hospital Charge Code |
APRDRG6261
|
| Min. Negotiated Rate |
$1,226.05 |
| Max. Negotiated Rate |
$1,226.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,226.05
|
| Rate for Payer: Mercy Care Medicaid |
$1,226.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,226.05
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$4,627.84
|
|
|
Service Code
|
APR-DRG 6263
|
| Hospital Charge Code |
APRDRG6264
|
| Min. Negotiated Rate |
$4,627.84 |
| Max. Negotiated Rate |
$4,627.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,627.84
|
| Rate for Payer: Mercy Care Medicaid |
$4,627.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,627.84
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,226.05
|
|
|
Service Code
|
APR-DRG 6261
|
| Hospital Charge Code |
APRDRG6263
|
| Min. Negotiated Rate |
$1,226.05 |
| Max. Negotiated Rate |
$1,226.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,226.05
|
| Rate for Payer: Mercy Care Medicaid |
$1,226.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,226.05
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,761.92
|
|
|
Service Code
|
APR-DRG 6262
|
| Hospital Charge Code |
APRDRG6262
|
| Min. Negotiated Rate |
$1,761.92 |
| Max. Negotiated Rate |
$1,761.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,761.92
|
| Rate for Payer: Mercy Care Medicaid |
$1,761.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,761.92
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,226.05
|
|
|
Service Code
|
APR-DRG 6261
|
| Hospital Charge Code |
APRDRG6264
|
| Min. Negotiated Rate |
$1,226.05 |
| Max. Negotiated Rate |
$1,226.05 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,226.05
|
| Rate for Payer: Mercy Care Medicaid |
$1,226.05
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,226.05
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$16,892.52
|
|
|
Service Code
|
APR-DRG 6264
|
| Hospital Charge Code |
APRDRG6261
|
| Min. Negotiated Rate |
$16,892.52 |
| Max. Negotiated Rate |
$16,892.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,892.52
|
| Rate for Payer: Mercy Care Medicaid |
$16,892.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,892.52
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$4,627.84
|
|
|
Service Code
|
APR-DRG 6263
|
| Hospital Charge Code |
APRDRG6261
|
| Min. Negotiated Rate |
$4,627.84 |
| Max. Negotiated Rate |
$4,627.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,627.84
|
| Rate for Payer: Mercy Care Medicaid |
$4,627.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,627.84
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$16,892.52
|
|
|
Service Code
|
APR-DRG 6264
|
| Hospital Charge Code |
APRDRG6264
|
| Min. Negotiated Rate |
$16,892.52 |
| Max. Negotiated Rate |
$16,892.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,892.52
|
| Rate for Payer: Mercy Care Medicaid |
$16,892.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,892.52
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$4,627.84
|
|
|
Service Code
|
APR-DRG 6263
|
| Hospital Charge Code |
APRDRG6263
|
| Min. Negotiated Rate |
$4,627.84 |
| Max. Negotiated Rate |
$4,627.84 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,627.84
|
| Rate for Payer: Mercy Care Medicaid |
$4,627.84
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,627.84
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,761.92
|
|
|
Service Code
|
APR-DRG 6262
|
| Hospital Charge Code |
APRDRG6261
|
| Min. Negotiated Rate |
$1,761.92 |
| Max. Negotiated Rate |
$1,761.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,761.92
|
| Rate for Payer: Mercy Care Medicaid |
$1,761.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,761.92
|
|
|
Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$16,892.52
|
|
|
Service Code
|
APR-DRG 6264
|
| Hospital Charge Code |
APRDRG6263
|
| Min. Negotiated Rate |
$16,892.52 |
| Max. Negotiated Rate |
$16,892.52 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,892.52
|
| Rate for Payer: Mercy Care Medicaid |
$16,892.52
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,892.52
|
|
