|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$332,371.75
|
|
|
Service Code
|
APR-DRG 6094
|
| Min. Negotiated Rate |
$278,913.36 |
| Max. Negotiated Rate |
$332,371.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$278,913.36
|
| Rate for Payer: IEHP medi-cal |
$332,371.75
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$54,620.12
|
|
|
Service Code
|
APR-DRG 6092
|
| Min. Negotiated Rate |
$45,835.07 |
| Max. Negotiated Rate |
$54,620.12 |
| Rate for Payer: Adventist Health Medi-Cal |
$45,835.07
|
| Rate for Payer: IEHP medi-cal |
$54,620.12
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$51,888.88
|
|
|
Service Code
|
APR-DRG 6091
|
| Min. Negotiated Rate |
$43,543.12 |
| Max. Negotiated Rate |
$51,888.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$43,543.12
|
| Rate for Payer: IEHP medi-cal |
$51,888.88
|
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$114,991.42
|
|
|
Service Code
|
APR-DRG 6093
|
| Min. Negotiated Rate |
$96,496.30 |
| Max. Negotiated Rate |
$114,991.42 |
| Rate for Payer: Adventist Health Medi-Cal |
$96,496.30
|
| Rate for Payer: IEHP medi-cal |
$114,991.42
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$531,129.30
|
|
|
Service Code
|
APR-DRG 5884
|
| Min. Negotiated Rate |
$445,702.91 |
| Max. Negotiated Rate |
$531,129.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$445,702.91
|
| Rate for Payer: IEHP medi-cal |
$531,129.30
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$153,157.26
|
|
|
Service Code
|
APR-DRG 5881
|
| Min. Negotiated Rate |
$128,523.58 |
| Max. Negotiated Rate |
$153,157.26 |
| Rate for Payer: Adventist Health Medi-Cal |
$128,523.58
|
| Rate for Payer: IEHP medi-cal |
$153,157.26
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$237,621.01
|
|
|
Service Code
|
APR-DRG 5883
|
| Min. Negotiated Rate |
$199,402.25 |
| Max. Negotiated Rate |
$237,621.01 |
| Rate for Payer: Adventist Health Medi-Cal |
$199,402.25
|
| Rate for Payer: IEHP medi-cal |
$237,621.01
|
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
IP
|
$232,675.71
|
|
|
Service Code
|
APR-DRG 5882
|
| Min. Negotiated Rate |
$195,252.35 |
| Max. Negotiated Rate |
$232,675.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$195,252.35
|
| Rate for Payer: IEHP medi-cal |
$232,675.71
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$2,156.97
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$1,810.04 |
| Max. Negotiated Rate |
$2,156.97 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,810.04
|
| Rate for Payer: IEHP medi-cal |
$2,156.97
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$1,848.65
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$1,551.31 |
| Max. Negotiated Rate |
$1,848.65 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,551.31
|
| Rate for Payer: IEHP medi-cal |
$1,848.65
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$50,646.21
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$42,500.32 |
| Max. Negotiated Rate |
$50,646.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$42,500.32
|
| Rate for Payer: IEHP medi-cal |
$50,646.21
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
IP
|
$6,383.51
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$5,356.79 |
| Max. Negotiated Rate |
$6,383.51 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,356.79
|
| Rate for Payer: IEHP medi-cal |
$6,383.51
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$21,436.27
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$17,988.48 |
| Max. Negotiated Rate |
$21,436.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,988.48
|
| Rate for Payer: IEHP medi-cal |
$21,436.27
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$13,215.82
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$11,090.20 |
| Max. Negotiated Rate |
$13,215.82 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,090.20
|
| Rate for Payer: IEHP medi-cal |
$13,215.82
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$47,165.49
|
|
|
Service Code
|
APR-DRG 6233
|
| Min. Negotiated Rate |
$39,579.43 |
| Max. Negotiated Rate |
$47,165.49 |
| Rate for Payer: Adventist Health Medi-Cal |
$39,579.43
|
| Rate for Payer: IEHP medi-cal |
$47,165.49
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
IP
|
$82,362.55
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$69,115.43 |
| Max. Negotiated Rate |
$82,362.55 |
| Rate for Payer: Adventist Health Medi-Cal |
$69,115.43
|
| Rate for Payer: IEHP medi-cal |
$82,362.55
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$6,018.11
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$5,050.16 |
| Max. Negotiated Rate |
$6,018.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,050.16
|
| Rate for Payer: IEHP medi-cal |
$6,018.11
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$113,699.30
|
|
|
Service Code
|
APR-DRG 6214
|
| Min. Negotiated Rate |
$95,412.00 |
| Max. Negotiated Rate |
$113,699.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$95,412.00
|
| Rate for Payer: IEHP medi-cal |
$113,699.30
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$46,347.94
|
|
|
Service Code
|
APR-DRG 6213
|
| Min. Negotiated Rate |
$38,893.38 |
| Max. Negotiated Rate |
$46,347.94 |
| Rate for Payer: Adventist Health Medi-Cal |
$38,893.38
|
| Rate for Payer: IEHP medi-cal |
$46,347.94
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
IP
|
$19,489.20
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$16,354.57 |
| Max. Negotiated Rate |
$19,489.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,354.57
|
| Rate for Payer: IEHP medi-cal |
$19,489.20
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$37,551.86
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$31,512.05 |
| Max. Negotiated Rate |
$37,551.86 |
| Rate for Payer: Adventist Health Medi-Cal |
$31,512.05
|
| Rate for Payer: IEHP medi-cal |
$37,551.86
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$15,269.68
|
|
|
Service Code
|
APR-DRG 6251
|
| Min. Negotiated Rate |
$12,813.72 |
| Max. Negotiated Rate |
$15,269.68 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,813.72
|
| Rate for Payer: IEHP medi-cal |
$15,269.68
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$75,875.61
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$63,671.84 |
| Max. Negotiated Rate |
$75,875.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$63,671.84
|
| Rate for Payer: IEHP medi-cal |
$75,875.61
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
IP
|
$20,763.89
|
|
|
Service Code
|
APR-DRG 6252
|
| Min. Negotiated Rate |
$17,424.24 |
| Max. Negotiated Rate |
$20,763.89 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,424.24
|
| Rate for Payer: IEHP medi-cal |
$20,763.89
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
IP
|
$21,397.91
|
|
|
Service Code
|
APR-DRG 6221
|
| Min. Negotiated Rate |
$17,956.28 |
| Max. Negotiated Rate |
$21,397.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,956.28
|
| Rate for Payer: IEHP medi-cal |
$21,397.91
|
|
