NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$18,111.46
|
|
Service Code
|
APR-DRG 6362
|
Min. Negotiated Rate |
$13,893.40 |
Max. Negotiated Rate |
$18,111.46 |
Rate for Payer: IEHP Medi-Cal |
$13,893.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,111.46
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$37,439.96
|
|
Service Code
|
APR-DRG 6363
|
Min. Negotiated Rate |
$28,720.39 |
Max. Negotiated Rate |
$37,439.96 |
Rate for Payer: IEHP Medi-Cal |
$28,720.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37,439.96
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$9,669.78
|
|
Service Code
|
APR-DRG 6361
|
Min. Negotiated Rate |
$7,417.74 |
Max. Negotiated Rate |
$9,669.78 |
Rate for Payer: IEHP Medi-Cal |
$7,417.74
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,669.78
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$87,119.08
|
|
Service Code
|
APR-DRG 6364
|
Min. Negotiated Rate |
$66,829.51 |
Max. Negotiated Rate |
$87,119.08 |
Rate for Payer: IEHP Medi-Cal |
$66,829.51
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87,119.08
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$10,388.04
|
|
Service Code
|
APR-DRG 6332
|
Min. Negotiated Rate |
$7,968.72 |
Max. Negotiated Rate |
$10,388.04 |
Rate for Payer: IEHP Medi-Cal |
$7,968.72
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,388.04
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$36,872.44
|
|
Service Code
|
APR-DRG 6333
|
Min. Negotiated Rate |
$28,285.05 |
Max. Negotiated Rate |
$36,872.44 |
Rate for Payer: IEHP Medi-Cal |
$28,285.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36,872.44
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$3,655.54
|
|
Service Code
|
APR-DRG 6331
|
Min. Negotiated Rate |
$2,804.19 |
Max. Negotiated Rate |
$3,655.54 |
Rate for Payer: IEHP Medi-Cal |
$2,804.19
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,655.54
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$137,307.30
|
|
Service Code
|
APR-DRG 6334
|
Min. Negotiated Rate |
$105,329.15 |
Max. Negotiated Rate |
$137,307.30 |
Rate for Payer: IEHP Medi-Cal |
$105,329.15
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137,307.30
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
IP
|
$109,045.62
|
|
Service Code
|
APR-DRG 6302
|
Min. Negotiated Rate |
$83,649.47 |
Max. Negotiated Rate |
$109,045.62 |
Rate for Payer: IEHP Medi-Cal |
$83,649.47
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109,045.62
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
IP
|
$171,870.45
|
|
Service Code
|
APR-DRG 6303
|
Min. Negotiated Rate |
$131,842.72 |
Max. Negotiated Rate |
$171,870.45 |
Rate for Payer: IEHP Medi-Cal |
$131,842.72
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171,870.45
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
IP
|
$512,221.72
|
|
Service Code
|
APR-DRG 6304
|
Min. Negotiated Rate |
$392,927.98 |
Max. Negotiated Rate |
$512,221.72 |
Rate for Payer: IEHP Medi-Cal |
$392,927.98
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512,221.72
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE
|
Facility
IP
|
$43,256.90
|
|
Service Code
|
APR-DRG 6301
|
Min. Negotiated Rate |
$33,182.60 |
Max. Negotiated Rate |
$43,256.90 |
Rate for Payer: IEHP Medi-Cal |
$33,182.60
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43,256.90
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
IP
|
$423,963.00
|
|
Service Code
|
APR-DRG 6314
|
Min. Negotiated Rate |
$325,224.25 |
Max. Negotiated Rate |
$423,963.00 |
Rate for Payer: IEHP Medi-Cal |
$325,224.25
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$423,963.00
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
IP
|
$113,064.72
|
|
Service Code
|
APR-DRG 6313
|
Min. Negotiated Rate |
$86,732.55 |
Max. Negotiated Rate |
$113,064.72 |
Rate for Payer: IEHP Medi-Cal |
$86,732.55
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113,064.72
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
IP
|
$8,953.75
|
|
Service Code
|
APR-DRG 6311
|
Min. Negotiated Rate |
$6,868.47 |
Max. Negotiated Rate |
$8,953.75 |
Rate for Payer: IEHP Medi-Cal |
$6,868.47
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,953.75
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE
|
Facility
IP
|
$69,342.29
|
|
Service Code
|
APR-DRG 6312
|
Min. Negotiated Rate |
$53,192.83 |
Max. Negotiated Rate |
$69,342.29 |
Rate for Payer: IEHP Medi-Cal |
$53,192.83
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69,342.29
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$64,409.58
|
|
Service Code
|
APR-DRG 6394
|
Min. Negotiated Rate |
$49,408.93 |
Max. Negotiated Rate |
$64,409.58 |
Rate for Payer: IEHP Medi-Cal |
$49,408.93
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64,409.58
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$6,763.52
|
|
Service Code
|
APR-DRG 6391
|
Min. Negotiated Rate |
$5,188.34 |
Max. Negotiated Rate |
$6,763.52 |
Rate for Payer: IEHP Medi-Cal |
$5,188.34
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,763.52
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$30,288.49
|
|
Service Code
|
APR-DRG 6393
|
Min. Negotiated Rate |
$23,234.46 |
Max. Negotiated Rate |
$30,288.49 |
Rate for Payer: IEHP Medi-Cal |
$23,234.46
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,288.49
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$9,248.59
|
|
Service Code
|
APR-DRG 6392
|
Min. Negotiated Rate |
$7,094.64 |
Max. Negotiated Rate |
$9,248.59 |
Rate for Payer: IEHP Medi-Cal |
$7,094.64
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,248.59
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$10,851.36
|
|
Service Code
|
APR-DRG 6341
|
Min. Negotiated Rate |
$8,324.13 |
Max. Negotiated Rate |
$10,851.36 |
Rate for Payer: IEHP Medi-Cal |
$8,324.13
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,851.36
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$22,261.35
|
|
Service Code
|
APR-DRG 6342
|
Min. Negotiated Rate |
$17,076.80 |
Max. Negotiated Rate |
$22,261.35 |
Rate for Payer: IEHP Medi-Cal |
$17,076.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,261.35
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$25,136.58
|
|
Service Code
|
APR-DRG 6343
|
Min. Negotiated Rate |
$19,282.40 |
Max. Negotiated Rate |
$25,136.58 |
Rate for Payer: IEHP Medi-Cal |
$19,282.40
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,136.58
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$105,235.00
|
|
Service Code
|
APR-DRG 6344
|
Min. Negotiated Rate |
$80,726.32 |
Max. Negotiated Rate |
$105,235.00 |
Rate for Payer: IEHP Medi-Cal |
$80,726.32
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$105,235.00
|
|
NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE
|
Facility
IP
|
$180,817.55
|
|
Service Code
|
APR-DRG 5913
|
Min. Negotiated Rate |
$138,706.09 |
Max. Negotiated Rate |
$180,817.55 |
Rate for Payer: IEHP Medi-Cal |
$138,706.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180,817.55
|
|