|
037A44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037A44Z
|
| Hospital Charge Code |
1679
|
| 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
|
|
|
037A45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037A45Z
|
| Hospital Charge Code |
1680
|
| 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
|
|
|
037A46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037A46Z
|
| Hospital Charge Code |
1681
|
| 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
|
|
|
037A47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037A47Z
|
| Hospital Charge Code |
1682
|
| 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
|
|
|
037B04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B04Z
|
| Hospital Charge Code |
1683
|
| 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
|
|
|
037B05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B05Z
|
| Hospital Charge Code |
1684
|
| 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
|
|
|
037B06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B06Z
|
| Hospital Charge Code |
1685
|
| 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
|
|
|
037B07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B07Z
|
| Hospital Charge Code |
1686
|
| 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
|
|
|
037B34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B34Z
|
| Hospital Charge Code |
1687
|
| 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
|
|
|
037B35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B35Z
|
| Hospital Charge Code |
1688
|
| 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
|
|
|
037B36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B36Z
|
| Hospital Charge Code |
1689
|
| 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
|
|
|
037B37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B37Z
|
| Hospital Charge Code |
1690
|
| 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
|
|
|
037B44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B44Z
|
| Hospital Charge Code |
1691
|
| 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
|
|
|
037B45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B45Z
|
| Hospital Charge Code |
1692
|
| 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
|
|
|
037B46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B46Z
|
| Hospital Charge Code |
1693
|
| 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
|
|
|
037B47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037B47Z
|
| Hospital Charge Code |
1694
|
| 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
|
|
|
037C04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C04Z
|
| Hospital Charge Code |
1695
|
| 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
|
|
|
037C05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C05Z
|
| Hospital Charge Code |
1696
|
| 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
|
|
|
037C06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C06Z
|
| Hospital Charge Code |
1697
|
| 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
|
|
|
037C07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C07Z
|
| Hospital Charge Code |
1698
|
| 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
|
|
|
037C34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C34Z
|
| Hospital Charge Code |
1699
|
| 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
|
|
|
037C35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C35Z
|
| Hospital Charge Code |
1700
|
| 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
|
|
|
037C36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C36Z
|
| Hospital Charge Code |
1701
|
| 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
|
|
|
037C37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C37Z
|
| Hospital Charge Code |
1702
|
| 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
|
|
|
037C44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037C44Z
|
| Hospital Charge Code |
1703
|
| 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
|
|
