|
02UK3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UK3KZ
|
| Hospital Charge Code |
1454
|
| 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
|
|
|
02UK4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UK4KZ
|
| Hospital Charge Code |
1455
|
| 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
|
|
|
02UL0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UL0KZ
|
| Hospital Charge Code |
1456
|
| 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
|
|
|
02UL3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UL3KZ
|
| Hospital Charge Code |
1457
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UL4KZ
|
| Hospital Charge Code |
1458
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| Hospital Charge Code |
1459
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM0JZ
|
| Hospital Charge Code |
1460
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM0KZ
|
| Hospital Charge Code |
1461
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM3JZ
|
| Hospital Charge Code |
1462
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM3KZ
|
| Hospital Charge Code |
1463
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM4JZ
|
| Hospital Charge Code |
1464
|
| 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
|
|
|
02UM4KZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UM4KZ
|
| Hospital Charge Code |
1465
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UN0JZ
|
| Hospital Charge Code |
1466
|
| 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
|
|
|
02UW3JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UW3JZ
|
| Hospital Charge Code |
1467
|
| 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
|
|
|
02UW4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UW4JZ
|
| Hospital Charge Code |
1468
|
| 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
|
|
|
02UX3JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UX3JZ
|
| Hospital Charge Code |
1469
|
| 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
|
|
|
02UX4JZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02UX4JZ
|
| Hospital Charge Code |
1470
|
| 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
|
|
|
02VA0CZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VA0CZ
|
| Hospital Charge Code |
1471
|
| 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
|
|
|
02VG0ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VG0ZZ
|
| Hospital Charge Code |
1472
|
| 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
|
|
|
02VG3ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VG3ZZ
|
| Hospital Charge Code |
1473
|
| 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
|
|
|
02VG4ZZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VG4ZZ
|
| Hospital Charge Code |
1474
|
| 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
|
|
|
02VR0ZT
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VR0ZT
|
| Hospital Charge Code |
1475
|
| 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
|
|
|
02VW0DZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VW0DZ
|
| Hospital Charge Code |
1476
|
| 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
|
|
|
02VW0EZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VW0EZ
|
| Hospital Charge Code |
1477
|
| 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
|
|
|
02VW0FZ
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 02VW0FZ
|
| Hospital Charge Code |
1478
|
| 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
|
|
