APR-DRG 41.00: SEIZURE
|
Facility
|
IP
|
$10,221.70
|
|
Service Code
|
APR-DRG 0532
|
Min. Negotiated Rate |
$6,455.81 |
Max. Negotiated Rate |
$10,221.70 |
Rate for Payer: Adventist Health Medi-Cal |
$6,455.81
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,693.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,221.70
|
|
APR-DRG 41.00: SEIZURE
|
Facility
|
IP
|
$7,861.67
|
|
Service Code
|
APR-DRG 0531
|
Min. Negotiated Rate |
$4,965.26 |
Max. Negotiated Rate |
$7,861.67 |
Rate for Payer: Adventist Health Medi-Cal |
$4,965.26
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,916.94
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,861.67
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$18,100.48
|
|
Service Code
|
APR-DRG 7203
|
Min. Negotiated Rate |
$11,431.88 |
Max. Negotiated Rate |
$18,100.48 |
Rate for Payer: Adventist Health Medi-Cal |
$11,431.88
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,623.00
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,100.48
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$12,115.79
|
|
Service Code
|
APR-DRG 7202
|
Min. Negotiated Rate |
$7,652.08 |
Max. Negotiated Rate |
$12,115.79 |
Rate for Payer: Adventist Health Medi-Cal |
$7,652.08
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,118.72
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,115.79
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$33,160.11
|
|
Service Code
|
APR-DRG 7204
|
Min. Negotiated Rate |
$20,943.23 |
Max. Negotiated Rate |
$33,160.11 |
Rate for Payer: Adventist Health Medi-Cal |
$20,943.23
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24,957.35
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33,160.11
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$9,462.91
|
|
Service Code
|
APR-DRG 7201
|
Min. Negotiated Rate |
$5,976.58 |
Max. Negotiated Rate |
$9,462.91 |
Rate for Payer: Adventist Health Medi-Cal |
$5,976.58
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,122.09
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,462.91
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$32,148.40
|
|
Service Code
|
APR-DRG 3222
|
Min. Negotiated Rate |
$20,304.25 |
Max. Negotiated Rate |
$32,148.40 |
Rate for Payer: Adventist Health Medi-Cal |
$20,304.25
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24,195.90
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,148.40
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$42,326.36
|
|
Service Code
|
APR-DRG 3223
|
Min. Negotiated Rate |
$26,732.44 |
Max. Negotiated Rate |
$42,326.36 |
Rate for Payer: Adventist Health Medi-Cal |
$26,732.44
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31,856.15
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42,326.36
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$60,900.36
|
|
Service Code
|
APR-DRG 3224
|
Min. Negotiated Rate |
$38,463.38 |
Max. Negotiated Rate |
$60,900.36 |
Rate for Payer: Adventist Health Medi-Cal |
$38,463.38
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45,835.53
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60,900.36
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$29,790.29
|
|
Service Code
|
APR-DRG 3221
|
Min. Negotiated Rate |
$18,814.92 |
Max. Negotiated Rate |
$29,790.29 |
Rate for Payer: Adventist Health Medi-Cal |
$18,814.92
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,421.11
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,790.29
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$16,280.53
|
|
Service Code
|
APR-DRG 3151
|
Min. Negotiated Rate |
$10,282.44 |
Max. Negotiated Rate |
$16,280.53 |
Rate for Payer: Adventist Health Medi-Cal |
$10,282.44
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,253.24
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,280.53
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$61,950.11
|
|
Service Code
|
APR-DRG 3154
|
Min. Negotiated Rate |
$39,126.38 |
Max. Negotiated Rate |
$61,950.11 |
Rate for Payer: Adventist Health Medi-Cal |
$39,126.38
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$46,625.61
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61,950.11
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$25,674.99
|
|
Service Code
|
APR-DRG 3152
|
Min. Negotiated Rate |
$16,215.78 |
Max. Negotiated Rate |
$25,674.99 |
Rate for Payer: Adventist Health Medi-Cal |
$16,215.78
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,323.80
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,674.99
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$38,133.10
|
|
Service Code
|
APR-DRG 3153
|
Min. Negotiated Rate |
$24,084.06 |
Max. Negotiated Rate |
$38,133.10 |
Rate for Payer: Adventist Health Medi-Cal |
$24,084.06
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28,700.17
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38,133.10
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$16,434.58
|
|
Service Code
|
APR-DRG 6623
|
Min. Negotiated Rate |
$10,379.74 |
Max. Negotiated Rate |
$16,434.58 |
Rate for Payer: Adventist Health Medi-Cal |
$10,379.74
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,369.19
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,434.58
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$11,395.04
|
|
Service Code
|
APR-DRG 6622
|
Min. Negotiated Rate |
$7,196.87 |
Max. Negotiated Rate |
$11,395.04 |
Rate for Payer: Adventist Health Medi-Cal |
$7,196.87
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,576.27
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,395.04
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$34,297.34
|
|
Service Code
|
APR-DRG 6624
|
Min. Negotiated Rate |
$21,661.48 |
Max. Negotiated Rate |
$34,297.34 |
Rate for Payer: Adventist Health Medi-Cal |
$21,661.48
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25,813.26
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,297.34
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$8,340.91
|
|
Service Code
|
APR-DRG 6621
|
Min. Negotiated Rate |
$5,267.94 |
Max. Negotiated Rate |
$8,340.91 |
Rate for Payer: Adventist Health Medi-Cal |
$5,267.94
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,277.63
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,340.91
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$10,158.94
|
|
Service Code
|
APR-DRG 8612
|
Min. Negotiated Rate |
$6,416.17 |
Max. Negotiated Rate |
$10,158.94 |
Rate for Payer: Adventist Health Medi-Cal |
$6,416.17
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,645.94
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,158.94
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$6,218.59
|
|
Service Code
|
APR-DRG 8611
|
Min. Negotiated Rate |
$3,927.53 |
Max. Negotiated Rate |
$6,218.59 |
Rate for Payer: Adventist Health Medi-Cal |
$3,927.53
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,680.30
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,218.59
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$14,764.88
|
|
Service Code
|
APR-DRG 8613
|
Min. Negotiated Rate |
$9,325.19 |
Max. Negotiated Rate |
$14,764.88 |
Rate for Payer: Adventist Health Medi-Cal |
$9,325.19
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,112.52
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,764.88
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$21,207.88
|
|
Service Code
|
APR-DRG 8614
|
Min. Negotiated Rate |
$13,394.45 |
Max. Negotiated Rate |
$21,207.88 |
Rate for Payer: Adventist Health Medi-Cal |
$13,394.45
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,961.72
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,207.88
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$50,357.28
|
|
Service Code
|
APR-DRG 3123
|
Min. Negotiated Rate |
$31,804.60 |
Max. Negotiated Rate |
$50,357.28 |
Rate for Payer: Adventist Health Medi-Cal |
$31,804.60
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37,900.48
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50,357.28
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$19,136.91
|
|
Service Code
|
APR-DRG 3121
|
Min. Negotiated Rate |
$12,086.47 |
Max. Negotiated Rate |
$19,136.91 |
Rate for Payer: Adventist Health Medi-Cal |
$12,086.47
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,403.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,136.91
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$30,225.77
|
|
Service Code
|
APR-DRG 3122
|
Min. Negotiated Rate |
$19,089.96 |
Max. Negotiated Rate |
$30,225.77 |
Rate for Payer: Adventist Health Medi-Cal |
$19,089.96
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,748.87
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,225.77
|
|