|
02713TZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
706
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02713Z6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
707
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02713ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
708
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
0271446
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
709
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
027144Z
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
710
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
0271456
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
711
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
027145Z
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
712
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
0271466
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
713
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
027146Z
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
714
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
0271476
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
715
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
027147Z
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
716
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714D6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
717
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
718
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714E6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
3061
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714E6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
3060
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
720
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714F6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
721
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
722
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714G6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
723
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714GZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
724
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714T6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
725
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714TZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
726
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714Z6
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
727
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
02714ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
728
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
|
0272046
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
730
|
| Min. Negotiated Rate |
$12,567.00 |
| Max. Negotiated Rate |
$12,567.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,567.00
|
|
