|
037Q46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037Q46Z
|
| Hospital Charge Code |
1829
|
| 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
|
|
|
037Q47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037Q47Z
|
| Hospital Charge Code |
1830
|
| 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
|
|
|
037R04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R04Z
|
| Hospital Charge Code |
1831
|
| 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
|
|
|
037R05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R05Z
|
| Hospital Charge Code |
1832
|
| 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
|
|
|
037R06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R06Z
|
| Hospital Charge Code |
1833
|
| 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
|
|
|
037R07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R07Z
|
| Hospital Charge Code |
1834
|
| 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
|
|
|
037R34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R34Z
|
| Hospital Charge Code |
1835
|
| 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
|
|
|
037R35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R35Z
|
| Hospital Charge Code |
1836
|
| 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
|
|
|
037R36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R36Z
|
| Hospital Charge Code |
1837
|
| 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
|
|
|
037R37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R37Z
|
| Hospital Charge Code |
1838
|
| 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
|
|
|
037R44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R44Z
|
| Hospital Charge Code |
1839
|
| 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
|
|
|
037R45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R45Z
|
| Hospital Charge Code |
1840
|
| 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
|
|
|
037R46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R46Z
|
| Hospital Charge Code |
1841
|
| 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
|
|
|
037R47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037R47Z
|
| Hospital Charge Code |
1842
|
| 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
|
|
|
037S04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S04Z
|
| Hospital Charge Code |
1843
|
| 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
|
|
|
037S05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S05Z
|
| Hospital Charge Code |
1844
|
| 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
|
|
|
037S06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S06Z
|
| Hospital Charge Code |
1845
|
| 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
|
|
|
037S07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S07Z
|
| Hospital Charge Code |
1846
|
| 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
|
|
|
037S34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S34Z
|
| Hospital Charge Code |
1847
|
| 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
|
|
|
037S35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S35Z
|
| Hospital Charge Code |
1848
|
| 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
|
|
|
037S36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S36Z
|
| Hospital Charge Code |
1849
|
| 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
|
|
|
037S37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S37Z
|
| Hospital Charge Code |
1850
|
| 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
|
|
|
037S44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S44Z
|
| Hospital Charge Code |
1851
|
| 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
|
|
|
037S45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S45Z
|
| Hospital Charge Code |
1852
|
| 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
|
|
|
037S46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 037S46Z
|
| Hospital Charge Code |
1853
|
| 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
|
|
