|
037L44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037L44Z
|
| Hospital Charge Code |
1779
|
| 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
|
|
|
037L45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037L45Z
|
| Hospital Charge Code |
1780
|
| 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
|
|
|
037L46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037L46Z
|
| Hospital Charge Code |
1781
|
| 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
|
|
|
037L47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037L47Z
|
| Hospital Charge Code |
1782
|
| 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
|
|
|
037M04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M04Z
|
| Hospital Charge Code |
1783
|
| 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
|
|
|
037M05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M05Z
|
| Hospital Charge Code |
1784
|
| 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
|
|
|
037M06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M06Z
|
| Hospital Charge Code |
1785
|
| 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
|
|
|
037M07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M07Z
|
| Hospital Charge Code |
1786
|
| 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
|
|
|
037M34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M34Z
|
| Hospital Charge Code |
1787
|
| 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
|
|
|
037M35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M35Z
|
| Hospital Charge Code |
1788
|
| 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
|
|
|
037M36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M36Z
|
| Hospital Charge Code |
1789
|
| 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
|
|
|
037M37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M37Z
|
| Hospital Charge Code |
1790
|
| 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
|
|
|
037M44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M44Z
|
| Hospital Charge Code |
1791
|
| 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
|
|
|
037M45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M45Z
|
| Hospital Charge Code |
1792
|
| 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
|
|
|
037M46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M46Z
|
| Hospital Charge Code |
1793
|
| 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
|
|
|
037M47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037M47Z
|
| Hospital Charge Code |
1794
|
| 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
|
|
|
037N04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N04Z
|
| Hospital Charge Code |
1795
|
| 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
|
|
|
037N05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N05Z
|
| Hospital Charge Code |
1796
|
| 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
|
|
|
037N06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N06Z
|
| Hospital Charge Code |
1797
|
| 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
|
|
|
037N07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N07Z
|
| Hospital Charge Code |
1798
|
| 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
|
|
|
037N34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N34Z
|
| Hospital Charge Code |
1799
|
| 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
|
|
|
037N35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N35Z
|
| Hospital Charge Code |
1800
|
| 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
|
|
|
037N36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N36Z
|
| Hospital Charge Code |
1801
|
| 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
|
|
|
037N37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N37Z
|
| Hospital Charge Code |
1802
|
| 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
|
|
|
037N44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037N44Z
|
| Hospital Charge Code |
1803
|
| 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
|
|
