|
NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$3,070.30
|
|
|
Service Code
|
APR-DRG 5812
|
| Min. Negotiated Rate |
$2,355.25 |
| Max. Negotiated Rate |
$3,070.30 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,355.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,070.30
|
|
|
NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE
|
Facility
|
IP
|
$4,708.54
|
|
|
Service Code
|
APR-DRG 5813
|
| Min. Negotiated Rate |
$3,611.95 |
| Max. Negotiated Rate |
$4,708.54 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,611.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,708.54
|
|
|
NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$12,352.15
|
|
|
Service Code
|
APR-DRG 5803
|
| Min. Negotiated Rate |
$9,475.40 |
| Max. Negotiated Rate |
$12,352.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9,475.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,352.15
|
|
|
NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$7,528.33
|
|
|
Service Code
|
APR-DRG 5802
|
| Min. Negotiated Rate |
$5,775.02 |
| Max. Negotiated Rate |
$7,528.33 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,775.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,528.33
|
|
|
NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$29,164.20
|
|
|
Service Code
|
APR-DRG 5804
|
| Min. Negotiated Rate |
$22,372.01 |
| Max. Negotiated Rate |
$29,164.20 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22,372.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,164.20
|
|
|
NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE
|
Facility
|
IP
|
$5,887.89
|
|
|
Service Code
|
APR-DRG 5801
|
| Min. Negotiated Rate |
$4,516.63 |
| Max. Negotiated Rate |
$5,887.89 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,516.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,887.89
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$473,187.95
|
|
|
Service Code
|
APR-DRG 5833
|
| Min. Negotiated Rate |
$362,984.97 |
| Max. Negotiated Rate |
$473,187.95 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$362,984.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$473,187.95
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$301,539.20
|
|
|
Service Code
|
APR-DRG 5831
|
| Min. Negotiated Rate |
$231,312.30 |
| Max. Negotiated Rate |
$301,539.20 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$231,312.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301,539.20
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$860,321.41
|
|
|
Service Code
|
APR-DRG 5834
|
| Min. Negotiated Rate |
$659,957.08 |
| Max. Negotiated Rate |
$860,321.41 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$659,957.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$860,321.41
|
|
|
NEONATE WITH ECMO
|
Facility
|
IP
|
$348,930.48
|
|
|
Service Code
|
APR-DRG 5832
|
| Min. Negotiated Rate |
$267,666.41 |
| Max. Negotiated Rate |
$348,930.48 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$267,666.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348,930.48
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION. [4085490]
|
Facility
|
OP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$22.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.24
|
| Rate for Payer: Blue Distinction Transplant |
$1.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2.23
|
| Rate for Payer: Blue Shield of California EPN |
$2.08
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.57
|
| Rate for Payer: Dignity Health Media |
$2.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.51
|
| Rate for Payer: United Healthcare All Other HMO |
$1.51
|
| Rate for Payer: United Healthcare HMO Rider |
$1.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Vantage Medical Group Senior |
$2.57
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION. [4085490]
|
Facility
|
IP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Blue Shield of California Commercial |
$2.15
|
| Rate for Payer: Blue Shield of California EPN |
$1.55
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
|
|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
|
IP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Blue Shield of California Commercial |
$2.15
|
| Rate for Payer: Blue Shield of California EPN |
$1.55
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
|
|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
|
OP
|
$3.02
|
|
|
Service Code
|
CPT J2710
|
| Hospital Charge Code |
NDG120692
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$22.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.24
|
| Rate for Payer: Blue Distinction Transplant |
$1.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2.23
|
| Rate for Payer: Blue Shield of California EPN |
$2.08
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$2.11
|
| Rate for Payer: Cigna of CA PPO |
$2.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.57
|
| Rate for Payer: Dignity Health Media |
$2.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.57
|
| Rate for Payer: Global Benefits Group Commercial |
$1.81
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.51
|
| Rate for Payer: Prime Health Services Commercial |
$2.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.51
|
| Rate for Payer: United Healthcare All Other HMO |
$1.51
|
| Rate for Payer: United Healthcare HMO Rider |
$1.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Vantage Medical Group Senior |
$2.57
|
|
|
NEPAFENAC 0.1 % EYE DROPS,SUSPENSION [42486]
|
Facility
|
IP
|
$125.38
|
|
|
Service Code
|
NDC 0065-0002-03
|
| Hospital Charge Code |
1740380
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$106.57 |
| Rate for Payer: Blue Shield of California Commercial |
$89.27
|
| Rate for Payer: Blue Shield of California EPN |
$64.19
|
| Rate for Payer: Cash Price |
$56.42
|
| Rate for Payer: Cigna of CA HMO |
$87.77
|
| Rate for Payer: Cigna of CA PPO |
$87.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.15
|
| Rate for Payer: Galaxy Health WC |
$106.57
|
| Rate for Payer: Global Benefits Group Commercial |
$75.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.09
|
| Rate for Payer: Multiplan Commercial |
$100.30
|
| Rate for Payer: Networks By Design Commercial |
$81.50
|
| Rate for Payer: Prime Health Services Commercial |
$106.57
|
|
|
NEPAFENAC 0.1 % EYE DROPS,SUSPENSION [42486]
|
Facility
|
OP
|
$125.38
|
|
|
Service Code
|
NDC 0065-0002-03
|
| Hospital Charge Code |
1740380
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$106.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$68.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.70
|
| Rate for Payer: Blue Distinction Transplant |
$75.23
|
| Rate for Payer: Blue Shield of California Commercial |
$92.41
|
| Rate for Payer: Blue Shield of California EPN |
$73.22
|
| Rate for Payer: Cash Price |
$56.42
|
| Rate for Payer: Cigna of CA HMO |
$87.77
|
| Rate for Payer: Cigna of CA PPO |
$87.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.57
|
| Rate for Payer: Dignity Health Media |
$106.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$50.15
|
| Rate for Payer: Galaxy Health WC |
$106.57
|
| Rate for Payer: Global Benefits Group Commercial |
$75.23
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$94.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.09
|
| Rate for Payer: Multiplan Commercial |
$100.30
|
| Rate for Payer: Networks By Design Commercial |
$81.50
|
| Rate for Payer: Prime Health Services Commercial |
$106.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.69
|
| Rate for Payer: United Healthcare All Other HMO |
$62.69
|
| Rate for Payer: United Healthcare HMO Rider |
$62.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.57
|
| Rate for Payer: Vantage Medical Group Senior |
$106.57
|
|
|
NEPAFENAC 0.3 % EYE DROPS,SUSPENSION [199693]
|
Facility
|
OP
|
$144.84
|
|
|
Service Code
|
NDC 0078-0743-03
|
| Hospital Charge Code |
NDG199693B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$123.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$79.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$79.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.30
|
| Rate for Payer: Blue Distinction Transplant |
$86.90
|
| Rate for Payer: Blue Shield of California Commercial |
$106.75
|
| Rate for Payer: Blue Shield of California EPN |
$84.59
|
| Rate for Payer: Cash Price |
$65.18
|
| Rate for Payer: Cigna of CA HMO |
$101.39
|
| Rate for Payer: Cigna of CA PPO |
$101.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.11
|
| Rate for Payer: Dignity Health Media |
$123.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$57.94
|
| Rate for Payer: Galaxy Health WC |
$123.11
|
| Rate for Payer: Global Benefits Group Commercial |
$86.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$108.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.76
|
| Rate for Payer: Multiplan Commercial |
$115.87
|
| Rate for Payer: Networks By Design Commercial |
$94.15
|
| Rate for Payer: Prime Health Services Commercial |
$123.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.42
|
| Rate for Payer: United Healthcare All Other HMO |
$72.42
|
| Rate for Payer: United Healthcare HMO Rider |
$72.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.11
|
| Rate for Payer: Vantage Medical Group Senior |
$123.11
|
|
|
NEPAFENAC 0.3 % EYE DROPS,SUSPENSION [199693]
|
Facility
|
IP
|
$144.84
|
|
|
Service Code
|
NDC 0078-0743-03
|
| Hospital Charge Code |
NDG199693B
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$123.11 |
| Rate for Payer: Blue Shield of California Commercial |
$103.13
|
| Rate for Payer: Blue Shield of California EPN |
$74.16
|
| Rate for Payer: Cash Price |
$65.18
|
| Rate for Payer: Cigna of CA HMO |
$101.39
|
| Rate for Payer: Cigna of CA PPO |
$101.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.94
|
| Rate for Payer: Galaxy Health WC |
$123.11
|
| Rate for Payer: Global Benefits Group Commercial |
$86.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$96.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.76
|
| Rate for Payer: Multiplan Commercial |
$115.87
|
| Rate for Payer: Networks By Design Commercial |
$94.15
|
| Rate for Payer: Prime Health Services Commercial |
$123.11
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$9,679.55
|
|
|
Service Code
|
APR-DRG 4622
|
| Min. Negotiated Rate |
$7,425.23 |
| Max. Negotiated Rate |
$9,679.55 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,425.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,679.55
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$6,629.20
|
|
|
Service Code
|
APR-DRG 4621
|
| Min. Negotiated Rate |
$5,085.29 |
| Max. Negotiated Rate |
$6,629.20 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,085.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,629.20
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$17,965.15
|
|
|
Service Code
|
APR-DRG 4623
|
| Min. Negotiated Rate |
$13,781.16 |
| Max. Negotiated Rate |
$17,965.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13,781.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,965.15
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$40,324.94
|
|
|
Service Code
|
APR-DRG 4624
|
| Min. Negotiated Rate |
$30,933.47 |
| Max. Negotiated Rate |
$40,324.94 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30,933.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40,324.94
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$16,376.14
|
|
|
Service Code
|
APR-DRG 0413
|
| Min. Negotiated Rate |
$12,562.22 |
| Max. Negotiated Rate |
$16,376.14 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12,562.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,376.14
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$12,398.26
|
|
|
Service Code
|
APR-DRG 0412
|
| Min. Negotiated Rate |
$9,510.77 |
| Max. Negotiated Rate |
$12,398.26 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9,510.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,398.26
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$24,227.24
|
|
|
Service Code
|
APR-DRG 0414
|
| Min. Negotiated Rate |
$18,584.84 |
| Max. Negotiated Rate |
$24,227.24 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18,584.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,227.24
|
|
