|
02BD3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BD3ZZ
|
| Hospital Charge Code |
979
|
| 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
|
|
|
02BD4ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BD4ZZ
|
| Hospital Charge Code |
980
|
| 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
|
|
|
02BF0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BF0ZZ
|
| Hospital Charge Code |
981
|
| 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
|
|
|
02BG0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BG0ZZ
|
| Hospital Charge Code |
982
|
| 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
|
|
|
02BH0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BH0ZZ
|
| Hospital Charge Code |
983
|
| 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
|
|
|
02BJ0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BJ0ZZ
|
| Hospital Charge Code |
984
|
| 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
|
|
|
02BK0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BK0ZZ
|
| Hospital Charge Code |
985
|
| 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
|
|
|
02BK3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BK3ZZ
|
| Hospital Charge Code |
986
|
| 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
|
|
|
02BK4ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BK4ZZ
|
| Hospital Charge Code |
987
|
| 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
|
|
|
02BL0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BL0ZZ
|
| Hospital Charge Code |
988
|
| 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
|
|
|
02BL3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BL3ZZ
|
| Hospital Charge Code |
989
|
| 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
|
|
|
02BL4ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BL4ZZ
|
| Hospital Charge Code |
990
|
| 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
|
|
|
02BM0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BM0ZZ
|
| Hospital Charge Code |
991
|
| 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
|
|
|
02BN0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BN0ZZ
|
| Hospital Charge Code |
992
|
| 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
|
|
|
02BN3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BN3ZZ
|
| Hospital Charge Code |
993
|
| 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
|
|
|
02BN4ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02BN4ZZ
|
| Hospital Charge Code |
994
|
| 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
|
|
|
02C00Z6
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C00Z6
|
| Hospital Charge Code |
995
|
| 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
|
|
|
02C00ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C00ZZ
|
| Hospital Charge Code |
996
|
| 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
|
|
|
02C03Z6
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C03Z6
|
| Hospital Charge Code |
998
|
| 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
|
|
|
02C03Z6
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C03Z6
|
| Hospital Charge Code |
997
|
| 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
|
|
|
02C03ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C03ZZ
|
| Hospital Charge Code |
1000
|
| 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
|
|
|
02C03ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C03ZZ
|
| Hospital Charge Code |
999
|
| 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
|
|
|
02C04Z6
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C04Z6
|
| Hospital Charge Code |
1001
|
| 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
|
|
|
02C04ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C04ZZ
|
| Hospital Charge Code |
1002
|
| 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
|
|
|
02C10Z6
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02C10Z6
|
| Hospital Charge Code |
1003
|
| 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
|
|
