|
027G3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G3DZ
|
| Hospital Charge Code |
10656
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G3DZ
|
| Hospital Charge Code |
892
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G3ZZ
|
| Hospital Charge Code |
10657
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G3ZZ
|
| Hospital Charge Code |
893
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G44Z
|
| Hospital Charge Code |
894
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G44Z
|
| Hospital Charge Code |
10658
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G4DZ
|
| Hospital Charge Code |
10659
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G4DZ
|
| Hospital Charge Code |
895
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G4ZZ
|
| Hospital Charge Code |
10660
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027G4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027G4ZZ
|
| Hospital Charge Code |
896
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H0DZ
|
| Hospital Charge Code |
10662
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H0DZ
|
| Hospital Charge Code |
897
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H34Z
|
| Hospital Charge Code |
898
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H34Z
|
| Hospital Charge Code |
10664
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H3DZ
|
| Hospital Charge Code |
10665
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H3DZ
|
| Hospital Charge Code |
899
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H3ZZ
|
| Hospital Charge Code |
900
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H3ZZ
|
| Hospital Charge Code |
10666
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H44Z
|
| Hospital Charge Code |
10667
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H44Z
|
| Hospital Charge Code |
901
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H4DZ
|
| Hospital Charge Code |
10668
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H4DZ
|
| Hospital Charge Code |
902
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H4ZZ
|
| Hospital Charge Code |
903
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027H4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027H4ZZ
|
| Hospital Charge Code |
10669
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
|
027J0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027J0DZ
|
| Hospital Charge Code |
904
|
| Min. Negotiated Rate |
$13,133.00 |
| Max. Negotiated Rate |
$13,133.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,133.00
|
|
