|
02UM4KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UM4KZ
|
| Hospital Charge Code |
1465
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UN0JZ
|
| Hospital Charge Code |
11389
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UN0JZ
|
| Hospital Charge Code |
1466
|
| 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
|
|
|
02UW3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UW3JZ
|
| Hospital Charge Code |
1467
|
| 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
|
|
|
02UW3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UW3JZ
|
| Hospital Charge Code |
11458
|
| 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
|
|
|
02UW4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UW4JZ
|
| Hospital Charge Code |
11462
|
| 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
|
|
|
02UW4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UW4JZ
|
| Hospital Charge Code |
1468
|
| 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
|
|
|
02UX3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UX3JZ
|
| Hospital Charge Code |
1469
|
| 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
|
|
|
02UX4JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02UX4JZ
|
| Hospital Charge Code |
1470
|
| 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
|
|
|
02VA0CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VA0CZ
|
| Hospital Charge Code |
11464
|
| 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
|
|
|
02VA0CZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VA0CZ
|
| Hospital Charge Code |
1471
|
| 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
|
|
|
02VG0ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VG0ZZ
|
| Hospital Charge Code |
1472
|
| 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
|
|
|
02VG3ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VG3ZZ
|
| Hospital Charge Code |
1473
|
| 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
|
|
|
02VG4ZZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VG4ZZ
|
| Hospital Charge Code |
1474
|
| 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
|
|
|
02VR0ZT
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VR0ZT
|
| Hospital Charge Code |
1475
|
| 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
|
|
|
02VW0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW0DZ
|
| Hospital Charge Code |
11470
|
| 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
|
|
|
02VW0DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW0DZ
|
| Hospital Charge Code |
1476
|
| 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
|
|
|
02VW0EZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW0EZ
|
| Hospital Charge Code |
1477
|
| 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
|
|
|
02VW0FZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW0FZ
|
| Hospital Charge Code |
1478
|
| 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
|
|
|
02VW3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW3DZ
|
| Hospital Charge Code |
1479
|
| 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
|
|
|
02VW3DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW3DZ
|
| Hospital Charge Code |
11471
|
| 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
|
|
|
02VW3EZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW3EZ
|
| Hospital Charge Code |
1480
|
| 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
|
|
|
02VW3FZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW3FZ
|
| Hospital Charge Code |
1481
|
| 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
|
|
|
02VW4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW4DZ
|
| Hospital Charge Code |
11472
|
| 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
|
|
|
02VW4DZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02VW4DZ
|
| Hospital Charge Code |
1482
|
| 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
|
|
