|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$8,145.36
|
|
|
Service Code
|
APR-DRG 1922
|
| Hospital Charge Code |
APRDRG1924
|
| Min. Negotiated Rate |
$8,145.36 |
| Max. Negotiated Rate |
$8,145.36 |
| Rate for Payer: AHCCCS Medicaid |
$8,145.36
|
| Rate for Payer: Allwell Medicaid |
$8,145.36
|
| Rate for Payer: AZCH Complete Medicaid |
$8,145.36
|
| Rate for Payer: Banner UC Health Medicaid |
$8,145.36
|
| Rate for Payer: Mercy Care Medicaid |
$8,145.36
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$19,239.40
|
|
|
Service Code
|
APR-DRG 1924
|
| Hospital Charge Code |
APRDRG1921
|
| Min. Negotiated Rate |
$19,239.40 |
| Max. Negotiated Rate |
$19,239.40 |
| Rate for Payer: AHCCCS Medicaid |
$19,239.40
|
| Rate for Payer: Allwell Medicaid |
$19,239.40
|
| Rate for Payer: AZCH Complete Medicaid |
$19,239.40
|
| Rate for Payer: Banner UC Health Medicaid |
$19,239.40
|
| Rate for Payer: Mercy Care Medicaid |
$19,239.40
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$11,871.90
|
|
|
Service Code
|
APR-DRG 1923
|
| Hospital Charge Code |
APRDRG1921
|
| Min. Negotiated Rate |
$11,871.90 |
| Max. Negotiated Rate |
$11,871.90 |
| Rate for Payer: AHCCCS Medicaid |
$11,871.90
|
| Rate for Payer: Allwell Medicaid |
$11,871.90
|
| Rate for Payer: AZCH Complete Medicaid |
$11,871.90
|
| Rate for Payer: Banner UC Health Medicaid |
$11,871.90
|
| Rate for Payer: Mercy Care Medicaid |
$11,871.90
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$6,492.86
|
|
|
Service Code
|
APR-DRG 1921
|
| Hospital Charge Code |
APRDRG1923
|
| Min. Negotiated Rate |
$6,492.86 |
| Max. Negotiated Rate |
$6,492.86 |
| Rate for Payer: AHCCCS Medicaid |
$6,492.86
|
| Rate for Payer: Allwell Medicaid |
$6,492.86
|
| Rate for Payer: AZCH Complete Medicaid |
$6,492.86
|
| Rate for Payer: Banner UC Health Medicaid |
$6,492.86
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.86
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$6,492.86
|
|
|
Service Code
|
APR-DRG 1921
|
| Hospital Charge Code |
APRDRG1921
|
| Min. Negotiated Rate |
$6,492.86 |
| Max. Negotiated Rate |
$6,492.86 |
| Rate for Payer: AHCCCS Medicaid |
$6,492.86
|
| Rate for Payer: Allwell Medicaid |
$6,492.86
|
| Rate for Payer: AZCH Complete Medicaid |
$6,492.86
|
| Rate for Payer: Banner UC Health Medicaid |
$6,492.86
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.86
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$11,871.90
|
|
|
Service Code
|
APR-DRG 1923
|
| Hospital Charge Code |
APRDRG1923
|
| Min. Negotiated Rate |
$11,871.90 |
| Max. Negotiated Rate |
$11,871.90 |
| Rate for Payer: AHCCCS Medicaid |
$11,871.90
|
| Rate for Payer: Allwell Medicaid |
$11,871.90
|
| Rate for Payer: AZCH Complete Medicaid |
$11,871.90
|
| Rate for Payer: Banner UC Health Medicaid |
$11,871.90
|
| Rate for Payer: Mercy Care Medicaid |
$11,871.90
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$19,239.40
|
|
|
Service Code
|
APR-DRG 1924
|
| Hospital Charge Code |
APRDRG1923
|
| Min. Negotiated Rate |
$19,239.40 |
| Max. Negotiated Rate |
$19,239.40 |
| Rate for Payer: AHCCCS Medicaid |
$19,239.40
|
| Rate for Payer: Allwell Medicaid |
$19,239.40
|
| Rate for Payer: AZCH Complete Medicaid |
$19,239.40
|
| Rate for Payer: Banner UC Health Medicaid |
$19,239.40
|
| Rate for Payer: Mercy Care Medicaid |
$19,239.40
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$8,145.36
|
|
|
Service Code
|
APR-DRG 1922
|
| Hospital Charge Code |
APRDRG1923
|
| Min. Negotiated Rate |
$8,145.36 |
| Max. Negotiated Rate |
$8,145.36 |
| Rate for Payer: AHCCCS Medicaid |
$8,145.36
|
| Rate for Payer: Allwell Medicaid |
$8,145.36
|
| Rate for Payer: AZCH Complete Medicaid |
$8,145.36
|
| Rate for Payer: Banner UC Health Medicaid |
$8,145.36
|
| Rate for Payer: Mercy Care Medicaid |
$8,145.36
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$11,871.90
|
|
|
Service Code
|
APR-DRG 1923
|
| Hospital Charge Code |
APRDRG1924
|
| Min. Negotiated Rate |
$11,871.90 |
| Max. Negotiated Rate |
$11,871.90 |
| Rate for Payer: AHCCCS Medicaid |
$11,871.90
|
| Rate for Payer: Allwell Medicaid |
$11,871.90
|
| Rate for Payer: AZCH Complete Medicaid |
$11,871.90
|
| Rate for Payer: Banner UC Health Medicaid |
$11,871.90
|
| Rate for Payer: Mercy Care Medicaid |
$11,871.90
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$6,492.86
|
|
|
Service Code
|
APR-DRG 1921
|
| Hospital Charge Code |
APRDRG1924
|
| Min. Negotiated Rate |
$6,492.86 |
| Max. Negotiated Rate |
$6,492.86 |
| Rate for Payer: AHCCCS Medicaid |
$6,492.86
|
| Rate for Payer: Allwell Medicaid |
$6,492.86
|
| Rate for Payer: AZCH Complete Medicaid |
$6,492.86
|
| Rate for Payer: Banner UC Health Medicaid |
$6,492.86
|
| Rate for Payer: Mercy Care Medicaid |
$6,492.86
|
|
|
Cardiac Catheterization For Other Non-Coronary Conditions
|
Facility
|
IP
|
$8,145.36
|
|
|
Service Code
|
APR-DRG 1922
|
| Hospital Charge Code |
APRDRG1922
|
| Min. Negotiated Rate |
$8,145.36 |
| Max. Negotiated Rate |
$8,145.36 |
| Rate for Payer: AHCCCS Medicaid |
$8,145.36
|
| Rate for Payer: Allwell Medicaid |
$8,145.36
|
| Rate for Payer: AZCH Complete Medicaid |
$8,145.36
|
| Rate for Payer: Banner UC Health Medicaid |
$8,145.36
|
| Rate for Payer: Mercy Care Medicaid |
$8,145.36
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$16,929.69
|
|
|
Service Code
|
APR-DRG 1773
|
| Hospital Charge Code |
APRDRG1774
|
| Min. Negotiated Rate |
$16,929.69 |
| Max. Negotiated Rate |
$16,929.69 |
| Rate for Payer: AHCCCS Medicaid |
$16,929.69
|
| Rate for Payer: Allwell Medicaid |
$16,929.69
|
| Rate for Payer: AZCH Complete Medicaid |
$16,929.69
|
| Rate for Payer: Banner UC Health Medicaid |
$16,929.69
|
| Rate for Payer: Mercy Care Medicaid |
$16,929.69
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$16,929.69
|
|
|
Service Code
|
APR-DRG 1773
|
| Hospital Charge Code |
APRDRG1771
|
| Min. Negotiated Rate |
$16,929.69 |
| Max. Negotiated Rate |
$16,929.69 |
| Rate for Payer: AHCCCS Medicaid |
$16,929.69
|
| Rate for Payer: Allwell Medicaid |
$16,929.69
|
| Rate for Payer: AZCH Complete Medicaid |
$16,929.69
|
| Rate for Payer: Banner UC Health Medicaid |
$16,929.69
|
| Rate for Payer: Mercy Care Medicaid |
$16,929.69
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$23,051.51
|
|
|
Service Code
|
APR-DRG 1774
|
| Hospital Charge Code |
APRDRG1771
|
| Min. Negotiated Rate |
$23,051.51 |
| Max. Negotiated Rate |
$23,051.51 |
| Rate for Payer: AHCCCS Medicaid |
$23,051.51
|
| Rate for Payer: Allwell Medicaid |
$23,051.51
|
| Rate for Payer: AZCH Complete Medicaid |
$23,051.51
|
| Rate for Payer: Banner UC Health Medicaid |
$23,051.51
|
| Rate for Payer: Mercy Care Medicaid |
$23,051.51
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$16,929.69
|
|
|
Service Code
|
APR-DRG 1773
|
| Hospital Charge Code |
APRDRG1773
|
| Min. Negotiated Rate |
$16,929.69 |
| Max. Negotiated Rate |
$16,929.69 |
| Rate for Payer: AHCCCS Medicaid |
$16,929.69
|
| Rate for Payer: Allwell Medicaid |
$16,929.69
|
| Rate for Payer: AZCH Complete Medicaid |
$16,929.69
|
| Rate for Payer: Banner UC Health Medicaid |
$16,929.69
|
| Rate for Payer: Mercy Care Medicaid |
$16,929.69
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$23,051.51
|
|
|
Service Code
|
APR-DRG 1774
|
| Hospital Charge Code |
APRDRG1773
|
| Min. Negotiated Rate |
$23,051.51 |
| Max. Negotiated Rate |
$23,051.51 |
| Rate for Payer: AHCCCS Medicaid |
$23,051.51
|
| Rate for Payer: Allwell Medicaid |
$23,051.51
|
| Rate for Payer: AZCH Complete Medicaid |
$23,051.51
|
| Rate for Payer: Banner UC Health Medicaid |
$23,051.51
|
| Rate for Payer: Mercy Care Medicaid |
$23,051.51
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$23,051.51
|
|
|
Service Code
|
APR-DRG 1774
|
| Hospital Charge Code |
APRDRG1772
|
| Min. Negotiated Rate |
$23,051.51 |
| Max. Negotiated Rate |
$23,051.51 |
| Rate for Payer: AHCCCS Medicaid |
$23,051.51
|
| Rate for Payer: Allwell Medicaid |
$23,051.51
|
| Rate for Payer: AZCH Complete Medicaid |
$23,051.51
|
| Rate for Payer: Banner UC Health Medicaid |
$23,051.51
|
| Rate for Payer: Mercy Care Medicaid |
$23,051.51
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$12,373.40
|
|
|
Service Code
|
APR-DRG 1772
|
| Hospital Charge Code |
APRDRG1773
|
| Min. Negotiated Rate |
$12,373.40 |
| Max. Negotiated Rate |
$12,373.40 |
| Rate for Payer: AHCCCS Medicaid |
$12,373.40
|
| Rate for Payer: Allwell Medicaid |
$12,373.40
|
| Rate for Payer: AZCH Complete Medicaid |
$12,373.40
|
| Rate for Payer: Banner UC Health Medicaid |
$12,373.40
|
| Rate for Payer: Mercy Care Medicaid |
$12,373.40
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$8,442.05
|
|
|
Service Code
|
APR-DRG 1771
|
| Hospital Charge Code |
APRDRG1771
|
| Min. Negotiated Rate |
$8,442.05 |
| Max. Negotiated Rate |
$8,442.05 |
| Rate for Payer: AHCCCS Medicaid |
$8,442.05
|
| Rate for Payer: Allwell Medicaid |
$8,442.05
|
| Rate for Payer: AZCH Complete Medicaid |
$8,442.05
|
| Rate for Payer: Banner UC Health Medicaid |
$8,442.05
|
| Rate for Payer: Mercy Care Medicaid |
$8,442.05
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$16,929.69
|
|
|
Service Code
|
APR-DRG 1773
|
| Hospital Charge Code |
APRDRG1772
|
| Min. Negotiated Rate |
$16,929.69 |
| Max. Negotiated Rate |
$16,929.69 |
| Rate for Payer: AHCCCS Medicaid |
$16,929.69
|
| Rate for Payer: Allwell Medicaid |
$16,929.69
|
| Rate for Payer: AZCH Complete Medicaid |
$16,929.69
|
| Rate for Payer: Banner UC Health Medicaid |
$16,929.69
|
| Rate for Payer: Mercy Care Medicaid |
$16,929.69
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$8,442.05
|
|
|
Service Code
|
APR-DRG 1771
|
| Hospital Charge Code |
APRDRG1772
|
| Min. Negotiated Rate |
$8,442.05 |
| Max. Negotiated Rate |
$8,442.05 |
| Rate for Payer: AHCCCS Medicaid |
$8,442.05
|
| Rate for Payer: Allwell Medicaid |
$8,442.05
|
| Rate for Payer: AZCH Complete Medicaid |
$8,442.05
|
| Rate for Payer: Banner UC Health Medicaid |
$8,442.05
|
| Rate for Payer: Mercy Care Medicaid |
$8,442.05
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$8,442.05
|
|
|
Service Code
|
APR-DRG 1771
|
| Hospital Charge Code |
APRDRG1774
|
| Min. Negotiated Rate |
$8,442.05 |
| Max. Negotiated Rate |
$8,442.05 |
| Rate for Payer: AHCCCS Medicaid |
$8,442.05
|
| Rate for Payer: Allwell Medicaid |
$8,442.05
|
| Rate for Payer: AZCH Complete Medicaid |
$8,442.05
|
| Rate for Payer: Banner UC Health Medicaid |
$8,442.05
|
| Rate for Payer: Mercy Care Medicaid |
$8,442.05
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$8,442.05
|
|
|
Service Code
|
APR-DRG 1771
|
| Hospital Charge Code |
APRDRG1773
|
| Min. Negotiated Rate |
$8,442.05 |
| Max. Negotiated Rate |
$8,442.05 |
| Rate for Payer: AHCCCS Medicaid |
$8,442.05
|
| Rate for Payer: Allwell Medicaid |
$8,442.05
|
| Rate for Payer: AZCH Complete Medicaid |
$8,442.05
|
| Rate for Payer: Banner UC Health Medicaid |
$8,442.05
|
| Rate for Payer: Mercy Care Medicaid |
$8,442.05
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$12,373.40
|
|
|
Service Code
|
APR-DRG 1772
|
| Hospital Charge Code |
APRDRG1774
|
| Min. Negotiated Rate |
$12,373.40 |
| Max. Negotiated Rate |
$12,373.40 |
| Rate for Payer: AHCCCS Medicaid |
$12,373.40
|
| Rate for Payer: Allwell Medicaid |
$12,373.40
|
| Rate for Payer: AZCH Complete Medicaid |
$12,373.40
|
| Rate for Payer: Banner UC Health Medicaid |
$12,373.40
|
| Rate for Payer: Mercy Care Medicaid |
$12,373.40
|
|
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
Facility
|
IP
|
$12,373.40
|
|
|
Service Code
|
APR-DRG 1772
|
| Hospital Charge Code |
APRDRG1771
|
| Min. Negotiated Rate |
$12,373.40 |
| Max. Negotiated Rate |
$12,373.40 |
| Rate for Payer: AHCCCS Medicaid |
$12,373.40
|
| Rate for Payer: Allwell Medicaid |
$12,373.40
|
| Rate for Payer: AZCH Complete Medicaid |
$12,373.40
|
| Rate for Payer: Banner UC Health Medicaid |
$12,373.40
|
| Rate for Payer: Mercy Care Medicaid |
$12,373.40
|
|
