|
02RL0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL0JZ
|
| Hospital Charge Code |
11136
|
| 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
|
|
|
02RL0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL0JZ
|
| Hospital Charge Code |
1320
|
| 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
|
|
|
02RL0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL0KZ
|
| Hospital Charge Code |
1321
|
| 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
|
|
|
02RL0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL0KZ
|
| Hospital Charge Code |
11137
|
| 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
|
|
|
02RL48Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL48Z
|
| Hospital Charge Code |
1322
|
| 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
|
|
|
02RL48Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL48Z
|
| Hospital Charge Code |
11139
|
| 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
|
|
|
02RL4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL4KZ
|
| Hospital Charge Code |
11141
|
| 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
|
|
|
02RL4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RL4KZ
|
| Hospital Charge Code |
1323
|
| 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
|
|
|
02RM08Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM08Z
|
| Hospital Charge Code |
1324
|
| 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
|
|
|
02RM08Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM08Z
|
| Hospital Charge Code |
11143
|
| 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
|
|
|
02RM0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM0JZ
|
| Hospital Charge Code |
1325
|
| 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
|
|
|
02RM0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM0JZ
|
| Hospital Charge Code |
11144
|
| 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
|
|
|
02RM0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM0KZ
|
| Hospital Charge Code |
11145
|
| 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
|
|
|
02RM0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM0KZ
|
| Hospital Charge Code |
1326
|
| 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
|
|
|
02RM48Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM48Z
|
| Hospital Charge Code |
11147
|
| 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
|
|
|
02RM48Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM48Z
|
| Hospital Charge Code |
1327
|
| 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
|
|
|
02RM4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM4JZ
|
| Hospital Charge Code |
1328
|
| 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
|
|
|
02RM4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM4KZ
|
| Hospital Charge Code |
1329
|
| 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
|
|
|
02RM4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RM4KZ
|
| Hospital Charge Code |
11148
|
| 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
|
|
|
02RP0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RP0JZ
|
| Hospital Charge Code |
11159
|
| 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
|
|
|
02RP0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RP0JZ
|
| Hospital Charge Code |
1330
|
| 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
|
|
|
02RQ07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RQ07Z
|
| Hospital Charge Code |
1331
|
| 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
|
|
|
02RQ07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RQ07Z
|
| Hospital Charge Code |
11165
|
| 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
|
|
|
02RQ0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RQ0JZ
|
| Hospital Charge Code |
11167
|
| 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
|
|
|
02RQ0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02RQ0JZ
|
| Hospital Charge Code |
1332
|
| 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
|
|