|
02160KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KP
|
| Hospital Charge Code |
321
|
| 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
|
|
|
02160KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KP
|
| Hospital Charge Code |
10276
|
| 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
|
|
|
02160KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KQ
|
| Hospital Charge Code |
322
|
| 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
|
|
|
02160KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KQ
|
| Hospital Charge Code |
10277
|
| 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
|
|
|
02160KR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KR
|
| Hospital Charge Code |
323
|
| 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
|
|
|
02160KR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160KR
|
| Hospital Charge Code |
10278
|
| 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
|
|
|
02160Z7
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160Z7
|
| Hospital Charge Code |
10279
|
| 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
|
|
|
02160Z7
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160Z7
|
| Hospital Charge Code |
324
|
| 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
|
|
|
02160ZP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZP
|
| Hospital Charge Code |
10280
|
| 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
|
|
|
02160ZP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZP
|
| Hospital Charge Code |
325
|
| 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
|
|
|
02160ZQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZQ
|
| Hospital Charge Code |
326
|
| 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
|
|
|
02160ZQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZQ
|
| Hospital Charge Code |
10281
|
| 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
|
|
|
02160ZR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZR
|
| Hospital Charge Code |
327
|
| 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
|
|
|
02160ZR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02160ZR
|
| Hospital Charge Code |
10282
|
| 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
|
|
|
02163Z7
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02163Z7
|
| Hospital Charge Code |
328
|
| 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
|
|
|
021648P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021648P
|
| Hospital Charge Code |
329
|
| 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
|
|
|
021648Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021648Q
|
| Hospital Charge Code |
330
|
| 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
|
|
|
021648R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021648R
|
| Hospital Charge Code |
331
|
| 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
|
|
|
021649P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649P
|
| Hospital Charge Code |
10283
|
| 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
|
|
|
021649P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649P
|
| Hospital Charge Code |
332
|
| 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
|
|
|
021649Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649Q
|
| Hospital Charge Code |
10284
|
| 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
|
|
|
021649Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649Q
|
| Hospital Charge Code |
333
|
| 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
|
|
|
021649R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649R
|
| Hospital Charge Code |
10285
|
| 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
|
|
|
021649R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021649R
|
| Hospital Charge Code |
334
|
| 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
|
|
|
02164AP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02164AP
|
| Hospital Charge Code |
335
|
| 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
|
|
