NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY
|
Facility
IP
|
$106,001.91
|
|
Service Code
|
APR-DRG 6072
|
Min. Negotiated Rate |
$81,314.62 |
Max. Negotiated Rate |
$106,001.91 |
Rate for Payer: IEHP Medi-Cal |
$81,314.62
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106,001.91
|
|
NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY
|
Facility
IP
|
$136,895.59
|
|
Service Code
|
APR-DRG 6073
|
Min. Negotiated Rate |
$105,013.33 |
Max. Negotiated Rate |
$136,895.59 |
Rate for Payer: IEHP Medi-Cal |
$105,013.33
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136,895.59
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$81,809.71
|
|
Service Code
|
APR-DRG 6133
|
Min. Negotiated Rate |
$62,756.66 |
Max. Negotiated Rate |
$81,809.71 |
Rate for Payer: IEHP Medi-Cal |
$62,756.66
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81,809.71
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$180,660.95
|
|
Service Code
|
APR-DRG 6134
|
Min. Negotiated Rate |
$138,585.96 |
Max. Negotiated Rate |
$180,660.95 |
Rate for Payer: IEHP Medi-Cal |
$138,585.96
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180,660.95
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$28,005.14
|
|
Service Code
|
APR-DRG 6131
|
Min. Negotiated Rate |
$21,482.89 |
Max. Negotiated Rate |
$28,005.14 |
Rate for Payer: IEHP Medi-Cal |
$21,482.89
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,005.14
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$50,827.36
|
|
Service Code
|
APR-DRG 6132
|
Min. Negotiated Rate |
$38,989.93 |
Max. Negotiated Rate |
$50,827.36 |
Rate for Payer: IEHP Medi-Cal |
$38,989.93
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50,827.36
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$49,889.65
|
|
Service Code
|
APR-DRG 6112
|
Min. Negotiated Rate |
$38,270.61 |
Max. Negotiated Rate |
$49,889.65 |
Rate for Payer: IEHP Medi-Cal |
$38,270.61
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49,889.65
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$87,099.06
|
|
Service Code
|
APR-DRG 6113
|
Min. Negotiated Rate |
$66,814.15 |
Max. Negotiated Rate |
$87,099.06 |
Rate for Payer: IEHP Medi-Cal |
$66,814.15
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87,099.06
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$192,561.58
|
|
Service Code
|
APR-DRG 6114
|
Min. Negotiated Rate |
$147,715.00 |
Max. Negotiated Rate |
$192,561.58 |
Rate for Payer: IEHP Medi-Cal |
$147,715.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192,561.58
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$22,447.57
|
|
Service Code
|
APR-DRG 6111
|
Min. Negotiated Rate |
$17,219.65 |
Max. Negotiated Rate |
$22,447.57 |
Rate for Payer: IEHP Medi-Cal |
$17,219.65
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,447.57
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$42,494.32
|
|
Service Code
|
APR-DRG 6142
|
Min. Negotiated Rate |
$32,597.61 |
Max. Negotiated Rate |
$42,494.32 |
Rate for Payer: IEHP Medi-Cal |
$32,597.61
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42,494.32
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$145,182.53
|
|
Service Code
|
APR-DRG 6144
|
Min. Negotiated Rate |
$111,370.29 |
Max. Negotiated Rate |
$145,182.53 |
Rate for Payer: IEHP Medi-Cal |
$111,370.29
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145,182.53
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$77,345.03
|
|
Service Code
|
APR-DRG 6143
|
Min. Negotiated Rate |
$59,331.78 |
Max. Negotiated Rate |
$77,345.03 |
Rate for Payer: IEHP Medi-Cal |
$59,331.78
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77,345.03
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$17,492.96
|
|
Service Code
|
APR-DRG 6141
|
Min. Negotiated Rate |
$13,418.94 |
Max. Negotiated Rate |
$17,492.96 |
Rate for Payer: IEHP Medi-Cal |
$13,418.94
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,492.96
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$89,929.94
|
|
Service Code
|
APR-DRG 6123
|
Min. Negotiated Rate |
$68,985.73 |
Max. Negotiated Rate |
$89,929.94 |
Rate for Payer: IEHP Medi-Cal |
$68,985.73
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89,929.94
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$45,520.28
|
|
Service Code
|
APR-DRG 6121
|
Min. Negotiated Rate |
$34,918.84 |
Max. Negotiated Rate |
$45,520.28 |
Rate for Payer: IEHP Medi-Cal |
$34,918.84
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45,520.28
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$184,137.28
|
|
Service Code
|
APR-DRG 6124
|
Min. Negotiated Rate |
$141,252.68 |
Max. Negotiated Rate |
$184,137.28 |
Rate for Payer: IEHP Medi-Cal |
$141,252.68
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184,137.28
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$69,641.56
|
|
Service Code
|
APR-DRG 6122
|
Min. Negotiated Rate |
$53,422.40 |
Max. Negotiated Rate |
$69,641.56 |
Rate for Payer: IEHP Medi-Cal |
$53,422.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69,641.56
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$68,943.27
|
|
Service Code
|
APR-DRG 6091
|
Min. Negotiated Rate |
$52,886.74 |
Max. Negotiated Rate |
$68,943.27 |
Rate for Payer: IEHP Medi-Cal |
$52,886.74
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68,943.27
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$152,785.80
|
|
Service Code
|
APR-DRG 6093
|
Min. Negotiated Rate |
$117,202.79 |
Max. Negotiated Rate |
$152,785.80 |
Rate for Payer: IEHP Medi-Cal |
$117,202.79
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152,785.80
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$72,572.19
|
|
Service Code
|
APR-DRG 6092
|
Min. Negotiated Rate |
$55,670.51 |
Max. Negotiated Rate |
$72,572.19 |
Rate for Payer: IEHP Medi-Cal |
$55,670.51
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72,572.19
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$441,612.82
|
|
Service Code
|
APR-DRG 6094
|
Min. Negotiated Rate |
$338,763.52 |
Max. Negotiated Rate |
$441,612.82 |
Rate for Payer: IEHP Medi-Cal |
$338,763.52
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$441,612.82
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$705,696.27
|
|
Service Code
|
APR-DRG 5884
|
Min. Negotiated Rate |
$541,343.32 |
Max. Negotiated Rate |
$705,696.27 |
Rate for Payer: IEHP Medi-Cal |
$541,343.32
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$705,696.27
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$203,495.66
|
|
Service Code
|
APR-DRG 5881
|
Min. Negotiated Rate |
$156,102.59 |
Max. Negotiated Rate |
$203,495.66 |
Rate for Payer: IEHP Medi-Cal |
$156,102.59
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$203,495.66
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$309,149.55
|
|
Service Code
|
APR-DRG 5882
|
Min. Negotiated Rate |
$237,150.25 |
Max. Negotiated Rate |
$309,149.55 |
Rate for Payer: IEHP Medi-Cal |
$237,150.25
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309,149.55
|
|