|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$59,441.83
|
|
|
Service Code
|
APR-DRG 6133
|
| Min. Negotiated Rate |
$58,276.30 |
| Max. Negotiated Rate |
$59,441.83 |
| Rate for Payer: UnitedHealthcare Community & State |
$58,276.30
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$59,441.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58,276.30
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$21,612.06
|
|
|
Service Code
|
APR-DRG 6131
|
| Min. Negotiated Rate |
$21,188.29 |
| Max. Negotiated Rate |
$21,612.06 |
| Rate for Payer: UnitedHealthcare Community & State |
$21,188.29
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$21,612.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21,188.29
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$33,564.72
|
|
|
Service Code
|
APR-DRG 6132
|
| Min. Negotiated Rate |
$32,906.59 |
| Max. Negotiated Rate |
$33,564.72 |
| Rate for Payer: UnitedHealthcare Community & State |
$32,906.59
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$33,564.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32,906.59
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$15,215.11
|
|
|
Service Code
|
APR-DRG 6111
|
| Min. Negotiated Rate |
$14,916.77 |
| Max. Negotiated Rate |
$15,215.11 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,916.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,215.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,916.77
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$101,689.81
|
|
|
Service Code
|
APR-DRG 6114
|
| Min. Negotiated Rate |
$99,695.89 |
| Max. Negotiated Rate |
$101,689.81 |
| Rate for Payer: UnitedHealthcare Community & State |
$99,695.89
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$101,689.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99,695.89
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$34,434.06
|
|
|
Service Code
|
APR-DRG 6112
|
| Min. Negotiated Rate |
$33,758.88 |
| Max. Negotiated Rate |
$34,434.06 |
| Rate for Payer: UnitedHealthcare Community & State |
$33,758.88
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$34,434.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33,758.88
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$61,010.50
|
|
|
Service Code
|
APR-DRG 6113
|
| Min. Negotiated Rate |
$59,814.22 |
| Max. Negotiated Rate |
$61,010.50 |
| Rate for Payer: UnitedHealthcare Community & State |
$59,814.22
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$61,010.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59,814.22
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$12,038.36
|
|
|
Service Code
|
APR-DRG 6141
|
| Min. Negotiated Rate |
$11,802.31 |
| Max. Negotiated Rate |
$12,038.36 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,802.31
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,038.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,802.31
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$28,735.07
|
|
|
Service Code
|
APR-DRG 6142
|
| Min. Negotiated Rate |
$28,171.64 |
| Max. Negotiated Rate |
$28,735.07 |
| Rate for Payer: UnitedHealthcare Community & State |
$28,171.64
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$28,735.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28,171.64
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$69,383.43
|
|
|
Service Code
|
APR-DRG 6144
|
| Min. Negotiated Rate |
$68,022.97 |
| Max. Negotiated Rate |
$69,383.43 |
| Rate for Payer: UnitedHealthcare Community & State |
$68,022.97
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$69,383.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$68,022.97
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$53,803.27
|
|
|
Service Code
|
APR-DRG 6143
|
| Min. Negotiated Rate |
$52,748.30 |
| Max. Negotiated Rate |
$53,803.27 |
| Rate for Payer: UnitedHealthcare Community & State |
$52,748.30
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$53,803.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$52,748.30
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$97,743.54
|
|
|
Service Code
|
APR-DRG 6124
|
| Min. Negotiated Rate |
$95,827.00 |
| Max. Negotiated Rate |
$97,743.54 |
| Rate for Payer: UnitedHealthcare Community & State |
$95,827.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$97,743.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$95,827.00
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$48,170.31
|
|
|
Service Code
|
APR-DRG 6122
|
| Min. Negotiated Rate |
$47,225.79 |
| Max. Negotiated Rate |
$48,170.31 |
| Rate for Payer: UnitedHealthcare Community & State |
$47,225.79
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$48,170.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47,225.79
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$61,472.54
|
|
|
Service Code
|
APR-DRG 6123
|
| Min. Negotiated Rate |
$60,267.20 |
| Max. Negotiated Rate |
$61,472.54 |
| Rate for Payer: UnitedHealthcare Community & State |
$60,267.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$61,472.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60,267.20
|
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$31,233.43
|
|
|
Service Code
|
APR-DRG 6121
|
| Min. Negotiated Rate |
$30,621.01 |
| Max. Negotiated Rate |
$31,233.43 |
| Rate for Payer: UnitedHealthcare Community & State |
$30,621.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,233.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30,621.01
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$56,956.06
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$55,839.27 |
| Max. Negotiated Rate |
$56,956.06 |
| Rate for Payer: UnitedHealthcare Community & State |
$55,839.27
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$56,956.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55,839.27
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$51,665.75
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$50,652.70 |
| Max. Negotiated Rate |
$51,665.75 |
| Rate for Payer: UnitedHealthcare Community & State |
$50,652.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$51,665.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50,652.70
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$229,819.93
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$225,313.66 |
| Max. Negotiated Rate |
$229,819.93 |
| Rate for Payer: UnitedHealthcare Community & State |
$225,313.66
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$229,819.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$225,313.66
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$100,240.51
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$98,275.01 |
| Max. Negotiated Rate |
$100,240.51 |
| Rate for Payer: UnitedHealthcare Community & State |
$98,275.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$100,240.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$98,275.01
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$363,602.76
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$356,473.29 |
| Max. Negotiated Rate |
$363,602.76 |
| Rate for Payer: UnitedHealthcare Community & State |
$356,473.29
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$363,602.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$356,473.29
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$150,982.18
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$148,021.75 |
| Max. Negotiated Rate |
$150,982.18 |
| Rate for Payer: UnitedHealthcare Community & State |
$148,021.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$150,982.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$148,021.75
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$233,204.52
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$228,631.88 |
| Max. Negotiated Rate |
$233,204.52 |
| Rate for Payer: UnitedHealthcare Community & State |
$228,631.88
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$233,204.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$228,631.88
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$227,002.81
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$222,551.77 |
| Max. Negotiated Rate |
$227,002.81 |
| Rate for Payer: UnitedHealthcare Community & State |
$222,551.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$227,002.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$222,551.77
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$2,379.05
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$2,332.40 |
| Max. Negotiated Rate |
$2,379.05 |
| Rate for Payer: UnitedHealthcare Community & State |
$2,332.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,379.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,332.40
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$5,583.82
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$5,474.33 |
| Max. Negotiated Rate |
$5,583.82 |
| Rate for Payer: UnitedHealthcare Community & State |
$5,474.33
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,583.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,474.33
|
|