|
APR-DRG 41.00: SEIZURE
|
Facility
|
IP
|
$0.46
|
|
|
Service Code
|
APR-DRG 0531
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.46
|
|
|
APR-DRG 41.00: SEIZURE
|
Facility
|
IP
|
$0.60
|
|
|
Service Code
|
APR-DRG 0532
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.60
|
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$1.95
|
|
|
Service Code
|
APR-DRG 7204
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.95
|
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$0.56
|
|
|
Service Code
|
APR-DRG 7201
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$0.56 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.56
|
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$1.06
|
|
|
Service Code
|
APR-DRG 7203
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$1.06 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.06
|
|
|
APR-DRG 41.00: SEPTICEMIA AND DISSEMINATED INFECTIONS
|
Facility
|
IP
|
$0.72
|
|
|
Service Code
|
APR-DRG 7202
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.72
|
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$3.58
|
|
|
Service Code
|
APR-DRG 3224
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$3.58 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.58
|
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$1.89
|
|
|
Service Code
|
APR-DRG 3222
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$1.89 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.89
|
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$2.50
|
|
|
Service Code
|
APR-DRG 3223
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.50
|
|
|
APR-DRG 41.00: SHOULDER AND ELBOW JOINT REPLACEMENT
|
Facility
|
IP
|
$1.76
|
|
|
Service Code
|
APR-DRG 3221
|
| Min. Negotiated Rate |
$1.76 |
| Max. Negotiated Rate |
$1.76 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.76
|
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$0.96
|
|
|
Service Code
|
APR-DRG 3151
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$0.96 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.96
|
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$2.25
|
|
|
Service Code
|
APR-DRG 3153
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$2.25 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.25
|
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$3.65
|
|
|
Service Code
|
APR-DRG 3154
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$3.65 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.65
|
|
|
APR-DRG 41.00: SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT
|
Facility
|
IP
|
$1.51
|
|
|
Service Code
|
APR-DRG 3152
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.51
|
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$0.49
|
|
|
Service Code
|
APR-DRG 6621
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$0.49 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.49
|
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$2.02
|
|
|
Service Code
|
APR-DRG 6624
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.02
|
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$0.67
|
|
|
Service Code
|
APR-DRG 6622
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$0.67 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.67
|
|
|
APR-DRG 41.00: SICKLE CELL ANEMIA CRISIS
|
Facility
|
IP
|
$0.96
|
|
|
Service Code
|
APR-DRG 6623
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$0.96 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.96
|
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$1.25
|
|
|
Service Code
|
APR-DRG 8614
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.25
|
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$0.37
|
|
|
Service Code
|
APR-DRG 8611
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.37
|
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$0.59
|
|
|
Service Code
|
APR-DRG 8612
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$0.59 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.59
|
|
|
APR-DRG 41.00: SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS
|
Facility
|
IP
|
$0.87
|
|
|
Service Code
|
APR-DRG 8613
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$0.87 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.87
|
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$1.78
|
|
|
Service Code
|
APR-DRG 3122
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.78
|
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$1.13
|
|
|
Service Code
|
APR-DRG 3121
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$1.13 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.13
|
|
|
APR-DRG 41.00: SKIN GRAFT, EXCEPT HAND, FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES
|
Facility
|
IP
|
$5.29
|
|
|
Service Code
|
APR-DRG 3124
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$5.29 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.29
|
|