|
02ND0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| Hospital Charge Code |
1238
|
| 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
|
|
|
02ND0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| Hospital Charge Code |
10920
|
| 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
|
|
|
02NF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NF0ZZ
|
| Hospital Charge Code |
1239
|
| 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
|
|
|
02NF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NF0ZZ
|
| Hospital Charge Code |
10923
|
| 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
|
|
|
02NG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NG0ZZ
|
| Hospital Charge Code |
10924
|
| 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
|
|
|
02NG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NG0ZZ
|
| Hospital Charge Code |
1240
|
| 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
|
|
|
02NH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NH0ZZ
|
| Hospital Charge Code |
10925
|
| 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
|
|
|
02NH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NH0ZZ
|
| Hospital Charge Code |
1241
|
| 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
|
|
|
02NJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NJ0ZZ
|
| Hospital Charge Code |
1242
|
| 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
|
|
|
02NJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NJ0ZZ
|
| Hospital Charge Code |
10926
|
| 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
|
|
|
02NK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NK0ZZ
|
| Hospital Charge Code |
1243
|
| 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
|
|
|
02NK0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NK0ZZ
|
| Hospital Charge Code |
10927
|
| 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
|
|
|
02NM0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NM0ZZ
|
| Hospital Charge Code |
1244
|
| 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
|
|
|
02NN0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NN0ZZ
|
| Hospital Charge Code |
10933
|
| 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
|
|
|
02NN0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02NN0ZZ
|
| Hospital Charge Code |
1245
|
| 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
|
|
|
02PA02Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA02Z
|
| Hospital Charge Code |
10936
|
| 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
|
|
|
02PA02Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA02Z
|
| Hospital Charge Code |
1246
|
| 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
|
|
|
02PA0CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0CZ
|
| Hospital Charge Code |
10940
|
| 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
|
|
|
02PA0CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0CZ
|
| Hospital Charge Code |
1247
|
| 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
|
|
|
02PA0MZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02PA0MZ
|
| Hospital Charge Code |
1248
|
| 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
|
|
|
02PA0QZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0QZ
|
| Hospital Charge Code |
1249
|
| 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
|
|
|
02PA0RS
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0RS
|
| Hospital Charge Code |
1250
|
| 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
|
|
|
02PA0RZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0RZ
|
| Hospital Charge Code |
10944
|
| 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
|
|
|
02PA0RZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0RZ
|
| Hospital Charge Code |
1251
|
| 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
|
|
|
02PA0YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02PA0YZ
|
| Hospital Charge Code |
1252
|
| 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
|
|