|
02HL40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HL40Z
|
| Hospital Charge Code |
1175
|
| 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
|
|
|
02HL42Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HL42Z
|
| Hospital Charge Code |
1176
|
| 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
|
|
|
02HL42Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HL42Z
|
| Hospital Charge Code |
10865
|
| 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
|
|
|
02HL4JZ
|
Facility
|
IP
|
$15,077.00
|
|
|
Service Code
|
ICD 02HL4JZ
|
| Hospital Charge Code |
1177
|
| Min. Negotiated Rate |
$15,077.00 |
| Max. Negotiated Rate |
$15,077.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,077.00
|
|
|
02HL4KZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02HL4KZ
|
| Hospital Charge Code |
10868
|
| Min. Negotiated Rate |
$47,615.00 |
| Max. Negotiated Rate |
$47,615.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,615.00
|
|
|
02HL4KZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02HL4KZ
|
| Hospital Charge Code |
1178
|
| Min. Negotiated Rate |
$47,615.00 |
| Max. Negotiated Rate |
$47,615.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,615.00
|
|
|
02HL4KZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02HL4KZ
|
| Hospital Charge Code |
1179
|
| Min. Negotiated Rate |
$47,615.00 |
| Max. Negotiated Rate |
$47,615.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,615.00
|
|
|
02HL4NZ
|
Facility
|
IP
|
$15,077.00
|
|
|
Service Code
|
ICD 02HL4NZ
|
| Hospital Charge Code |
1180
|
| Min. Negotiated Rate |
$15,077.00 |
| Max. Negotiated Rate |
$15,077.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,077.00
|
|
|
02HL4YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HL4YZ
|
| Hospital Charge Code |
1181
|
| 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
|
|
|
02HN00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN00Z
|
| Hospital Charge Code |
10869
|
| 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
|
|
|
02HN00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN00Z
|
| Hospital Charge Code |
1182
|
| 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
|
|
|
02HN0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN0KZ
|
| Hospital Charge Code |
10871
|
| 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
|
|
|
02HN0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN0KZ
|
| Hospital Charge Code |
1183
|
| 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
|
|
|
02HN0YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN0YZ
|
| Hospital Charge Code |
1184
|
| 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
|
|
|
02HN30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN30Z
|
| Hospital Charge Code |
1185
|
| 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
|
|
|
02HN30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN30Z
|
| Hospital Charge Code |
10872
|
| 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
|
|
|
02HN3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN3KZ
|
| Hospital Charge Code |
10874
|
| 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
|
|
|
02HN3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN3KZ
|
| Hospital Charge Code |
1186
|
| 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
|
|
|
02HN3YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN3YZ
|
| Hospital Charge Code |
1187
|
| 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
|
|
|
02HN40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN40Z
|
| Hospital Charge Code |
1188
|
| 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
|
|
|
02HN40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN40Z
|
| Hospital Charge Code |
10875
|
| 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
|
|
|
02HN4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN4KZ
|
| Hospital Charge Code |
1189
|
| 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
|
|
|
02HN4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN4KZ
|
| Hospital Charge Code |
10877
|
| 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
|
|
|
02HN4YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HN4YZ
|
| Hospital Charge Code |
1190
|
| 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
|
|
|
02HS00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HS00Z
|
| Hospital Charge Code |
1191
|
| 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
|
|
