|
02VW3DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1479
|
| 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
|
|
|
02VW3EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1480
|
| 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
|
|
|
02VW3FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1481
|
| 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
|
|
|
02VW4DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1482
|
| 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
|
|
|
02VW4EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1483
|
| 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
|
|
|
02VW4FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1484
|
| 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
|
|
|
02VX0DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1485
|
| 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
|
|
|
02VX0EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1486
|
| 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
|
|
|
02VX0FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1487
|
| 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
|
|
|
02VX3DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1488
|
| 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
|
|
|
02VX3EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1489
|
| 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
|
|
|
02VX3FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1490
|
| 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
|
|
|
02VX4DZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1491
|
| 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
|
|
|
02VX4EZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1492
|
| 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
|
|
|
02VX4FZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1493
|
| 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
|
|
|
02W50JZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1494
|
| 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
|
|
|
02WA02Z
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1495
|
| 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
|
|
|
02WA0CZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1496
|
| 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
|
|
|
02WA0JZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1497
|
| 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
|
|
|
02WA0KZ
|
Facility
|
IP
|
$12,567.00
|
|
| Hospital Charge Code |
1498
|
| 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
|
|
|
02WA0NZ
|
Facility
|
IP
|
$14,428.00
|
|
| Hospital Charge Code |
1499
|
| Min. Negotiated Rate |
$14,428.00 |
| Max. Negotiated Rate |
$14,428.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,428.00
|
|
|
02WA0QZ
|
Facility
|
IP
|
$129,104.00
|
|
| Hospital Charge Code |
1501
|
| Min. Negotiated Rate |
$129,104.00 |
| Max. Negotiated Rate |
$129,104.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129,104.00
|
|
|
02WA0QZ
|
Facility
|
IP
|
$129,104.00
|
|
| Hospital Charge Code |
1500
|
| Min. Negotiated Rate |
$129,104.00 |
| Max. Negotiated Rate |
$129,104.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129,104.00
|
|
|
02WA0RS
|
Facility
|
IP
|
$129,104.00
|
|
| Hospital Charge Code |
1503
|
| Min. Negotiated Rate |
$129,104.00 |
| Max. Negotiated Rate |
$129,104.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129,104.00
|
|
|
02WA0RS
|
Facility
|
IP
|
$129,104.00
|
|
| Hospital Charge Code |
1502
|
| Min. Negotiated Rate |
$129,104.00 |
| Max. Negotiated Rate |
$129,104.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129,104.00
|
|
