|
02HS30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HS30Z
|
| Hospital Charge Code |
1192
|
| 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
|
|
|
02HS40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HS40Z
|
| Hospital Charge Code |
1193
|
| 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
|
|
|
02HT00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HT00Z
|
| Hospital Charge Code |
1194
|
| 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
|
|
|
02HT30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HT30Z
|
| Hospital Charge Code |
1195
|
| 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
|
|
|
02HT40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HT40Z
|
| Hospital Charge Code |
1196
|
| 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
|
|
|
02HV00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HV00Z
|
| Hospital Charge Code |
1197
|
| 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
|
|
|
02HV30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HV30Z
|
| Hospital Charge Code |
1198
|
| 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
|
|
|
02HV40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HV40Z
|
| Hospital Charge Code |
1199
|
| 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
|
|
|
02HW00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HW00Z
|
| Hospital Charge Code |
1200
|
| 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
|
|
|
02HW30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HW30Z
|
| Hospital Charge Code |
1201
|
| 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
|
|
|
02HW40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HW40Z
|
| Hospital Charge Code |
1202
|
| 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
|
|
|
02HX00Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HX00Z
|
| Hospital Charge Code |
1203
|
| 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
|
|
|
02HX30Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HX30Z
|
| Hospital Charge Code |
1204
|
| 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
|
|
|
02HX40Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02HX40Z
|
| Hospital Charge Code |
1205
|
| 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
|
|
|
02L70ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02L70ZK
|
| Hospital Charge Code |
1206
|
| 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
|
|
|
02L73ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02L73ZK
|
| Hospital Charge Code |
1207
|
| 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
|
|
|
02L74ZK
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02L74ZK
|
| Hospital Charge Code |
1208
|
| 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
|
|
|
02LH0CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH0CZ
|
| Hospital Charge Code |
1209
|
| 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
|
|
|
02LH0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH0DZ
|
| Hospital Charge Code |
1210
|
| 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
|
|
|
02LH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH0ZZ
|
| Hospital Charge Code |
1211
|
| 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
|
|
|
02LH3CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH3CZ
|
| Hospital Charge Code |
1212
|
| 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
|
|
|
02LH3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH3DZ
|
| Hospital Charge Code |
1213
|
| 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
|
|
|
02LH3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH3ZZ
|
| Hospital Charge Code |
1214
|
| 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
|
|
|
02LH4CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH4CZ
|
| Hospital Charge Code |
1215
|
| 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
|
|
|
02LH4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02LH4DZ
|
| Hospital Charge Code |
1216
|
| 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
|
|