|
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 |
APRDRG6264
|
| 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
|
$1,761.92
|
|
|
Service Code
|
APR-DRG 6262
|
| Hospital Charge Code |
APRDRG6263
|
| 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 |
APRDRG6262
|
| 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 With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$42,547.63
|
|
|
Service Code
|
APR-DRG 6234
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$42,547.63 |
| Max. Negotiated Rate |
$42,547.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,547.63
|
| Rate for Payer: Mercy Care Medicaid |
$42,547.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,547.63
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$42,547.63
|
|
|
Service Code
|
APR-DRG 6234
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$42,547.63 |
| Max. Negotiated Rate |
$42,547.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,547.63
|
| Rate for Payer: Mercy Care Medicaid |
$42,547.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,547.63
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$7,804.48
|
|
|
Service Code
|
APR-DRG 6231
|
| Hospital Charge Code |
APRDRG6232
|
| Min. Negotiated Rate |
$7,804.48 |
| Max. Negotiated Rate |
$7,804.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,804.48
|
| Rate for Payer: Mercy Care Medicaid |
$7,804.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,804.48
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6233
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$7,804.48
|
|
|
Service Code
|
APR-DRG 6231
|
| Hospital Charge Code |
APRDRG6233
|
| Min. Negotiated Rate |
$7,804.48 |
| Max. Negotiated Rate |
$7,804.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,804.48
|
| Rate for Payer: Mercy Care Medicaid |
$7,804.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,804.48
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$42,547.63
|
|
|
Service Code
|
APR-DRG 6234
|
| Hospital Charge Code |
APRDRG6232
|
| Min. Negotiated Rate |
$42,547.63 |
| Max. Negotiated Rate |
$42,547.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,547.63
|
| Rate for Payer: Mercy Care Medicaid |
$42,547.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,547.63
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$7,804.48
|
|
|
Service Code
|
APR-DRG 6231
|
| Hospital Charge Code |
APRDRG6234
|
| Min. Negotiated Rate |
$7,804.48 |
| Max. Negotiated Rate |
$7,804.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,804.48
|
| Rate for Payer: Mercy Care Medicaid |
$7,804.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,804.48
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$42,547.63
|
|
|
Service Code
|
APR-DRG 6234
|
| Hospital Charge Code |
APRDRG6233
|
| Min. Negotiated Rate |
$42,547.63 |
| Max. Negotiated Rate |
$42,547.63 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$42,547.63
|
| Rate for Payer: Mercy Care Medicaid |
$42,547.63
|
| Rate for Payer: NaphCare Correctional Healthcare |
$42,547.63
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6232
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6232
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$25,929.36
|
|
|
Service Code
|
APR-DRG 6233
|
| Hospital Charge Code |
APRDRG6233
|
| Min. Negotiated Rate |
$25,929.36 |
| Max. Negotiated Rate |
$25,929.36 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$25,929.36
|
| Rate for Payer: Mercy Care Medicaid |
$25,929.36
|
| Rate for Payer: NaphCare Correctional Healthcare |
$25,929.36
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$7,804.48
|
|
|
Service Code
|
APR-DRG 6231
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$7,804.48 |
| Max. Negotiated Rate |
$7,804.48 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$7,804.48
|
| Rate for Payer: Mercy Care Medicaid |
$7,804.48
|
| Rate for Payer: NaphCare Correctional Healthcare |
$7,804.48
|
|
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$13,704.65
|
|
|
Service Code
|
APR-DRG 6232
|
| Hospital Charge Code |
APRDRG6231
|
| Min. Negotiated Rate |
$13,704.65 |
| Max. Negotiated Rate |
$13,704.65 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$13,704.65
|
| Rate for Payer: Mercy Care Medicaid |
$13,704.65
|
| Rate for Payer: NaphCare Correctional Healthcare |
$13,704.65
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$5,088.66
|
|
|
Service Code
|
APR-DRG 6211
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$5,088.66 |
| Max. Negotiated Rate |
$5,088.66 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$5,088.66
|
| Rate for Payer: Mercy Care Medicaid |
$5,088.66
|
| Rate for Payer: NaphCare Correctional Healthcare |
$5,088.66
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6211
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$14,645.93
|
|
|
Service Code
|
APR-DRG 6212
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$14,645.93 |
| Max. Negotiated Rate |
$14,645.93 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,645.93
|
| Rate for Payer: Mercy Care Medicaid |
$14,645.93
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,645.93
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6214
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,217.83
|
|
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
Facility
|
IP
|
$27,217.83
|
|
|
Service Code
|
APR-DRG 6213
|
| Hospital Charge Code |
APRDRG6212
|
| Min. Negotiated Rate |
$27,217.83 |
| Max. Negotiated Rate |
$27,217.83 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$27,217.83
|
| Rate for Payer: Mercy Care Medicaid |
$27,217.83
|
| Rate for Payer: NaphCare Correctional Healthcare |
$27,217.83
|
|
