|
021K0KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KP
|
| Hospital Charge Code |
10338
|
| 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
|
|
|
021K0KP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KP
|
| Hospital Charge Code |
421
|
| 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
|
|
|
021K0KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KQ
|
| Hospital Charge Code |
422
|
| 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
|
|
|
021K0KQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KQ
|
| Hospital Charge Code |
10339
|
| 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
|
|
|
021K0KR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KR
|
| Hospital Charge Code |
423
|
| 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
|
|
|
021K0KR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0KR
|
| Hospital Charge Code |
10340
|
| 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
|
|
|
021K0Z5
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0Z5
|
| Hospital Charge Code |
10341
|
| 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
|
|
|
021K0Z5
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0Z5
|
| Hospital Charge Code |
424
|
| 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
|
|
|
021K0Z8
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0Z8
|
| Hospital Charge Code |
425
|
| 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
|
|
|
021K0Z8
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0Z8
|
| Hospital Charge Code |
10342
|
| 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
|
|
|
021K0ZC
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZC
|
| Hospital Charge Code |
10344
|
| 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
|
|
|
021K0ZC
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZC
|
| Hospital Charge Code |
426
|
| 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
|
|
|
021K0ZP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZP
|
| Hospital Charge Code |
427
|
| 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
|
|
|
021K0ZP
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZP
|
| Hospital Charge Code |
10346
|
| 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
|
|
|
021K0ZQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZQ
|
| Hospital Charge Code |
428
|
| 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
|
|
|
021K0ZQ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZQ
|
| Hospital Charge Code |
10347
|
| 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
|
|
|
021K0ZR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZR
|
| Hospital Charge Code |
429
|
| 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
|
|
|
021K0ZR
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZR
|
| Hospital Charge Code |
10348
|
| 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
|
|
|
021K0ZW
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZW
|
| Hospital Charge Code |
10349
|
| 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
|
|
|
021K0ZW
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K0ZW
|
| Hospital Charge Code |
430
|
| 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
|
|
|
021K48P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K48P
|
| Hospital Charge Code |
431
|
| 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
|
|
|
021K48Q
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K48Q
|
| Hospital Charge Code |
432
|
| 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
|
|
|
021K48R
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K48R
|
| Hospital Charge Code |
433
|
| 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
|
|
|
021K49P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K49P
|
| Hospital Charge Code |
10350
|
| 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
|
|
|
021K49P
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 021K49P
|
| Hospital Charge Code |
434
|
| 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
|
|
