|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,377.93
|
|
|
Service Code
|
APR-DRG 6261
|
| Min. Negotiated Rate |
$1,377.93 |
| Max. Negotiated Rate |
$1,377.93 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,377.93
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$4,758.09
|
|
|
Service Code
|
APR-DRG 6263
|
| Min. Negotiated Rate |
$4,758.09 |
| Max. Negotiated Rate |
$4,758.09 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,758.09
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,607.75
|
|
|
Service Code
|
APR-DRG 6262
|
| Min. Negotiated Rate |
$1,607.75 |
| Max. Negotiated Rate |
$1,607.75 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,607.75
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$37,750.33
|
|
|
Service Code
|
APR-DRG 6264
|
| Min. Negotiated Rate |
$37,750.33 |
| Max. Negotiated Rate |
$37,750.33 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37,750.33
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$35,155.89
|
|
|
Service Code
|
APR-DRG 6233
|
| Min. Negotiated Rate |
$35,155.89 |
| Max. Negotiated Rate |
$35,155.89 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$35,155.89
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$15,978.03
|
|
|
Service Code
|
APR-DRG 6232
|
| Min. Negotiated Rate |
$15,978.03 |
| Max. Negotiated Rate |
$15,978.03 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15,978.03
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$9,850.71
|
|
|
Service Code
|
APR-DRG 6231
|
| Min. Negotiated Rate |
$9,850.71 |
| Max. Negotiated Rate |
$9,850.71 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9,850.71
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$61,390.85
|
|
|
Service Code
|
APR-DRG 6234
|
| Min. Negotiated Rate |
$61,390.85 |
| Max. Negotiated Rate |
$61,390.85 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$61,390.85
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$84,748.42
|
|
|
Service Code
|
APR-DRG 6214
|
| Min. Negotiated Rate |
$84,748.42 |
| Max. Negotiated Rate |
$84,748.42 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84,748.42
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$14,526.72
|
|
|
Service Code
|
APR-DRG 6212
|
| Min. Negotiated Rate |
$14,526.72 |
| Max. Negotiated Rate |
$14,526.72 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14,526.72
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$4,485.74
|
|
|
Service Code
|
APR-DRG 6211
|
| Min. Negotiated Rate |
$4,485.74 |
| Max. Negotiated Rate |
$4,485.74 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,485.74
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY
|
Facility
|
IP
|
$34,546.52
|
|
|
Service Code
|
APR-DRG 6213
|
| Min. Negotiated Rate |
$34,546.52 |
| Max. Negotiated Rate |
$34,546.52 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34,546.52
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$56,555.66
|
|
|
Service Code
|
APR-DRG 6254
|
| Min. Negotiated Rate |
$56,555.66 |
| Max. Negotiated Rate |
$56,555.66 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56,555.66
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$27,990.15
|
|
|
Service Code
|
APR-DRG 6253
|
| Min. Negotiated Rate |
$27,990.15 |
| Max. Negotiated Rate |
$27,990.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27,990.15
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$11,381.61
|
|
|
Service Code
|
APR-DRG 6251
|
| Min. Negotiated Rate |
$11,381.61 |
| Max. Negotiated Rate |
$11,381.61 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,381.61
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION
|
Facility
|
IP
|
$15,476.85
|
|
|
Service Code
|
APR-DRG 6252
|
| Min. Negotiated Rate |
$15,476.85 |
| Max. Negotiated Rate |
$15,476.85 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15,476.85
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$27,052.47
|
|
|
Service Code
|
APR-DRG 6223
|
| Min. Negotiated Rate |
$27,052.47 |
| Max. Negotiated Rate |
$27,052.47 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27,052.47
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$66,892.23
|
|
|
Service Code
|
APR-DRG 6224
|
| Min. Negotiated Rate |
$66,892.23 |
| Max. Negotiated Rate |
$66,892.23 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$66,892.23
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$15,949.43
|
|
|
Service Code
|
APR-DRG 6221
|
| Min. Negotiated Rate |
$15,949.43 |
| Max. Negotiated Rate |
$15,949.43 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15,949.43
|
|
|
NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION
|
Facility
|
IP
|
$23,855.12
|
|
|
Service Code
|
APR-DRG 6222
|
| Min. Negotiated Rate |
$23,855.12 |
| Max. Negotiated Rate |
$23,855.12 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23,855.12
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$2,293.24
|
|
|
Service Code
|
APR-DRG 6403
|
| Min. Negotiated Rate |
$2,293.24 |
| Max. Negotiated Rate |
$2,293.24 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,293.24
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$1,268.49
|
|
|
Service Code
|
APR-DRG 6402
|
| Min. Negotiated Rate |
$1,268.49 |
| Max. Negotiated Rate |
$1,268.49 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,268.49
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$959.08
|
|
|
Service Code
|
APR-DRG 6401
|
| Min. Negotiated Rate |
$959.08 |
| Max. Negotiated Rate |
$959.08 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$959.08
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM
|
Facility
|
IP
|
$31,149.40
|
|
|
Service Code
|
APR-DRG 6404
|
| Min. Negotiated Rate |
$31,149.40 |
| Max. Negotiated Rate |
$31,149.40 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31,149.40
|
|
|
NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION
|
Facility
|
IP
|
$10,160.38
|
|
|
Service Code
|
APR-DRG 6362
|
| Min. Negotiated Rate |
$10,160.38 |
| Max. Negotiated Rate |
$10,160.38 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10,160.38
|
|
