|
02QA1ZZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02QA1ZZ
|
| Hospital Charge Code |
1270
|
| 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
|
|
|
02QA2ZZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02QA2ZZ
|
| Hospital Charge Code |
1271
|
| 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
|
|
|
02QA3ZZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02QA3ZZ
|
| Hospital Charge Code |
1272
|
| 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
|
|
|
02QA4ZZ
|
Facility
|
IP
|
$47,615.00
|
|
|
Service Code
|
ICD 02QA4ZZ
|
| Hospital Charge Code |
1273
|
| 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
|
|
|
02QB0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QB0ZZ
|
| Hospital Charge Code |
11017
|
| 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
|
|
|
02QB0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QB0ZZ
|
| Hospital Charge Code |
1274
|
| 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
|
|
|
02QC0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QC0ZZ
|
| Hospital Charge Code |
11020
|
| 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
|
|
|
02QC0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QC0ZZ
|
| Hospital Charge Code |
1275
|
| 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
|
|
|
02QD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QD0ZZ
|
| Hospital Charge Code |
11023
|
| 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
|
|
|
02QD0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QD0ZZ
|
| Hospital Charge Code |
1276
|
| 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
|
|
|
02QF0ZJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QF0ZJ
|
| Hospital Charge Code |
1277
|
| 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
|
|
|
02QF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QF0ZZ
|
| Hospital Charge Code |
11026
|
| 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
|
|
|
02QF0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QF0ZZ
|
| Hospital Charge Code |
1278
|
| 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
|
|
|
02QF3ZJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QF3ZJ
|
| Hospital Charge Code |
1279
|
| 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
|
|
|
02QF4ZJ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QF4ZJ
|
| Hospital Charge Code |
1280
|
| 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
|
|
|
02QG0ZE
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QG0ZE
|
| Hospital Charge Code |
1281
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QG0ZZ
|
| Hospital Charge Code |
11029
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QG0ZZ
|
| Hospital Charge Code |
1282
|
| 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
|
|
|
02QG3ZE
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QG3ZE
|
| Hospital Charge Code |
1283
|
| 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
|
|
|
02QG4ZE
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QG4ZE
|
| Hospital Charge Code |
1284
|
| 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
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QH0ZZ
|
| Hospital Charge Code |
11032
|
| 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
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QH0ZZ
|
| Hospital Charge Code |
1285
|
| 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
|
|
|
02QJ0ZG
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QJ0ZG
|
| Hospital Charge Code |
1286
|
| 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
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QJ0ZZ
|
| Hospital Charge Code |
11035
|
| 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
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02QJ0ZZ
|
| Hospital Charge Code |
1287
|
| 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
|
|
