|
00H00MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00H00MZ
|
| Hospital Charge Code |
54
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00H60MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00H60MZ
|
| Hospital Charge Code |
55
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HE0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HE0MZ
|
| Hospital Charge Code |
56
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HE3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HE3MZ
|
| Hospital Charge Code |
57
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HE4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HE4MZ
|
| Hospital Charge Code |
58
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU0MZ
|
| Hospital Charge Code |
14121
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU0MZ
|
| Hospital Charge Code |
59
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU3MZ
|
| Hospital Charge Code |
14123
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU3MZ
|
| Hospital Charge Code |
60
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU4MZ
|
| Hospital Charge Code |
14125
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HU4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HU4MZ
|
| Hospital Charge Code |
61
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV0MZ
|
| Hospital Charge Code |
14127
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV0MZ
|
| Hospital Charge Code |
62
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV3MZ
|
| Hospital Charge Code |
63
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV3MZ
|
| Hospital Charge Code |
14129
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV4MZ
|
| Hospital Charge Code |
14131
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00HV4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00HV4MZ
|
| Hospital Charge Code |
64
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV0MZ
|
| Hospital Charge Code |
65
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV0MZ
|
| Hospital Charge Code |
14161
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV3MZ
|
| Hospital Charge Code |
14162
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV3MZ
|
| Hospital Charge Code |
66
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV4MZ
|
| Hospital Charge Code |
67
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
00PV4MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 00PV4MZ
|
| Hospital Charge Code |
14163
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
01HY0MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 01HY0MZ
|
| Hospital Charge Code |
68
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|
|
01HY3MZ
|
Facility
|
IP
|
$31,446.00
|
|
|
Service Code
|
ICD 01HY3MZ
|
| Hospital Charge Code |
69
|
| Min. Negotiated Rate |
$31,446.00 |
| Max. Negotiated Rate |
$31,446.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,446.00
|
|