|
02C60ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1029
|
| 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
|
|
|
02CD0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1030
|
| 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
|
|
|
02CF0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1031
|
| 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
|
|
|
02CG0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1032
|
| 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
|
|
|
02CH0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1033
|
| 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
|
|
|
02CJ0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1034
|
| 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
|
|
|
02CK0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1035
|
| 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
|
|
|
02CM0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1036
|
| 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
|
|
|
02CN0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1037
|
| 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
|
|
|
02CP3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1038
|
| 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
|
|
|
02CQ3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1039
|
| 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
|
|
|
02CR3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1040
|
| 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
|
|
|
02CS3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1041
|
| 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
|
|
|
02CT3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1042
|
| 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
|
|
|
02CV3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1043
|
| 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
|
|
|
02CW3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1044
|
| 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
|
|
|
02CX3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1045
|
| 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
|
|
|
02FN0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1046
|
| 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
|
|
|
02H00YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1047
|
| 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
|
|
|
02H03YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1048
|
| 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
|
|
|
02H04YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1049
|
| 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
|
|
|
02H10YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1050
|
| 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
|
|
|
02H13YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1051
|
| 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
|
|
|
02H14YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1052
|
| 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
|
|
|
02H20YZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1053
|
| 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
|
|
