|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$13,418.48
|
|
|
Service Code
|
APR-DRG 1974
|
| Hospital Charge Code |
APRDRG1971
|
| Min. Negotiated Rate |
$13,418.48 |
| Max. Negotiated Rate |
$13,418.48 |
| Rate for Payer: AHCCCS Medicaid |
$13,418.48
|
| Rate for Payer: Allwell Medicaid |
$13,418.48
|
| Rate for Payer: AZCH Complete Medicaid |
$13,418.48
|
| Rate for Payer: Banner UC Health Medicaid |
$13,418.48
|
| Rate for Payer: Mercy Care Medicaid |
$13,418.48
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$4,634.85
|
|
|
Service Code
|
APR-DRG 1972
|
| Hospital Charge Code |
APRDRG1974
|
| Min. Negotiated Rate |
$4,634.85 |
| Max. Negotiated Rate |
$4,634.85 |
| Rate for Payer: AHCCCS Medicaid |
$4,634.85
|
| Rate for Payer: Allwell Medicaid |
$4,634.85
|
| Rate for Payer: AZCH Complete Medicaid |
$4,634.85
|
| Rate for Payer: Banner UC Health Medicaid |
$4,634.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,634.85
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$13,418.48
|
|
|
Service Code
|
APR-DRG 1974
|
| Hospital Charge Code |
APRDRG1973
|
| Min. Negotiated Rate |
$13,418.48 |
| Max. Negotiated Rate |
$13,418.48 |
| Rate for Payer: AHCCCS Medicaid |
$13,418.48
|
| Rate for Payer: Allwell Medicaid |
$13,418.48
|
| Rate for Payer: AZCH Complete Medicaid |
$13,418.48
|
| Rate for Payer: Banner UC Health Medicaid |
$13,418.48
|
| Rate for Payer: Mercy Care Medicaid |
$13,418.48
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$6,431.84
|
|
|
Service Code
|
APR-DRG 1973
|
| Hospital Charge Code |
APRDRG1973
|
| Min. Negotiated Rate |
$6,431.84 |
| Max. Negotiated Rate |
$6,431.84 |
| Rate for Payer: AHCCCS Medicaid |
$6,431.84
|
| Rate for Payer: Allwell Medicaid |
$6,431.84
|
| Rate for Payer: AZCH Complete Medicaid |
$6,431.84
|
| Rate for Payer: Banner UC Health Medicaid |
$6,431.84
|
| Rate for Payer: Mercy Care Medicaid |
$6,431.84
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$13,418.48
|
|
|
Service Code
|
APR-DRG 1974
|
| Hospital Charge Code |
APRDRG1974
|
| Min. Negotiated Rate |
$13,418.48 |
| Max. Negotiated Rate |
$13,418.48 |
| Rate for Payer: AHCCCS Medicaid |
$13,418.48
|
| Rate for Payer: Allwell Medicaid |
$13,418.48
|
| Rate for Payer: AZCH Complete Medicaid |
$13,418.48
|
| Rate for Payer: Banner UC Health Medicaid |
$13,418.48
|
| Rate for Payer: Mercy Care Medicaid |
$13,418.48
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$3,568.72
|
|
|
Service Code
|
APR-DRG 1971
|
| Hospital Charge Code |
APRDRG1973
|
| Min. Negotiated Rate |
$3,568.72 |
| Max. Negotiated Rate |
$3,568.72 |
| Rate for Payer: AHCCCS Medicaid |
$3,568.72
|
| Rate for Payer: Allwell Medicaid |
$3,568.72
|
| Rate for Payer: AZCH Complete Medicaid |
$3,568.72
|
| Rate for Payer: Banner UC Health Medicaid |
$3,568.72
|
| Rate for Payer: Mercy Care Medicaid |
$3,568.72
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$4,634.85
|
|
|
Service Code
|
APR-DRG 1972
|
| Hospital Charge Code |
APRDRG1971
|
| Min. Negotiated Rate |
$4,634.85 |
| Max. Negotiated Rate |
$4,634.85 |
| Rate for Payer: AHCCCS Medicaid |
$4,634.85
|
| Rate for Payer: Allwell Medicaid |
$4,634.85
|
| Rate for Payer: AZCH Complete Medicaid |
$4,634.85
|
| Rate for Payer: Banner UC Health Medicaid |
$4,634.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,634.85
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$4,634.85
|
|
|
Service Code
|
APR-DRG 1972
|
| Hospital Charge Code |
APRDRG1973
|
| Min. Negotiated Rate |
$4,634.85 |
| Max. Negotiated Rate |
$4,634.85 |
| Rate for Payer: AHCCCS Medicaid |
$4,634.85
|
| Rate for Payer: Allwell Medicaid |
$4,634.85
|
| Rate for Payer: AZCH Complete Medicaid |
$4,634.85
|
| Rate for Payer: Banner UC Health Medicaid |
$4,634.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,634.85
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$3,568.72
|
|
|
Service Code
|
APR-DRG 1971
|
| Hospital Charge Code |
APRDRG1974
|
| Min. Negotiated Rate |
$3,568.72 |
| Max. Negotiated Rate |
$3,568.72 |
| Rate for Payer: AHCCCS Medicaid |
$3,568.72
|
| Rate for Payer: Allwell Medicaid |
$3,568.72
|
| Rate for Payer: AZCH Complete Medicaid |
$3,568.72
|
| Rate for Payer: Banner UC Health Medicaid |
$3,568.72
|
| Rate for Payer: Mercy Care Medicaid |
$3,568.72
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$6,431.84
|
|
|
Service Code
|
APR-DRG 1973
|
| Hospital Charge Code |
APRDRG1974
|
| Min. Negotiated Rate |
$6,431.84 |
| Max. Negotiated Rate |
$6,431.84 |
| Rate for Payer: AHCCCS Medicaid |
$6,431.84
|
| Rate for Payer: Allwell Medicaid |
$6,431.84
|
| Rate for Payer: AZCH Complete Medicaid |
$6,431.84
|
| Rate for Payer: Banner UC Health Medicaid |
$6,431.84
|
| Rate for Payer: Mercy Care Medicaid |
$6,431.84
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$6,431.84
|
|
|
Service Code
|
APR-DRG 1973
|
| Hospital Charge Code |
APRDRG1972
|
| Min. Negotiated Rate |
$6,431.84 |
| Max. Negotiated Rate |
$6,431.84 |
| Rate for Payer: AHCCCS Medicaid |
$6,431.84
|
| Rate for Payer: Allwell Medicaid |
$6,431.84
|
| Rate for Payer: AZCH Complete Medicaid |
$6,431.84
|
| Rate for Payer: Banner UC Health Medicaid |
$6,431.84
|
| Rate for Payer: Mercy Care Medicaid |
$6,431.84
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$13,418.48
|
|
|
Service Code
|
APR-DRG 1974
|
| Hospital Charge Code |
APRDRG1972
|
| Min. Negotiated Rate |
$13,418.48 |
| Max. Negotiated Rate |
$13,418.48 |
| Rate for Payer: AHCCCS Medicaid |
$13,418.48
|
| Rate for Payer: Allwell Medicaid |
$13,418.48
|
| Rate for Payer: AZCH Complete Medicaid |
$13,418.48
|
| Rate for Payer: Banner UC Health Medicaid |
$13,418.48
|
| Rate for Payer: Mercy Care Medicaid |
$13,418.48
|
|
|
Peripheral And Other Vascular Disorders
|
Facility
|
IP
|
$4,634.85
|
|
|
Service Code
|
APR-DRG 1972
|
| Hospital Charge Code |
APRDRG1972
|
| Min. Negotiated Rate |
$4,634.85 |
| Max. Negotiated Rate |
$4,634.85 |
| Rate for Payer: AHCCCS Medicaid |
$4,634.85
|
| Rate for Payer: Allwell Medicaid |
$4,634.85
|
| Rate for Payer: AZCH Complete Medicaid |
$4,634.85
|
| Rate for Payer: Banner UC Health Medicaid |
$4,634.85
|
| Rate for Payer: Mercy Care Medicaid |
$4,634.85
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: AHCCCS Medicaid |
$14,633.31
|
| Rate for Payer: Allwell Medicaid |
$14,633.31
|
| Rate for Payer: AZCH Complete Medicaid |
$14,633.31
|
| Rate for Payer: Banner UC Health Medicaid |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: AHCCCS Medicaid |
$14,633.31
|
| Rate for Payer: Allwell Medicaid |
$14,633.31
|
| Rate for Payer: AZCH Complete Medicaid |
$14,633.31
|
| Rate for Payer: Banner UC Health Medicaid |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: AHCCCS Medicaid |
$7,108.69
|
| Rate for Payer: Allwell Medicaid |
$7,108.69
|
| Rate for Payer: AZCH Complete Medicaid |
$7,108.69
|
| Rate for Payer: Banner UC Health Medicaid |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: AHCCCS Medicaid |
$4,945.57
|
| Rate for Payer: Allwell Medicaid |
$4,945.57
|
| Rate for Payer: AZCH Complete Medicaid |
$4,945.57
|
| Rate for Payer: Banner UC Health Medicaid |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: AHCCCS Medicaid |
$4,326.94
|
| Rate for Payer: Allwell Medicaid |
$4,326.94
|
| Rate for Payer: AZCH Complete Medicaid |
$4,326.94
|
| Rate for Payer: Banner UC Health Medicaid |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: AHCCCS Medicaid |
$4,945.57
|
| Rate for Payer: Allwell Medicaid |
$4,945.57
|
| Rate for Payer: AZCH Complete Medicaid |
$4,945.57
|
| Rate for Payer: Banner UC Health Medicaid |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,945.57
|
|
|
Service Code
|
APR-DRG 0482
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$4,945.57 |
| Max. Negotiated Rate |
$4,945.57 |
| Rate for Payer: AHCCCS Medicaid |
$4,945.57
|
| Rate for Payer: Allwell Medicaid |
$4,945.57
|
| Rate for Payer: AZCH Complete Medicaid |
$4,945.57
|
| Rate for Payer: Banner UC Health Medicaid |
$4,945.57
|
| Rate for Payer: Mercy Care Medicaid |
$4,945.57
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$4,326.94
|
|
|
Service Code
|
APR-DRG 0481
|
| Hospital Charge Code |
APRDRG0484
|
| Min. Negotiated Rate |
$4,326.94 |
| Max. Negotiated Rate |
$4,326.94 |
| Rate for Payer: AHCCCS Medicaid |
$4,326.94
|
| Rate for Payer: Allwell Medicaid |
$4,326.94
|
| Rate for Payer: AZCH Complete Medicaid |
$4,326.94
|
| Rate for Payer: Banner UC Health Medicaid |
$4,326.94
|
| Rate for Payer: Mercy Care Medicaid |
$4,326.94
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0483
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: AHCCCS Medicaid |
$14,633.31
|
| Rate for Payer: Allwell Medicaid |
$14,633.31
|
| Rate for Payer: AZCH Complete Medicaid |
$14,633.31
|
| Rate for Payer: Banner UC Health Medicaid |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0482
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: AHCCCS Medicaid |
$7,108.69
|
| Rate for Payer: Allwell Medicaid |
$7,108.69
|
| Rate for Payer: AZCH Complete Medicaid |
$7,108.69
|
| Rate for Payer: Banner UC Health Medicaid |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$7,108.69
|
|
|
Service Code
|
APR-DRG 0483
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$7,108.69 |
| Max. Negotiated Rate |
$7,108.69 |
| Rate for Payer: AHCCCS Medicaid |
$7,108.69
|
| Rate for Payer: Allwell Medicaid |
$7,108.69
|
| Rate for Payer: AZCH Complete Medicaid |
$7,108.69
|
| Rate for Payer: Banner UC Health Medicaid |
$7,108.69
|
| Rate for Payer: Mercy Care Medicaid |
$7,108.69
|
|
|
Peripheral, Cranial And Autonomic Nerve Disorders
|
Facility
|
IP
|
$14,633.31
|
|
|
Service Code
|
APR-DRG 0484
|
| Hospital Charge Code |
APRDRG0481
|
| Min. Negotiated Rate |
$14,633.31 |
| Max. Negotiated Rate |
$14,633.31 |
| Rate for Payer: AHCCCS Medicaid |
$14,633.31
|
| Rate for Payer: Allwell Medicaid |
$14,633.31
|
| Rate for Payer: AZCH Complete Medicaid |
$14,633.31
|
| Rate for Payer: Banner UC Health Medicaid |
$14,633.31
|
| Rate for Payer: Mercy Care Medicaid |
$14,633.31
|
|