NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY
|
Facility
|
IP
|
$142,152.93
|
|
Service Code
|
APR-DRG 6074
|
Min. Negotiated Rate |
$142,152.93 |
Max. Negotiated Rate |
$142,152.93 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$142,152.93
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$45,894.56
|
|
Service Code
|
APR-DRG 6133
|
Min. Negotiated Rate |
$45,894.56 |
Max. Negotiated Rate |
$45,894.56 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$45,894.56
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$28,513.72
|
|
Service Code
|
APR-DRG 6132
|
Min. Negotiated Rate |
$28,513.72 |
Max. Negotiated Rate |
$28,513.72 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28,513.72
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$15,710.65
|
|
Service Code
|
APR-DRG 6131
|
Min. Negotiated Rate |
$15,710.65 |
Max. Negotiated Rate |
$15,710.65 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15,710.65
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$101,349.26
|
|
Service Code
|
APR-DRG 6134
|
Min. Negotiated Rate |
$101,349.26 |
Max. Negotiated Rate |
$101,349.26 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$101,349.26
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$48,861.84
|
|
Service Code
|
APR-DRG 6113
|
Min. Negotiated Rate |
$48,861.84 |
Max. Negotiated Rate |
$48,861.84 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48,861.84
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$12,592.90
|
|
Service Code
|
APR-DRG 6111
|
Min. Negotiated Rate |
$12,592.90 |
Max. Negotiated Rate |
$12,592.90 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12,592.90
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$108,025.41
|
|
Service Code
|
APR-DRG 6114
|
Min. Negotiated Rate |
$108,025.41 |
Max. Negotiated Rate |
$108,025.41 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$108,025.41
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$27,987.67
|
|
Service Code
|
APR-DRG 6112
|
Min. Negotiated Rate |
$27,987.67 |
Max. Negotiated Rate |
$27,987.67 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27,987.67
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$23,838.95
|
|
Service Code
|
APR-DRG 6142
|
Min. Negotiated Rate |
$23,838.95 |
Max. Negotiated Rate |
$23,838.95 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23,838.95
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$9,813.41
|
|
Service Code
|
APR-DRG 6141
|
Min. Negotiated Rate |
$9,813.41 |
Max. Negotiated Rate |
$9,813.41 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9,813.41
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$81,446.17
|
|
Service Code
|
APR-DRG 6144
|
Min. Negotiated Rate |
$81,446.17 |
Max. Negotiated Rate |
$81,446.17 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81,446.17
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$43,389.91
|
|
Service Code
|
APR-DRG 6143
|
Min. Negotiated Rate |
$43,389.91 |
Max. Negotiated Rate |
$43,389.91 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43,389.91
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$103,299.45
|
|
Service Code
|
APR-DRG 6124
|
Min. Negotiated Rate |
$103,299.45 |
Max. Negotiated Rate |
$103,299.45 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$103,299.45
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$50,449.93
|
|
Service Code
|
APR-DRG 6123
|
Min. Negotiated Rate |
$50,449.93 |
Max. Negotiated Rate |
$50,449.93 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$50,449.93
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$25,536.49
|
|
Service Code
|
APR-DRG 6121
|
Min. Negotiated Rate |
$25,536.49 |
Max. Negotiated Rate |
$25,536.49 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$25,536.49
|
|
NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$39,068.32
|
|
Service Code
|
APR-DRG 6122
|
Min. Negotiated Rate |
$39,068.32 |
Max. Negotiated Rate |
$39,068.32 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$39,068.32
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$247,741.04
|
|
Service Code
|
APR-DRG 6094
|
Min. Negotiated Rate |
$247,741.04 |
Max. Negotiated Rate |
$247,741.04 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$247,741.04
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$85,711.53
|
|
Service Code
|
APR-DRG 6093
|
Min. Negotiated Rate |
$85,711.53 |
Max. Negotiated Rate |
$85,711.53 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$85,711.53
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$40,712.39
|
|
Service Code
|
APR-DRG 6092
|
Min. Negotiated Rate |
$40,712.39 |
Max. Negotiated Rate |
$40,712.39 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40,712.39
|
|
NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$38,676.58
|
|
Service Code
|
APR-DRG 6091
|
Min. Negotiated Rate |
$38,676.58 |
Max. Negotiated Rate |
$38,676.58 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38,676.58
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$395,889.62
|
|
Service Code
|
APR-DRG 5884
|
Min. Negotiated Rate |
$395,889.62 |
Max. Negotiated Rate |
$395,889.62 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$395,889.62
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$177,116.36
|
|
Service Code
|
APR-DRG 5883
|
Min. Negotiated Rate |
$177,116.36 |
Max. Negotiated Rate |
$177,116.36 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$177,116.36
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$114,159.34
|
|
Service Code
|
APR-DRG 5881
|
Min. Negotiated Rate |
$114,159.34 |
Max. Negotiated Rate |
$114,159.34 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$114,159.34
|
|
NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE
|
Facility
|
IP
|
$173,430.27
|
|
Service Code
|
APR-DRG 5882
|
Min. Negotiated Rate |
$173,430.27 |
Max. Negotiated Rate |
$173,430.27 |
Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$173,430.27
|
|