|
02UK0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK0KZ
|
| Hospital Charge Code |
1453
|
| 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
|
|
|
02UK0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK0KZ
|
| Hospital Charge Code |
11354
|
| 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
|
|
|
02UK3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK3KZ
|
| Hospital Charge Code |
11358
|
| 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
|
|
|
02UK3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK3KZ
|
| Hospital Charge Code |
1454
|
| 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
|
|
|
02UK4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK4KZ
|
| Hospital Charge Code |
1455
|
| 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
|
|
|
02UK4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UK4KZ
|
| Hospital Charge Code |
11362
|
| 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
|
|
|
02UL0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL0KZ
|
| Hospital Charge Code |
1456
|
| 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
|
|
|
02UL0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL0KZ
|
| Hospital Charge Code |
11366
|
| 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
|
|
|
02UL3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL3KZ
|
| Hospital Charge Code |
11370
|
| 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
|
|
|
02UL3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL3KZ
|
| Hospital Charge Code |
1457
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL4KZ
|
| Hospital Charge Code |
11374
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UL4KZ
|
| Hospital Charge Code |
1458
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| Hospital Charge Code |
11376
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| Hospital Charge Code |
1459
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM0JZ
|
| Hospital Charge Code |
11377
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM0JZ
|
| Hospital Charge Code |
1460
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM0KZ
|
| Hospital Charge Code |
11378
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM0KZ
|
| Hospital Charge Code |
1461
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM3JZ
|
| Hospital Charge Code |
1462
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM3JZ
|
| Hospital Charge Code |
11381
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM3KZ
|
| Hospital Charge Code |
11382
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM3KZ
|
| Hospital Charge Code |
1463
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM4JZ
|
| Hospital Charge Code |
1464
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM4JZ
|
| Hospital Charge Code |
11385
|
| 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
|
|
|
02UM4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM4KZ
|
| Hospital Charge Code |
11386
|
| 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
|
|