|
02UG0JE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG0JE
|
| Hospital Charge Code |
1429
|
| 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
|
|
|
02UG0KE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG0KE
|
| Hospital Charge Code |
1430
|
| 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
|
|
|
02UG37E
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG37E
|
| Hospital Charge Code |
1431
|
| 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
|
|
|
02UG38E
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG38E
|
| Hospital Charge Code |
1432
|
| 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
|
|
|
02UG3JE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG3JE
|
| Hospital Charge Code |
1433
|
| 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
|
|
|
02UG3JH
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG3JH
|
| Hospital Charge Code |
1434
|
| 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
|
|
|
02UG3KE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG3KE
|
| Hospital Charge Code |
1435
|
| 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
|
|
|
02UG47E
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG47E
|
| Hospital Charge Code |
1436
|
| 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
|
|
|
02UG48E
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG48E
|
| Hospital Charge Code |
1437
|
| 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
|
|
|
02UG4JE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG4JE
|
| Hospital Charge Code |
1438
|
| 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
|
|
|
02UG4KE
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UG4KE
|
| Hospital Charge Code |
1439
|
| 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
|
|
|
02UJ07G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ07G
|
| Hospital Charge Code |
1440
|
| 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
|
|
|
02UJ08G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ08G
|
| Hospital Charge Code |
1441
|
| 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
|
|
|
02UJ0JG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ0JG
|
| Hospital Charge Code |
1442
|
| 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
|
|
|
02UJ0KG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ0KG
|
| Hospital Charge Code |
1443
|
| 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
|
|
|
02UJ37G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ37G
|
| Hospital Charge Code |
1444
|
| 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
|
|
|
02UJ38G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ38G
|
| Hospital Charge Code |
1445
|
| 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
|
|
|
02UJ3JG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ3JG
|
| Hospital Charge Code |
1446
|
| 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
|
|
|
02UJ3KG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ3KG
|
| Hospital Charge Code |
1447
|
| 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
|
|
|
02UJ47G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ47G
|
| Hospital Charge Code |
1448
|
| 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
|
|
|
02UJ48G
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ48G
|
| Hospital Charge Code |
1449
|
| 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
|
|
|
02UJ4JG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ4JG
|
| Hospital Charge Code |
1450
|
| 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
|
|
|
02UJ4KG
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UJ4KG
|
| Hospital Charge Code |
1451
|
| 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
|
|
|
02UK0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UK0JZ
|
| Hospital Charge Code |
1452
|
| 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
|
|
|
02UK0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UK0KZ
|
| Hospital Charge Code |
1453
|
| 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
|
|
