|
027P34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027P34Z
|
| Hospital Charge Code |
922
|
| 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
|
|
|
027P44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027P44Z
|
| Hospital Charge Code |
923
|
| 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
|
|
|
027Q04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027Q04Z
|
| Hospital Charge Code |
924
|
| 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
|
|
|
027Q34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027Q34Z
|
| Hospital Charge Code |
925
|
| 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
|
|
|
027Q44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027Q44Z
|
| Hospital Charge Code |
926
|
| 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
|
|
|
027R04T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R04T
|
| Hospital Charge Code |
927
|
| 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
|
|
|
027R04T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R04T
|
| Hospital Charge Code |
10688
|
| 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
|
|
|
027R04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R04Z
|
| Hospital Charge Code |
928
|
| 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
|
|
|
027R0DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R0DT
|
| Hospital Charge Code |
10689
|
| 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
|
|
|
027R0DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R0DT
|
| Hospital Charge Code |
929
|
| 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
|
|
|
027R0ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R0ZT
|
| Hospital Charge Code |
10690
|
| 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
|
|
|
027R0ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R0ZT
|
| Hospital Charge Code |
930
|
| 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
|
|
|
027R34T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R34T
|
| Hospital Charge Code |
931
|
| 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
|
|
|
027R34T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R34T
|
| Hospital Charge Code |
10691
|
| 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
|
|
|
027R34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R34Z
|
| Hospital Charge Code |
932
|
| 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
|
|
|
027R3DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R3DT
|
| Hospital Charge Code |
933
|
| 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
|
|
|
027R3DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R3DT
|
| Hospital Charge Code |
10692
|
| 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
|
|
|
027R3ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R3ZT
|
| Hospital Charge Code |
10693
|
| 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
|
|
|
027R3ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R3ZT
|
| Hospital Charge Code |
934
|
| 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
|
|
|
027R44T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R44T
|
| Hospital Charge Code |
935
|
| 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
|
|
|
027R44T
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R44T
|
| Hospital Charge Code |
10694
|
| 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
|
|
|
027R44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R44Z
|
| Hospital Charge Code |
936
|
| 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
|
|
|
027R4DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R4DT
|
| Hospital Charge Code |
937
|
| 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
|
|
|
027R4DT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R4DT
|
| Hospital Charge Code |
10695
|
| 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
|
|
|
027R4ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 027R4ZT
|
| Hospital Charge Code |
938
|
| 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
|
|
