|
02C33Z6
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C33Z6
|
| Hospital Charge Code |
1022
|
| 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
|
|
|
02C33Z6
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C33Z6
|
| Hospital Charge Code |
1021
|
| 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
|
|
|
02C33ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C33ZZ
|
| Hospital Charge Code |
1023
|
| 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
|
|
|
02C33ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C33ZZ
|
| Hospital Charge Code |
10772
|
| 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
|
|
|
02C33ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C33ZZ
|
| Hospital Charge Code |
1024
|
| 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
|
|
|
02C34Z6
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C34Z6
|
| Hospital Charge Code |
1025
|
| 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
|
|
|
02C34ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C34ZZ
|
| Hospital Charge Code |
1026
|
| 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
|
|
|
02C34ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C34ZZ
|
| Hospital Charge Code |
10773
|
| 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
|
|
|
02C40ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C40ZZ
|
| Hospital Charge Code |
10774
|
| 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
|
|
|
02C40ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C40ZZ
|
| Hospital Charge Code |
1027
|
| 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
|
|
|
02C50ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C50ZZ
|
| Hospital Charge Code |
1028
|
| 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
|
|
|
02C60ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C60ZZ
|
| Hospital Charge Code |
10777
|
| 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
|
|
|
02C60ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02C60ZZ
|
| Hospital Charge Code |
1029
|
| 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
|
|
|
02CD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CD0ZZ
|
| Hospital Charge Code |
1030
|
| 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
|
|
|
02CD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CD0ZZ
|
| Hospital Charge Code |
10789
|
| 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
|
|
|
02CF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CF0ZZ
|
| Hospital Charge Code |
1031
|
| 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
|
|
|
02CG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CG0ZZ
|
| Hospital Charge Code |
1032
|
| 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
|
|
|
02CH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CH0ZZ
|
| Hospital Charge Code |
1033
|
| 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
|
|
|
02CJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CJ0ZZ
|
| Hospital Charge Code |
1034
|
| 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
|
|
|
02CK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CK0ZZ
|
| Hospital Charge Code |
1035
|
| 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
|
|
|
02CK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CK0ZZ
|
| Hospital Charge Code |
10792
|
| 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
|
|
|
02CM0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CM0ZZ
|
| Hospital Charge Code |
1036
|
| 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
|
|
|
02CN0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CN0ZZ
|
| Hospital Charge Code |
10798
|
| 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
|
|
|
02CN0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CN0ZZ
|
| Hospital Charge Code |
1037
|
| 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
|
|
|
02CP3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02CP3ZZ
|
| Hospital Charge Code |
1038
|
| 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
|
|
