|
02RH3JH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RH3JH
|
| Hospital Charge Code |
1304
|
| 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
|
|
|
02RH4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RH4JZ
|
| Hospital Charge Code |
1305
|
| 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
|
|
|
02RJ37H
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ37H
|
| Hospital Charge Code |
1306
|
| 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
|
|
|
02RJ37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ37Z
|
| Hospital Charge Code |
1307
|
| 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
|
|
|
02RJ38H
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ38H
|
| Hospital Charge Code |
1308
|
| 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
|
|
|
02RJ38Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ38Z
|
| Hospital Charge Code |
1309
|
| 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
|
|
|
02RJ3JH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ3JH
|
| Hospital Charge Code |
1310
|
| 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
|
|
|
02RJ3JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ3JZ
|
| Hospital Charge Code |
1311
|
| 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
|
|
|
02RJ3KH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ3KH
|
| Hospital Charge Code |
1312
|
| 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
|
|
|
02RJ3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RJ3KZ
|
| Hospital Charge Code |
1313
|
| 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
|
|
|
02RK08Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RK08Z
|
| Hospital Charge Code |
1314
|
| 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
|
|
|
02RK0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RK0JZ
|
| Hospital Charge Code |
1315
|
| 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
|
|
|
02RK0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RK0KZ
|
| Hospital Charge Code |
1316
|
| 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
|
|
|
02RK48Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RK48Z
|
| Hospital Charge Code |
1317
|
| 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
|
|
|
02RK4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RK4KZ
|
| Hospital Charge Code |
1318
|
| 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
|
|
|
02RL08Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RL08Z
|
| Hospital Charge Code |
1319
|
| 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
|
|
|
02RL0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RL0JZ
|
| Hospital Charge Code |
1320
|
| 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
|
|
|
02RL0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RL0KZ
|
| Hospital Charge Code |
1321
|
| 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
|
|
|
02RL48Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RL48Z
|
| Hospital Charge Code |
1322
|
| 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
|
|
|
02RL4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RL4KZ
|
| Hospital Charge Code |
1323
|
| 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
|
|
|
02RM08Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RM08Z
|
| Hospital Charge Code |
1324
|
| 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
|
|
|
02RM0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RM0JZ
|
| Hospital Charge Code |
1325
|
| 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
|
|
|
02RM0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RM0KZ
|
| Hospital Charge Code |
1326
|
| 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
|
|
|
02RM48Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RM48Z
|
| Hospital Charge Code |
1327
|
| 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
|
|
|
02RM4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02RM4JZ
|
| Hospital Charge Code |
1328
|
| 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
|
|
