|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$76,487.67
|
|
|
Service Code
|
APR-DRG 5893
|
| Hospital Charge Code |
APRDRG5894
|
| Min. Negotiated Rate |
$76,487.67 |
| Max. Negotiated Rate |
$76,487.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$76,487.67
|
| Rate for Payer: Mercy Care Medicaid |
$76,487.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$76,487.67
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$76,487.67
|
|
|
Service Code
|
APR-DRG 5893
|
| Hospital Charge Code |
APRDRG5892
|
| Min. Negotiated Rate |
$76,487.67 |
| Max. Negotiated Rate |
$76,487.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$76,487.67
|
| Rate for Payer: Mercy Care Medicaid |
$76,487.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$76,487.67
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$76,487.67
|
|
|
Service Code
|
APR-DRG 5893
|
| Hospital Charge Code |
APRDRG5891
|
| Min. Negotiated Rate |
$76,487.67 |
| Max. Negotiated Rate |
$76,487.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$76,487.67
|
| Rate for Payer: Mercy Care Medicaid |
$76,487.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$76,487.67
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$14,492.33
|
|
|
Service Code
|
APR-DRG 5894
|
| Hospital Charge Code |
APRDRG5891
|
| Min. Negotiated Rate |
$14,492.33 |
| Max. Negotiated Rate |
$14,492.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,492.33
|
| Rate for Payer: Mercy Care Medicaid |
$14,492.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,492.33
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$14,492.33
|
|
|
Service Code
|
APR-DRG 5894
|
| Hospital Charge Code |
APRDRG5892
|
| Min. Negotiated Rate |
$14,492.33 |
| Max. Negotiated Rate |
$14,492.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,492.33
|
| Rate for Payer: Mercy Care Medicaid |
$14,492.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,492.33
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$14,492.33
|
|
|
Service Code
|
APR-DRG 5894
|
| Hospital Charge Code |
APRDRG5894
|
| Min. Negotiated Rate |
$14,492.33 |
| Max. Negotiated Rate |
$14,492.33 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$14,492.33
|
| Rate for Payer: Mercy Care Medicaid |
$14,492.33
|
| Rate for Payer: NaphCare Correctional Healthcare |
$14,492.33
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$87,221.90
|
|
|
Service Code
|
APR-DRG 5891
|
| Hospital Charge Code |
APRDRG5891
|
| Min. Negotiated Rate |
$87,221.90 |
| Max. Negotiated Rate |
$87,221.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$87,221.90
|
| Rate for Payer: Mercy Care Medicaid |
$87,221.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$87,221.90
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$76,487.67
|
|
|
Service Code
|
APR-DRG 5893
|
| Hospital Charge Code |
APRDRG5893
|
| Min. Negotiated Rate |
$76,487.67 |
| Max. Negotiated Rate |
$76,487.67 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$76,487.67
|
| Rate for Payer: Mercy Care Medicaid |
$76,487.67
|
| Rate for Payer: NaphCare Correctional Healthcare |
$76,487.67
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$87,221.90
|
|
|
Service Code
|
APR-DRG 5891
|
| Hospital Charge Code |
APRDRG5893
|
| Min. Negotiated Rate |
$87,221.90 |
| Max. Negotiated Rate |
$87,221.90 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$87,221.90
|
| Rate for Payer: Mercy Care Medicaid |
$87,221.90
|
| Rate for Payer: NaphCare Correctional Healthcare |
$87,221.90
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$84,136.44
|
|
|
Service Code
|
APR-DRG 5892
|
| Hospital Charge Code |
APRDRG5892
|
| Min. Negotiated Rate |
$84,136.44 |
| Max. Negotiated Rate |
$84,136.44 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$84,136.44
|
| Rate for Payer: Mercy Care Medicaid |
$84,136.44
|
| Rate for Payer: NaphCare Correctional Healthcare |
$84,136.44
|
|
|
Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention
|
Facility
|
IP
|
$84,136.44
|
|
|
Service Code
|
APR-DRG 5892
|
| Hospital Charge Code |
APRDRG5891
|
| Min. Negotiated Rate |
$84,136.44 |
| Max. Negotiated Rate |
$84,136.44 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$84,136.44
|
| Rate for Payer: Mercy Care Medicaid |
$84,136.44
|
| Rate for Payer: NaphCare Correctional Healthcare |
$84,136.44
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$18,365.46
|
|
|
Service Code
|
APR-DRG 5931
|
| Hospital Charge Code |
APRDRG5934
|
| Min. Negotiated Rate |
$18,365.46 |
| Max. Negotiated Rate |
$18,365.46 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$18,365.46
|
| Rate for Payer: Mercy Care Medicaid |
$18,365.46
|
| Rate for Payer: NaphCare Correctional Healthcare |
$18,365.46
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$70,334.29
|
|
|
Service Code
|
APR-DRG 5932
|
| Hospital Charge Code |
APRDRG5933
|
| Min. Negotiated Rate |
$70,334.29 |
| Max. Negotiated Rate |
$70,334.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$70,334.29
|
| Rate for Payer: Mercy Care Medicaid |
$70,334.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$70,334.29
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$117,243.92
|
|
|
Service Code
|
APR-DRG 5934
|
| Hospital Charge Code |
APRDRG5934
|
| Min. Negotiated Rate |
$117,243.92 |
| Max. Negotiated Rate |
$117,243.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$117,243.92
|
| Rate for Payer: Mercy Care Medicaid |
$117,243.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$117,243.92
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$18,365.46
|
|
|
Service Code
|
APR-DRG 5931
|
| Hospital Charge Code |
APRDRG5933
|
| Min. Negotiated Rate |
$18,365.46 |
| Max. Negotiated Rate |
$18,365.46 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$18,365.46
|
| Rate for Payer: Mercy Care Medicaid |
$18,365.46
|
| Rate for Payer: NaphCare Correctional Healthcare |
$18,365.46
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$117,243.92
|
|
|
Service Code
|
APR-DRG 5934
|
| Hospital Charge Code |
APRDRG5933
|
| Min. Negotiated Rate |
$117,243.92 |
| Max. Negotiated Rate |
$117,243.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$117,243.92
|
| Rate for Payer: Mercy Care Medicaid |
$117,243.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$117,243.92
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$81,194.06
|
|
|
Service Code
|
APR-DRG 5933
|
| Hospital Charge Code |
APRDRG5932
|
| Min. Negotiated Rate |
$81,194.06 |
| Max. Negotiated Rate |
$81,194.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$81,194.06
|
| Rate for Payer: Mercy Care Medicaid |
$81,194.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$81,194.06
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$18,365.46
|
|
|
Service Code
|
APR-DRG 5931
|
| Hospital Charge Code |
APRDRG5932
|
| Min. Negotiated Rate |
$18,365.46 |
| Max. Negotiated Rate |
$18,365.46 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$18,365.46
|
| Rate for Payer: Mercy Care Medicaid |
$18,365.46
|
| Rate for Payer: NaphCare Correctional Healthcare |
$18,365.46
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$70,334.29
|
|
|
Service Code
|
APR-DRG 5932
|
| Hospital Charge Code |
APRDRG5934
|
| Min. Negotiated Rate |
$70,334.29 |
| Max. Negotiated Rate |
$70,334.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$70,334.29
|
| Rate for Payer: Mercy Care Medicaid |
$70,334.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$70,334.29
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$81,194.06
|
|
|
Service Code
|
APR-DRG 5933
|
| Hospital Charge Code |
APRDRG5931
|
| Min. Negotiated Rate |
$81,194.06 |
| Max. Negotiated Rate |
$81,194.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$81,194.06
|
| Rate for Payer: Mercy Care Medicaid |
$81,194.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$81,194.06
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$81,194.06
|
|
|
Service Code
|
APR-DRG 5933
|
| Hospital Charge Code |
APRDRG5933
|
| Min. Negotiated Rate |
$81,194.06 |
| Max. Negotiated Rate |
$81,194.06 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$81,194.06
|
| Rate for Payer: Mercy Care Medicaid |
$81,194.06
|
| Rate for Payer: NaphCare Correctional Healthcare |
$81,194.06
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$18,365.46
|
|
|
Service Code
|
APR-DRG 5931
|
| Hospital Charge Code |
APRDRG5931
|
| Min. Negotiated Rate |
$18,365.46 |
| Max. Negotiated Rate |
$18,365.46 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$18,365.46
|
| Rate for Payer: Mercy Care Medicaid |
$18,365.46
|
| Rate for Payer: NaphCare Correctional Healthcare |
$18,365.46
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$70,334.29
|
|
|
Service Code
|
APR-DRG 5932
|
| Hospital Charge Code |
APRDRG5932
|
| Min. Negotiated Rate |
$70,334.29 |
| Max. Negotiated Rate |
$70,334.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$70,334.29
|
| Rate for Payer: Mercy Care Medicaid |
$70,334.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$70,334.29
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$70,334.29
|
|
|
Service Code
|
APR-DRG 5932
|
| Hospital Charge Code |
APRDRG5931
|
| Min. Negotiated Rate |
$70,334.29 |
| Max. Negotiated Rate |
$70,334.29 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$70,334.29
|
| Rate for Payer: Mercy Care Medicaid |
$70,334.29
|
| Rate for Payer: NaphCare Correctional Healthcare |
$70,334.29
|
|
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
Facility
|
IP
|
$117,243.92
|
|
|
Service Code
|
APR-DRG 5934
|
| Hospital Charge Code |
APRDRG5932
|
| Min. Negotiated Rate |
$117,243.92 |
| Max. Negotiated Rate |
$117,243.92 |
| Rate for Payer: Blue Cross Blue Shield of Arizona Health Choice |
$117,243.92
|
| Rate for Payer: Mercy Care Medicaid |
$117,243.92
|
| Rate for Payer: NaphCare Correctional Healthcare |
$117,243.92
|
|
