|
02HL4KZ
|
Facility
|
IP
|
$45,565.00
|
|
|
Service Code
|
ICD 02HL4KZ
|
| Hospital Charge Code |
1179
|
| Min. Negotiated Rate |
$45,565.00 |
| Max. Negotiated Rate |
$45,565.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,565.00
|
|
|
02HL4NZ
|
Facility
|
IP
|
$14,428.00
|
|
|
Service Code
|
ICD 02HL4NZ
|
| Hospital Charge Code |
1180
|
| Min. Negotiated Rate |
$14,428.00 |
| Max. Negotiated Rate |
$14,428.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,428.00
|
|
|
02HL4YZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HL4YZ
|
| Hospital Charge Code |
1181
|
| 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
|
|
|
02HN00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN00Z
|
| Hospital Charge Code |
1182
|
| 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
|
|
|
02HN0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN0KZ
|
| Hospital Charge Code |
1183
|
| 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
|
|
|
02HN0YZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN0YZ
|
| Hospital Charge Code |
1184
|
| 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
|
|
|
02HN30Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN30Z
|
| Hospital Charge Code |
1185
|
| 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
|
|
|
02HN3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN3KZ
|
| Hospital Charge Code |
1186
|
| 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
|
|
|
02HN3YZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN3YZ
|
| Hospital Charge Code |
1187
|
| 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
|
|
|
02HN40Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN40Z
|
| Hospital Charge Code |
1188
|
| 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
|
|
|
02HN4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN4KZ
|
| Hospital Charge Code |
1189
|
| 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
|
|
|
02HN4YZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HN4YZ
|
| Hospital Charge Code |
1190
|
| 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
|
|
|
02HS00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HS00Z
|
| Hospital Charge Code |
1191
|
| 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
|
|
|
02HS30Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HS30Z
|
| Hospital Charge Code |
1192
|
| 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
|
|
|
02HS40Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HS40Z
|
| Hospital Charge Code |
1193
|
| 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
|
|
|
02HT00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HT00Z
|
| Hospital Charge Code |
1194
|
| 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
|
|
|
02HT30Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HT30Z
|
| Hospital Charge Code |
1195
|
| 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
|
|
|
02HT40Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HT40Z
|
| Hospital Charge Code |
1196
|
| 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
|
|
|
02HV00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HV00Z
|
| Hospital Charge Code |
1197
|
| 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
|
|
|
02HV30Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HV30Z
|
| Hospital Charge Code |
1198
|
| 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
|
|
|
02HV40Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HV40Z
|
| Hospital Charge Code |
1199
|
| 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
|
|
|
02HW00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HW00Z
|
| Hospital Charge Code |
1200
|
| 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
|
|
|
02HW30Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HW30Z
|
| Hospital Charge Code |
1201
|
| 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
|
|
|
02HW40Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HW40Z
|
| Hospital Charge Code |
1202
|
| 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
|
|
|
02HX00Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02HX00Z
|
| Hospital Charge Code |
1203
|
| 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
|
|
