|
02560ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02560ZZ
|
| Hospital Charge Code |
10498
|
| 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
|
|
|
02570ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02570ZK
|
| Hospital Charge Code |
560
|
| 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
|
|
|
02570ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02570ZZ
|
| Hospital Charge Code |
561
|
| 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
|
|
|
02570ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02570ZZ
|
| Hospital Charge Code |
10500
|
| 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
|
|
|
02573ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02573ZK
|
| Hospital Charge Code |
562
|
| 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
|
|
|
02574ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02574ZK
|
| Hospital Charge Code |
563
|
| 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
|
|
|
02580ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02580ZZ
|
| Hospital Charge Code |
564
|
| 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
|
|
|
02580ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02580ZZ
|
| Hospital Charge Code |
10502
|
| 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
|
|
|
02590ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02590ZZ
|
| Hospital Charge Code |
565
|
| 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
|
|
|
02590ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02590ZZ
|
| Hospital Charge Code |
10504
|
| 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
|
|
|
025D0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025D0ZZ
|
| Hospital Charge Code |
10506
|
| 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
|
|
|
025D0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025D0ZZ
|
| Hospital Charge Code |
566
|
| 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
|
|
|
025F0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025F0ZZ
|
| Hospital Charge Code |
567
|
| 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
|
|
|
025F0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025F0ZZ
|
| Hospital Charge Code |
10509
|
| 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
|
|
|
025G0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025G0ZZ
|
| Hospital Charge Code |
10511
|
| 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
|
|
|
025G0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025G0ZZ
|
| Hospital Charge Code |
568
|
| 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
|
|
|
025H0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025H0ZZ
|
| Hospital Charge Code |
10513
|
| 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
|
|
|
025H0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025H0ZZ
|
| Hospital Charge Code |
569
|
| 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
|
|
|
025J0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025J0ZZ
|
| Hospital Charge Code |
570
|
| 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
|
|
|
025J0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025J0ZZ
|
| Hospital Charge Code |
10515
|
| 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
|
|
|
025K0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025K0ZZ
|
| Hospital Charge Code |
571
|
| 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
|
|
|
025K0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025K0ZZ
|
| Hospital Charge Code |
10517
|
| 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
|
|
|
025L0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025L0ZZ
|
| Hospital Charge Code |
10519
|
| 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
|
|
|
025L0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025L0ZZ
|
| Hospital Charge Code |
572
|
| 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
|
|
|
025M0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 025M0ZZ
|
| Hospital Charge Code |
10521
|
| 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
|
|
