|
02QF3ZJ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QF3ZJ
|
| Hospital Charge Code |
1279
|
| 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
|
|
|
02QF4ZJ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QF4ZJ
|
| Hospital Charge Code |
1280
|
| 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
|
|
|
02QG0ZE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QG0ZE
|
| Hospital Charge Code |
1281
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QG0ZZ
|
| Hospital Charge Code |
1282
|
| 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
|
|
|
02QG3ZE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QG3ZE
|
| Hospital Charge Code |
1283
|
| 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
|
|
|
02QG4ZE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QG4ZE
|
| Hospital Charge Code |
1284
|
| 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
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QH0ZZ
|
| Hospital Charge Code |
1285
|
| 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
|
|
|
02QJ0ZG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QJ0ZG
|
| Hospital Charge Code |
1286
|
| 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
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QJ0ZZ
|
| Hospital Charge Code |
1287
|
| 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
|
|
|
02QJ3ZG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QJ3ZG
|
| Hospital Charge Code |
1288
|
| 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
|
|
|
02QJ4ZG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QJ4ZG
|
| Hospital Charge Code |
1289
|
| 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
|
|
|
02QK0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QK0ZZ
|
| Hospital Charge Code |
1290
|
| 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
|
|
|
02QM0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QM0ZZ
|
| Hospital Charge Code |
1291
|
| 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
|
|
|
02QN0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02QN0ZZ
|
| Hospital Charge Code |
1292
|
| 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
|
|
|
02R50JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02R50JZ
|
| Hospital Charge Code |
1293
|
| 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
|
|
|
02R90JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02R90JZ
|
| Hospital Charge Code |
1294
|
| 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
|
|
|
02RF0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RF0JZ
|
| Hospital Charge Code |
1295
|
| 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
|
|
|
02RF38Z
|
Facility
|
IP
|
$38,882.00
|
|
|
Service Code
|
ICD 02RF38Z
|
| Hospital Charge Code |
1296
|
| Min. Negotiated Rate |
$38,882.00 |
| Max. Negotiated Rate |
$38,882.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,882.00
|
|
|
02RF3JH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RF3JH
|
| Hospital Charge Code |
1297
|
| 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
|
|
|
02RF4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RF4JZ
|
| Hospital Charge Code |
1298
|
| 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
|
|
|
02RG37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RG37Z
|
| Hospital Charge Code |
1299
|
| 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
|
|
|
02RG38Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RG38Z
|
| Hospital Charge Code |
1300
|
| 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
|
|
|
02RG3JH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RG3JH
|
| Hospital Charge Code |
1301
|
| 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
|
|
|
02RG3JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RG3JZ
|
| Hospital Charge Code |
1302
|
| 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
|
|
|
02RG3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RG3KZ
|
| Hospital Charge Code |
1303
|
| 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
|
|
