|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
IP
|
$9.00
|
|
|
Service Code
|
NDC 70748-258-07
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$7.65 |
| Rate for Payer: Blue Shield of California Commercial |
$6.41
|
| Rate for Payer: Blue Shield of California EPN |
$4.61
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cigna of CA HMO |
$6.30
|
| Rate for Payer: Cigna of CA PPO |
$6.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.60
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$7.20
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
|
|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
OP
|
$19.24
|
|
|
Service Code
|
NDC 0527-2133-35
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$16.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.46
|
| Rate for Payer: BCBS Transplant Transplant |
$11.54
|
| Rate for Payer: Blue Shield of California Commercial |
$14.18
|
| Rate for Payer: Blue Shield of California EPN |
$11.24
|
| Rate for Payer: Cash Price |
$8.66
|
| Rate for Payer: Cigna of CA HMO |
$13.47
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.35
|
| Rate for Payer: Dignity Health Media |
$16.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.70
|
| Rate for Payer: Galaxy Health WC |
$16.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11.54
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.62
|
| Rate for Payer: Multiplan Commercial |
$15.39
|
| Rate for Payer: Networks By Design Commercial |
$12.51
|
| Rate for Payer: Prime Health Services Commercial |
$16.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.62
|
| Rate for Payer: United Healthcare All Other HMO |
$9.62
|
| Rate for Payer: United Healthcare HMO Rider |
$9.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.35
|
| Rate for Payer: Vantage Medical Group Senior |
$16.35
|
|
|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
OP
|
$56.60
|
|
|
Service Code
|
NDC 60687-523-21
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$48.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$48.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$31.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.72
|
| Rate for Payer: BCBS Transplant Transplant |
$33.96
|
| Rate for Payer: Blue Shield of California Commercial |
$41.71
|
| Rate for Payer: Blue Shield of California EPN |
$33.05
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cigna of CA HMO |
$39.62
|
| Rate for Payer: Cigna of CA PPO |
$39.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.11
|
| Rate for Payer: Dignity Health Media |
$48.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.64
|
| Rate for Payer: Galaxy Health WC |
$48.11
|
| Rate for Payer: Global Benefits Group Commercial |
$33.96
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$42.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.58
|
| Rate for Payer: Multiplan Commercial |
$45.28
|
| Rate for Payer: Networks By Design Commercial |
$36.79
|
| Rate for Payer: Prime Health Services Commercial |
$48.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$33.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.30
|
| Rate for Payer: United Healthcare All Other HMO |
$28.30
|
| Rate for Payer: United Healthcare HMO Rider |
$28.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.11
|
| Rate for Payer: Vantage Medical Group Senior |
$48.11
|
|
|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
IP
|
$56.60
|
|
|
Service Code
|
NDC 60687-523-21
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$48.11 |
| Rate for Payer: Blue Shield of California Commercial |
$40.30
|
| Rate for Payer: Blue Shield of California EPN |
$28.98
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cigna of CA HMO |
$39.62
|
| Rate for Payer: Cigna of CA PPO |
$39.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.64
|
| Rate for Payer: Galaxy Health WC |
$48.11
|
| Rate for Payer: Global Benefits Group Commercial |
$33.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.58
|
| Rate for Payer: Multiplan Commercial |
$45.28
|
| Rate for Payer: Networks By Design Commercial |
$36.79
|
| Rate for Payer: Prime Health Services Commercial |
$48.11
|
|
|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
IP
|
$56.60
|
|
|
Service Code
|
NDC 60687-523-11
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$48.11 |
| Rate for Payer: Blue Shield of California Commercial |
$40.30
|
| Rate for Payer: Blue Shield of California EPN |
$28.98
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cigna of CA HMO |
$39.62
|
| Rate for Payer: Cigna of CA PPO |
$39.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.64
|
| Rate for Payer: Galaxy Health WC |
$48.11
|
| Rate for Payer: Global Benefits Group Commercial |
$33.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.58
|
| Rate for Payer: Multiplan Commercial |
$45.28
|
| Rate for Payer: Networks By Design Commercial |
$36.79
|
| Rate for Payer: Prime Health Services Commercial |
$48.11
|
|
|
POSACONAZOLE 100 MG TABLET,DELAYED RELEASE [204306]
|
Facility
IP
|
$19.24
|
|
|
Service Code
|
NDC 0527-2133-35
|
| Hospital Charge Code |
ERX204306
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$16.35 |
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California EPN |
$9.85
|
| Rate for Payer: Cash Price |
$8.66
|
| Rate for Payer: Cigna of CA HMO |
$13.47
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.70
|
| Rate for Payer: Galaxy Health WC |
$16.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.62
|
| Rate for Payer: Multiplan Commercial |
$15.39
|
| Rate for Payer: Networks By Design Commercial |
$12.51
|
| Rate for Payer: Prime Health Services Commercial |
$16.35
|
|
|
POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION [77371]
|
Facility
OP
|
$16.45
|
|
|
Service Code
|
NDC 0085-1328-01
|
| Hospital Charge Code |
1715196
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$13.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.80
|
| Rate for Payer: BCBS Transplant Transplant |
$9.87
|
| Rate for Payer: Blue Shield of California Commercial |
$12.12
|
| Rate for Payer: Blue Shield of California EPN |
$9.61
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$11.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.98
|
| Rate for Payer: Dignity Health Media |
$13.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.58
|
| Rate for Payer: Galaxy Health WC |
$13.98
|
| Rate for Payer: Global Benefits Group Commercial |
$9.87
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$13.16
|
| Rate for Payer: Networks By Design Commercial |
$10.69
|
| Rate for Payer: Prime Health Services Commercial |
$13.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.22
|
| Rate for Payer: United Healthcare All Other HMO |
$8.22
|
| Rate for Payer: United Healthcare HMO Rider |
$8.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.98
|
| Rate for Payer: Vantage Medical Group Senior |
$13.98
|
|
|
POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION [77371]
|
Facility
IP
|
$16.45
|
|
|
Service Code
|
NDC 0085-1328-01
|
| Hospital Charge Code |
1715196
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$13.98 |
| Rate for Payer: Blue Shield of California Commercial |
$11.71
|
| Rate for Payer: Blue Shield of California EPN |
$8.42
|
| Rate for Payer: Cash Price |
$7.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.58
|
| Rate for Payer: Galaxy Health WC |
$13.98
|
| Rate for Payer: Global Benefits Group Commercial |
$9.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$13.16
|
| Rate for Payer: Networks By Design Commercial |
$10.69
|
| Rate for Payer: Prime Health Services Commercial |
$13.98
|
|
|
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION [205239]
|
Facility
IP
|
$38.12
|
|
|
Service Code
|
NDC 0085-4331-01
|
| Hospital Charge Code |
NDG2211
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Blue Shield of California Commercial |
$27.14
|
| Rate for Payer: Blue Shield of California EPN |
$19.52
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.25
|
| Rate for Payer: Galaxy Health WC |
$32.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.15
|
| Rate for Payer: Multiplan Commercial |
$30.50
|
| Rate for Payer: Networks By Design Commercial |
$24.78
|
| Rate for Payer: Prime Health Services Commercial |
$32.40
|
|
|
POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION [205239]
|
Facility
OP
|
$38.12
|
|
|
Service Code
|
NDC 0085-4331-01
|
| Hospital Charge Code |
NDG2211
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$9.15 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.97
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.71
|
| Rate for Payer: BCBS Transplant Transplant |
$22.87
|
| Rate for Payer: Blue Shield of California Commercial |
$28.09
|
| Rate for Payer: Blue Shield of California EPN |
$22.26
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cash Price |
$17.15
|
| Rate for Payer: Cigna of CA HMO |
$24.40
|
| Rate for Payer: Cigna of CA PPO |
$28.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.40
|
| Rate for Payer: Dignity Health Media |
$32.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.25
|
| Rate for Payer: Galaxy Health WC |
$32.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22.87
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.15
|
| Rate for Payer: Multiplan Commercial |
$30.50
|
| Rate for Payer: Networks By Design Commercial |
$24.78
|
| Rate for Payer: Prime Health Services Commercial |
$32.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.06
|
| Rate for Payer: United Healthcare All Other HMO |
$19.06
|
| Rate for Payer: United Healthcare HMO Rider |
$19.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.40
|
| Rate for Payer: Vantage Medical Group Senior |
$32.40
|
|
|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
IP
|
$16,360.18
|
|
|
Service Code
|
APR-DRG 7111
|
| Min. Negotiated Rate |
$12,549.98 |
| Max. Negotiated Rate |
$16,360.18 |
| Rate for Payer: IEHP Medi-Cal |
$12,549.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,360.18
|
|
|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
IP
|
$35,350.37
|
|
|
Service Code
|
APR-DRG 7113
|
| Min. Negotiated Rate |
$27,117.46 |
| Max. Negotiated Rate |
$35,350.37 |
| Rate for Payer: IEHP Medi-Cal |
$27,117.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35,350.37
|
|
|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
IP
|
$66,382.39
|
|
|
Service Code
|
APR-DRG 7114
|
| Min. Negotiated Rate |
$50,922.28 |
| Max. Negotiated Rate |
$66,382.39 |
| Rate for Payer: IEHP Medi-Cal |
$50,922.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66,382.39
|
|
|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
IP
|
$21,393.24
|
|
|
Service Code
|
APR-DRG 7112
|
| Min. Negotiated Rate |
$16,410.87 |
| Max. Negotiated Rate |
$21,393.24 |
| Rate for Payer: IEHP Medi-Cal |
$16,410.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,393.24
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$32,464.96
|
|
|
Service Code
|
APR-DRG 7214
|
| Min. Negotiated Rate |
$24,904.04 |
| Max. Negotiated Rate |
$32,464.96 |
| Rate for Payer: IEHP Medi-Cal |
$24,904.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,464.96
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$11,488.48
|
|
|
Service Code
|
APR-DRG 7212
|
| Min. Negotiated Rate |
$8,812.88 |
| Max. Negotiated Rate |
$11,488.48 |
| Rate for Payer: IEHP Medi-Cal |
$8,812.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,488.48
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$18,119.44
|
|
|
Service Code
|
APR-DRG 7213
|
| Min. Negotiated Rate |
$13,899.52 |
| Max. Negotiated Rate |
$18,119.44 |
| Rate for Payer: IEHP Medi-Cal |
$13,899.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,119.44
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
IP
|
$8,718.32
|
|
|
Service Code
|
APR-DRG 7211
|
| Min. Negotiated Rate |
$6,687.87 |
| Max. Negotiated Rate |
$8,718.32 |
| Rate for Payer: IEHP Medi-Cal |
$6,687.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,718.32
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
IP
|
$21,437.42
|
|
|
Service Code
|
APR-DRG 5614
|
| Min. Negotiated Rate |
$16,444.75 |
| Max. Negotiated Rate |
$21,437.42 |
| Rate for Payer: IEHP Medi-Cal |
$16,444.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,437.42
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
IP
|
$9,221.99
|
|
|
Service Code
|
APR-DRG 5613
|
| Min. Negotiated Rate |
$7,074.24 |
| Max. Negotiated Rate |
$9,221.99 |
| Rate for Payer: IEHP Medi-Cal |
$7,074.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,221.99
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
IP
|
$5,896.76
|
|
|
Service Code
|
APR-DRG 5612
|
| Min. Negotiated Rate |
$4,523.44 |
| Max. Negotiated Rate |
$5,896.76 |
| Rate for Payer: IEHP Medi-Cal |
$4,523.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,896.76
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
IP
|
$3,883.88
|
|
|
Service Code
|
APR-DRG 5611
|
| Min. Negotiated Rate |
$2,979.35 |
| Max. Negotiated Rate |
$3,883.88 |
| Rate for Payer: IEHP Medi-Cal |
$2,979.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,883.88
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
IP
|
$13,407.35
|
|
|
Service Code
|
APR-DRG 5482
|
| Min. Negotiated Rate |
$10,284.85 |
| Max. Negotiated Rate |
$13,407.35 |
| Rate for Payer: IEHP Medi-Cal |
$10,284.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,407.35
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
IP
|
$22,397.03
|
|
|
Service Code
|
APR-DRG 5483
|
| Min. Negotiated Rate |
$17,180.88 |
| Max. Negotiated Rate |
$22,397.03 |
| Rate for Payer: IEHP Medi-Cal |
$17,180.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,397.03
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
IP
|
$6,466.04
|
|
|
Service Code
|
APR-DRG 5481
|
| Min. Negotiated Rate |
$4,960.13 |
| Max. Negotiated Rate |
$6,466.04 |
| Rate for Payer: IEHP Medi-Cal |
$4,960.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,466.04
|
|
