NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$315,720.23
|
|
Service Code
|
APR-DRG 5883
|
Min. Negotiated Rate |
$242,190.65 |
Max. Negotiated Rate |
$315,720.23 |
Rate for Payer: IEHP Medi-Cal |
$242,190.65
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315,720.23
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$2,456.24
|
|
Service Code
|
APR-DRG 6261
|
Min. Negotiated Rate |
$1,884.20 |
Max. Negotiated Rate |
$2,456.24 |
Rate for Payer: IEHP Medi-Cal |
$1,884.20
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,456.24
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$67,292.17
|
|
Service Code
|
APR-DRG 6264
|
Min. Negotiated Rate |
$51,620.18 |
Max. Negotiated Rate |
$67,292.17 |
Rate for Payer: IEHP Medi-Cal |
$51,620.18
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67,292.17
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$8,481.58
|
|
Service Code
|
APR-DRG 6263
|
Min. Negotiated Rate |
$6,506.27 |
Max. Negotiated Rate |
$8,481.58 |
Rate for Payer: IEHP Medi-Cal |
$6,506.27
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,481.58
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$2,865.90
|
|
Service Code
|
APR-DRG 6262
|
Min. Negotiated Rate |
$2,198.45 |
Max. Negotiated Rate |
$2,865.90 |
Rate for Payer: IEHP Medi-Cal |
$2,198.45
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,865.90
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$28,481.76
|
|
Service Code
|
APR-DRG 6232
|
Min. Negotiated Rate |
$21,848.51 |
Max. Negotiated Rate |
$28,481.76 |
Rate for Payer: IEHP Medi-Cal |
$21,848.51
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,481.76
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$17,559.48
|
|
Service Code
|
APR-DRG 6231
|
Min. Negotiated Rate |
$13,469.97 |
Max. Negotiated Rate |
$17,559.48 |
Rate for Payer: IEHP Medi-Cal |
$13,469.97
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,559.48
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$62,667.43
|
|
Service Code
|
APR-DRG 6233
|
Min. Negotiated Rate |
$48,072.52 |
Max. Negotiated Rate |
$62,667.43 |
Rate for Payer: IEHP Medi-Cal |
$48,072.52
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$62,667.43
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$109,432.76
|
|
Service Code
|
APR-DRG 6234
|
Min. Negotiated Rate |
$83,946.45 |
Max. Negotiated Rate |
$109,432.76 |
Rate for Payer: IEHP Medi-Cal |
$83,946.45
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109,432.76
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$151,069.00
|
|
Service Code
|
APR-DRG 6214
|
Min. Negotiated Rate |
$115,885.82 |
Max. Negotiated Rate |
$151,069.00 |
Rate for Payer: IEHP Medi-Cal |
$115,885.82
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151,069.00
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$25,894.74
|
|
Service Code
|
APR-DRG 6212
|
Min. Negotiated Rate |
$19,863.99 |
Max. Negotiated Rate |
$25,894.74 |
Rate for Payer: IEHP Medi-Cal |
$19,863.99
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,894.74
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$7,996.09
|
|
Service Code
|
APR-DRG 6211
|
Min. Negotiated Rate |
$6,133.85 |
Max. Negotiated Rate |
$7,996.09 |
Rate for Payer: IEHP Medi-Cal |
$6,133.85
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,996.09
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$61,581.18
|
|
Service Code
|
APR-DRG 6213
|
Min. Negotiated Rate |
$47,239.25 |
Max. Negotiated Rate |
$61,581.18 |
Rate for Payer: IEHP Medi-Cal |
$47,239.25
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61,581.18
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$49,894.08
|
|
Service Code
|
APR-DRG 6253
|
Min. Negotiated Rate |
$38,274.01 |
Max. Negotiated Rate |
$49,894.08 |
Rate for Payer: IEHP Medi-Cal |
$38,274.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49,894.08
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$27,588.38
|
|
Service Code
|
APR-DRG 6252
|
Min. Negotiated Rate |
$21,163.19 |
Max. Negotiated Rate |
$27,588.38 |
Rate for Payer: IEHP Medi-Cal |
$21,163.19
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27,588.38
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$100,813.75
|
|
Service Code
|
APR-DRG 6254
|
Min. Negotiated Rate |
$77,334.76 |
Max. Negotiated Rate |
$100,813.75 |
Rate for Payer: IEHP Medi-Cal |
$77,334.76
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100,813.75
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$20,288.39
|
|
Service Code
|
APR-DRG 6251
|
Min. Negotiated Rate |
$15,563.33 |
Max. Negotiated Rate |
$20,288.39 |
Rate for Payer: IEHP Medi-Cal |
$15,563.33
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,288.39
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$48,222.59
|
|
Service Code
|
APR-DRG 6223
|
Min. Negotiated Rate |
$36,991.80 |
Max. Negotiated Rate |
$48,222.59 |
Rate for Payer: IEHP Medi-Cal |
$36,991.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48,222.59
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$28,430.78
|
|
Service Code
|
APR-DRG 6221
|
Min. Negotiated Rate |
$21,809.40 |
Max. Negotiated Rate |
$28,430.78 |
Rate for Payer: IEHP Medi-Cal |
$21,809.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,430.78
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$119,239.29
|
|
Service Code
|
APR-DRG 6224
|
Min. Negotiated Rate |
$91,469.09 |
Max. Negotiated Rate |
$119,239.29 |
Rate for Payer: IEHP Medi-Cal |
$91,469.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119,239.29
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$42,523.14
|
|
Service Code
|
APR-DRG 6222
|
Min. Negotiated Rate |
$32,619.72 |
Max. Negotiated Rate |
$42,523.14 |
Rate for Payer: IEHP Medi-Cal |
$32,619.72
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42,523.14
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$2,261.17
|
|
Service Code
|
APR-DRG 6402
|
Min. Negotiated Rate |
$1,734.56 |
Max. Negotiated Rate |
$2,261.17 |
Rate for Payer: IEHP Medi-Cal |
$1,734.56
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,261.17
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$1,709.62
|
|
Service Code
|
APR-DRG 6401
|
Min. Negotiated Rate |
$1,311.46 |
Max. Negotiated Rate |
$1,709.62 |
Rate for Payer: IEHP Medi-Cal |
$1,311.46
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,709.62
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$55,525.62
|
|
Service Code
|
APR-DRG 6404
|
Min. Negotiated Rate |
$42,593.99 |
Max. Negotiated Rate |
$55,525.62 |
Rate for Payer: IEHP Medi-Cal |
$42,593.99
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55,525.62
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$4,087.83
|
|
Service Code
|
APR-DRG 6403
|
Min. Negotiated Rate |
$3,135.80 |
Max. Negotiated Rate |
$4,087.83 |
Rate for Payer: IEHP Medi-Cal |
$3,135.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,087.83
|
|