|
047P46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047P46Z
|
| Hospital Charge Code |
2285
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047P47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047P47Z
|
| Hospital Charge Code |
2286
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q041
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q041
|
| Hospital Charge Code |
2287
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q04Z
|
| Hospital Charge Code |
2288
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q05Z
|
| Hospital Charge Code |
2289
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q06Z
|
| Hospital Charge Code |
2290
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q07Z
|
| Hospital Charge Code |
2291
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q341
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q341
|
| Hospital Charge Code |
2292
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q34Z
|
| Hospital Charge Code |
2293
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q35Z
|
| Hospital Charge Code |
2294
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q36Z
|
| Hospital Charge Code |
2295
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q37Z
|
| Hospital Charge Code |
2296
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q441
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q441
|
| Hospital Charge Code |
2297
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q44Z
|
| Hospital Charge Code |
2298
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q45Z
|
| Hospital Charge Code |
2299
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q46Z
|
| Hospital Charge Code |
2300
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047Q47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047Q47Z
|
| Hospital Charge Code |
2301
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R041
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R041
|
| Hospital Charge Code |
2302
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R04Z
|
| Hospital Charge Code |
2303
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R05Z
|
| Hospital Charge Code |
2304
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R06Z
|
| Hospital Charge Code |
2305
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R07Z
|
| Hospital Charge Code |
2306
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R341
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R341
|
| Hospital Charge Code |
2307
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R34Z
|
| Hospital Charge Code |
2308
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
047R35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 047R35Z
|
| Hospital Charge Code |
2309
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|