|
02B74ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02B74ZZ
|
| Hospital Charge Code |
975
|
| 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
|
|
|
02B80ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02B80ZZ
|
| Hospital Charge Code |
10715
|
| 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
|
|
|
02B80ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02B80ZZ
|
| Hospital Charge Code |
976
|
| 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
|
|
|
02B90ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02B90ZZ
|
| Hospital Charge Code |
10717
|
| 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
|
|
|
02B90ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02B90ZZ
|
| Hospital Charge Code |
977
|
| 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
|
|
|
02BD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD0ZZ
|
| Hospital Charge Code |
10719
|
| 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
|
|
|
02BD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD0ZZ
|
| Hospital Charge Code |
978
|
| 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
|
|
|
02BD3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD3ZZ
|
| Hospital Charge Code |
10720
|
| 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
|
|
|
02BD3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD3ZZ
|
| Hospital Charge Code |
979
|
| 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
|
|
|
02BD4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD4ZZ
|
| Hospital Charge Code |
980
|
| 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
|
|
|
02BD4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BD4ZZ
|
| Hospital Charge Code |
10721
|
| 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
|
|
|
02BF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BF0ZZ
|
| Hospital Charge Code |
981
|
| 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
|
|
|
02BF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BF0ZZ
|
| Hospital Charge Code |
10722
|
| 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
|
|
|
02BG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BG0ZZ
|
| Hospital Charge Code |
10724
|
| 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
|
|
|
02BG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BG0ZZ
|
| Hospital Charge Code |
982
|
| 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
|
|
|
02BH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BH0ZZ
|
| Hospital Charge Code |
10726
|
| 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
|
|
|
02BH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BH0ZZ
|
| Hospital Charge Code |
983
|
| 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
|
|
|
02BJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BJ0ZZ
|
| Hospital Charge Code |
984
|
| 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
|
|
|
02BJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BJ0ZZ
|
| Hospital Charge Code |
10728
|
| 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
|
|
|
02BK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK0ZZ
|
| Hospital Charge Code |
10730
|
| 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
|
|
|
02BK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK0ZZ
|
| Hospital Charge Code |
985
|
| 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
|
|
|
02BK3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK3ZZ
|
| Hospital Charge Code |
986
|
| 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
|
|
|
02BK3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK3ZZ
|
| Hospital Charge Code |
10731
|
| 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
|
|
|
02BK4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK4ZZ
|
| Hospital Charge Code |
10732
|
| 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
|
|
|
02BK4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02BK4ZZ
|
| Hospital Charge Code |
987
|
| 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
|
|
