|
02H74YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02H74YZ
|
| Hospital Charge Code |
1117
|
| 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
|
|
|
02HA0QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0QZ
|
| Hospital Charge Code |
1119
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0QZ
|
| Hospital Charge Code |
10842
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0QZ
|
| Hospital Charge Code |
1118
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0RJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA0RJ
|
| Hospital Charge Code |
1120
|
| 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
|
|
|
02HA0RS
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA0RS
|
| Hospital Charge Code |
1121
|
| 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
|
|
|
02HA0RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0RZ
|
| Hospital Charge Code |
1123
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0RZ
|
| Hospital Charge Code |
10843
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA0RZ
|
| Hospital Charge Code |
1122
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA0YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA0YZ
|
| Hospital Charge Code |
1124
|
| 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
|
|
|
02HA3QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3QZ
|
| Hospital Charge Code |
1126
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3QZ
|
| Hospital Charge Code |
1125
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3QZ
|
| Hospital Charge Code |
10844
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3RJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA3RJ
|
| Hospital Charge Code |
1127
|
| 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
|
|
|
02HA3RS
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA3RS
|
| Hospital Charge Code |
1128
|
| 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
|
|
|
02HA3RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3RZ
|
| Hospital Charge Code |
10845
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3RZ
|
| Hospital Charge Code |
1129
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA3RZ
|
| Hospital Charge Code |
1130
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA3YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA3YZ
|
| Hospital Charge Code |
1131
|
| 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
|
|
|
02HA4QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA4QZ
|
| Hospital Charge Code |
1132
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA4QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA4QZ
|
| Hospital Charge Code |
1133
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA4QZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA4QZ
|
| Hospital Charge Code |
10846
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
|
02HA4RJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA4RJ
|
| Hospital Charge Code |
1134
|
| 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
|
|
|
02HA4RS
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HA4RS
|
| Hospital Charge Code |
1135
|
| 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
|
|
|
02HA4RZ
|
Facility
|
IP
|
$134,914.00
|
|
|
Service Code
|
ICD 02HA4RZ
|
| Hospital Charge Code |
1136
|
| Min. Negotiated Rate |
$134,914.00 |
| Max. Negotiated Rate |
$134,914.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134,914.00
|
|
