|
APR-DRG 41.00: HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
|
IP
|
$28,449.57
|
|
|
Service Code
|
APR-DRG 8924
|
| Min. Negotiated Rate |
$17,968.15 |
| Max. Negotiated Rate |
$28,449.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,968.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,412.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,449.57
|
|
|
APR-DRG 41.00: HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
|
IP
|
$11,855.26
|
|
|
Service Code
|
APR-DRG 8921
|
| Min. Negotiated Rate |
$7,487.53 |
| Max. Negotiated Rate |
$11,855.26 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,487.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,922.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,855.26
|
|
|
APR-DRG 41.00: HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
|
IP
|
$12,479.03
|
|
|
Service Code
|
APR-DRG 8922
|
| Min. Negotiated Rate |
$7,881.49 |
| Max. Negotiated Rate |
$12,479.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,881.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,392.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,479.03
|
|
|
APR-DRG 41.00: HIV WITH MAJOR HIV RELATED CONDITION
|
Facility
|
IP
|
$17,121.09
|
|
|
Service Code
|
APR-DRG 8923
|
| Min. Negotiated Rate |
$10,813.32 |
| Max. Negotiated Rate |
$17,121.09 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,813.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,885.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,121.09
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$12,598.82
|
|
|
Service Code
|
APR-DRG 8901
|
| Min. Negotiated Rate |
$7,957.15 |
| Max. Negotiated Rate |
$12,598.82 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,957.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,482.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,598.82
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$13,262.53
|
|
|
Service Code
|
APR-DRG 8902
|
| Min. Negotiated Rate |
$8,376.34 |
| Max. Negotiated Rate |
$13,262.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,376.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,981.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,262.53
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$21,293.45
|
|
|
Service Code
|
APR-DRG 8903
|
| Min. Negotiated Rate |
$13,448.50 |
| Max. Negotiated Rate |
$21,293.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,448.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,026.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,293.45
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS
|
Facility
|
IP
|
$41,613.21
|
|
|
Service Code
|
APR-DRG 8904
|
| Min. Negotiated Rate |
$26,282.03 |
| Max. Negotiated Rate |
$41,613.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$26,282.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31,319.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41,613.21
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
|
Facility
|
IP
|
$13,466.00
|
|
|
Service Code
|
APR-DRG 8932
|
| Min. Negotiated Rate |
$8,504.84 |
| Max. Negotiated Rate |
$13,466.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,504.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,134.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,466.00
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
|
Facility
|
IP
|
$26,791.29
|
|
|
Service Code
|
APR-DRG 8934
|
| Min. Negotiated Rate |
$16,920.82 |
| Max. Negotiated Rate |
$26,791.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,920.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20,163.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26,791.29
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
|
Facility
|
IP
|
$18,728.03
|
|
|
Service Code
|
APR-DRG 8933
|
| Min. Negotiated Rate |
$11,828.23 |
| Max. Negotiated Rate |
$18,728.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,828.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,095.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,728.03
|
|
|
APR-DRG 41.00: HIV WITH MULTIPLE SIGNIFICANT HIV RELATED CONDITIONS
|
Facility
|
IP
|
$12,454.29
|
|
|
Service Code
|
APR-DRG 8931
|
| Min. Negotiated Rate |
$7,865.87 |
| Max. Negotiated Rate |
$12,454.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,865.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,373.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,454.29
|
|
|
APR-DRG 41.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$16,381.33
|
|
|
Service Code
|
APR-DRG 8943
|
| Min. Negotiated Rate |
$10,346.10 |
| Max. Negotiated Rate |
$16,381.33 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,346.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,329.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,381.33
|
|
|
APR-DRG 41.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$11,590.93
|
|
|
Service Code
|
APR-DRG 8942
|
| Min. Negotiated Rate |
$7,320.59 |
| Max. Negotiated Rate |
$11,590.93 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,723.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,590.93
|
|
|
APR-DRG 41.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$25,167.23
|
|
|
Service Code
|
APR-DRG 8944
|
| Min. Negotiated Rate |
$15,895.09 |
| Max. Negotiated Rate |
$25,167.23 |
| Rate for Payer: Adventist Health Medi-Cal |
$15,895.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18,941.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,167.23
|
|
|
APR-DRG 41.00: HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS
|
Facility
|
IP
|
$9,337.40
|
|
|
Service Code
|
APR-DRG 8941
|
| Min. Negotiated Rate |
$5,897.30 |
| Max. Negotiated Rate |
$9,337.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,897.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,027.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,337.40
|
|
|
APR-DRG 41.00: HYPERTENSION
|
Facility
|
IP
|
$24,640.45
|
|
|
Service Code
|
APR-DRG 1994
|
| Min. Negotiated Rate |
$15,562.39 |
| Max. Negotiated Rate |
$24,640.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$15,562.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18,545.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,640.45
|
|
|
APR-DRG 41.00: HYPERTENSION
|
Facility
|
IP
|
$10,170.34
|
|
|
Service Code
|
APR-DRG 1992
|
| Min. Negotiated Rate |
$6,423.37 |
| Max. Negotiated Rate |
$10,170.34 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,423.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,654.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,170.34
|
|
|
APR-DRG 41.00: HYPERTENSION
|
Facility
|
IP
|
$8,335.19
|
|
|
Service Code
|
APR-DRG 1991
|
| Min. Negotiated Rate |
$5,264.33 |
| Max. Negotiated Rate |
$8,335.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,264.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,273.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,335.19
|
|
|
APR-DRG 41.00: HYPERTENSION
|
Facility
|
IP
|
$14,076.45
|
|
|
Service Code
|
APR-DRG 1993
|
| Min. Negotiated Rate |
$8,890.39 |
| Max. Negotiated Rate |
$14,076.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,890.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,594.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,076.45
|
|
|
APR-DRG 41.00: HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS
|
Facility
|
IP
|
$12,191.86
|
|
|
Service Code
|
APR-DRG 4223
|
| Min. Negotiated Rate |
$7,700.12 |
| Max. Negotiated Rate |
$12,191.86 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,700.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,175.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,191.86
|
|
|
APR-DRG 41.00: HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS
|
Facility
|
IP
|
$20,213.28
|
|
|
Service Code
|
APR-DRG 4224
|
| Min. Negotiated Rate |
$12,766.28 |
| Max. Negotiated Rate |
$20,213.28 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,766.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,213.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,213.28
|
|
|
APR-DRG 41.00: HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS
|
Facility
|
IP
|
$8,367.52
|
|
|
Service Code
|
APR-DRG 4222
|
| Min. Negotiated Rate |
$5,284.75 |
| Max. Negotiated Rate |
$8,367.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,284.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,297.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,367.52
|
|
|
APR-DRG 41.00: HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS
|
Facility
|
IP
|
$5,792.61
|
|
|
Service Code
|
APR-DRG 4221
|
| Min. Negotiated Rate |
$3,658.49 |
| Max. Negotiated Rate |
$5,792.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,658.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,359.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,792.61
|
|
|
APR-DRG 41.00: IMPLANTABLE HEART ASSIST SYSTEMS
|
Facility
|
IP
|
$245,974.78
|
|
|
Service Code
|
APR-DRG 1612
|
| Min. Negotiated Rate |
$155,352.49 |
| Max. Negotiated Rate |
$245,974.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$155,352.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$185,128.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245,974.78
|
|