|
02N24ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N24ZZ
|
| Hospital Charge Code |
1229
|
| 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
|
|
|
02N30ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N30ZZ
|
| Hospital Charge Code |
1230
|
| 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
|
|
|
02N33ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N33ZZ
|
| Hospital Charge Code |
1231
|
| 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
|
|
|
02N34ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N34ZZ
|
| Hospital Charge Code |
1232
|
| 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
|
|
|
02N40ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N40ZZ
|
| Hospital Charge Code |
1233
|
| 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
|
|
|
02N50ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N50ZZ
|
| Hospital Charge Code |
1234
|
| 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
|
|
|
02N60ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N60ZZ
|
| Hospital Charge Code |
1235
|
| 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
|
|
|
02N80ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N80ZZ
|
| Hospital Charge Code |
1236
|
| 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
|
|
|
02N90ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02N90ZZ
|
| Hospital Charge Code |
1237
|
| 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
|
|
|
02ND0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| Hospital Charge Code |
1238
|
| 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
|
|
|
02NF0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NF0ZZ
|
| Hospital Charge Code |
1239
|
| 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
|
|
|
02NG0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NG0ZZ
|
| Hospital Charge Code |
1240
|
| 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
|
|
|
02NH0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NH0ZZ
|
| Hospital Charge Code |
1241
|
| 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
|
|
|
02NJ0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NJ0ZZ
|
| Hospital Charge Code |
1242
|
| 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
|
|
|
02NK0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NK0ZZ
|
| Hospital Charge Code |
1243
|
| 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
|
|
|
02NM0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NM0ZZ
|
| Hospital Charge Code |
1244
|
| 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
|
|
|
02NN0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02NN0ZZ
|
| Hospital Charge Code |
1245
|
| 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
|
|
|
02PA02Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA02Z
|
| Hospital Charge Code |
1246
|
| 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
|
|
|
02PA0CZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA0CZ
|
| Hospital Charge Code |
1247
|
| 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
|
|
|
02PA0MZ
|
Facility
|
IP
|
$45,565.00
|
|
|
Service Code
|
ICD 02PA0MZ
|
| Hospital Charge Code |
1248
|
| 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
|
|
|
02PA0QZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA0QZ
|
| Hospital Charge Code |
1249
|
| 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
|
|
|
02PA0RS
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA0RS
|
| Hospital Charge Code |
1250
|
| 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
|
|
|
02PA0RZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA0RZ
|
| Hospital Charge Code |
1251
|
| 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
|
|
|
02PA0YZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA0YZ
|
| Hospital Charge Code |
1252
|
| 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
|
|
|
02PA32Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02PA32Z
|
| Hospital Charge Code |
1253
|
| 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
|
|
