|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
|
Service Code
|
APR-DRG 6403
|
| Hospital Charge Code |
APRDRG6401
|
| Min. Negotiated Rate |
$2,353.20 |
| Max. Negotiated Rate |
$2,353.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,353.20
|
| Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,353.20
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
|
Service Code
|
APR-DRG 6401
|
| Hospital Charge Code |
APRDRG6403
|
| Min. Negotiated Rate |
$692.28 |
| Max. Negotiated Rate |
$692.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$692.28
|
| Rate for Payer: Mercy Care Medicaid |
$692.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$692.28
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
|
Service Code
|
APR-DRG 6402
|
| Hospital Charge Code |
APRDRG6403
|
| Min. Negotiated Rate |
$1,007.21 |
| Max. Negotiated Rate |
$1,007.21 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,007.21
|
| Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,007.21
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
|
Service Code
|
APR-DRG 6402
|
| Hospital Charge Code |
APRDRG6401
|
| Min. Negotiated Rate |
$1,007.21 |
| Max. Negotiated Rate |
$1,007.21 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,007.21
|
| Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,007.21
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$2,353.20
|
|
|
Service Code
|
APR-DRG 6403
|
| Hospital Charge Code |
APRDRG6402
|
| Min. Negotiated Rate |
$2,353.20 |
| Max. Negotiated Rate |
$2,353.20 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$2,353.20
|
| Rate for Payer: Mercy Care Medicaid |
$2,353.20
|
| Rate for Payer: NaphCare Correctional Healthcare |
$2,353.20
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$1,007.21
|
|
|
Service Code
|
APR-DRG 6402
|
| Hospital Charge Code |
APRDRG6402
|
| Min. Negotiated Rate |
$1,007.21 |
| Max. Negotiated Rate |
$1,007.21 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,007.21
|
| Rate for Payer: Mercy Care Medicaid |
$1,007.21
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,007.21
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$17,536.40
|
|
|
Service Code
|
APR-DRG 6404
|
| Hospital Charge Code |
APRDRG6401
|
| Min. Negotiated Rate |
$17,536.40 |
| Max. Negotiated Rate |
$17,536.40 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$17,536.40
|
| Rate for Payer: Mercy Care Medicaid |
$17,536.40
|
| Rate for Payer: NaphCare Correctional Healthcare |
$17,536.40
|
|
|
Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem
|
Facility
|
IP
|
$692.28
|
|
|
Service Code
|
APR-DRG 6401
|
| Hospital Charge Code |
APRDRG6401
|
| Min. Negotiated Rate |
$692.28 |
| Max. Negotiated Rate |
$692.28 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$692.28
|
| Rate for Payer: Mercy Care Medicaid |
$692.28
|
| Rate for Payer: NaphCare Correctional Healthcare |
$692.28
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6361
|
| Min. Negotiated Rate |
$8,089.25 |
| Max. Negotiated Rate |
$8,089.25 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,089.25
|
| Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,089.25
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6364
|
| Min. Negotiated Rate |
$8,089.25 |
| Max. Negotiated Rate |
$8,089.25 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,089.25
|
| Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,089.25
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6364
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
|
Service Code
|
APR-DRG 6364
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$29,347.98 |
| Max. Negotiated Rate |
$29,347.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$29,347.98
|
| Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29,347.98
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6362
|
| Min. Negotiated Rate |
$8,089.25 |
| Max. Negotiated Rate |
$8,089.25 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,089.25
|
| Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,089.25
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6361
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
|
Service Code
|
APR-DRG 6364
|
| Hospital Charge Code |
APRDRG6361
|
| Min. Negotiated Rate |
$29,347.98 |
| Max. Negotiated Rate |
$29,347.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$29,347.98
|
| Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29,347.98
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6361
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
|
Service Code
|
APR-DRG 6364
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$29,347.98 |
| Max. Negotiated Rate |
$29,347.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$29,347.98
|
| Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29,347.98
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$29,347.98
|
|
|
Service Code
|
APR-DRG 6364
|
| Hospital Charge Code |
APRDRG6364
|
| Min. Negotiated Rate |
$29,347.98 |
| Max. Negotiated Rate |
$29,347.98 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$29,347.98
|
| Rate for Payer: Mercy Care Medicaid |
$29,347.98
|
| Rate for Payer: NaphCare Correctional Healthcare |
$29,347.98
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$4,584.35
|
|
|
Service Code
|
APR-DRG 6361
|
| Hospital Charge Code |
APRDRG6364
|
| Min. Negotiated Rate |
$4,584.35 |
| Max. Negotiated Rate |
$4,584.35 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$4,584.35
|
| Rate for Payer: Mercy Care Medicaid |
$4,584.35
|
| Rate for Payer: NaphCare Correctional Healthcare |
$4,584.35
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$16,258.45
|
|
|
Service Code
|
APR-DRG 6363
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$16,258.45 |
| Max. Negotiated Rate |
$16,258.45 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$16,258.45
|
| Rate for Payer: Mercy Care Medicaid |
$16,258.45
|
| Rate for Payer: NaphCare Correctional Healthcare |
$16,258.45
|
|
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
Facility
|
IP
|
$8,089.25
|
|
|
Service Code
|
APR-DRG 6362
|
| Hospital Charge Code |
APRDRG6363
|
| Min. Negotiated Rate |
$8,089.25 |
| Max. Negotiated Rate |
$8,089.25 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$8,089.25
|
| Rate for Payer: Mercy Care Medicaid |
$8,089.25
|
| Rate for Payer: NaphCare Correctional Healthcare |
$8,089.25
|
|
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
Facility
|
IP
|
$1,907.11
|
|
|
Service Code
|
APR-DRG 6331
|
| Hospital Charge Code |
APRDRG6333
|
| Min. Negotiated Rate |
$1,907.11 |
| Max. Negotiated Rate |
$1,907.11 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$1,907.11
|
| Rate for Payer: Mercy Care Medicaid |
$1,907.11
|
| Rate for Payer: NaphCare Correctional Healthcare |
$1,907.11
|
|
