|
02WA4YZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WA4YZ
|
| Hospital Charge Code |
1521
|
| 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
|
|
|
02WAXNZ
|
Facility
|
IP
|
$15,077.00
|
|
|
Service Code
|
ICD 02WAXNZ
|
| Hospital Charge Code |
1522
|
| Min. Negotiated Rate |
$15,077.00 |
| Max. Negotiated Rate |
$15,077.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,077.00
|
|
|
02WF0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF0JZ
|
| Hospital Charge Code |
1523
|
| 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
|
|
|
02WF0JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF0JZ
|
| Hospital Charge Code |
11506
|
| 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
|
|
|
02WF37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF37Z
|
| Hospital Charge Code |
1524
|
| 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
|
|
|
02WF38Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF38Z
|
| Hospital Charge Code |
1525
|
| 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
|
|
|
02WF3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF3JZ
|
| Hospital Charge Code |
1526
|
| 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
|
|
|
02WF3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WF3KZ
|
| Hospital Charge Code |
1527
|
| 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
|
|
|
02WG37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WG37Z
|
| Hospital Charge Code |
1528
|
| 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
|
|
|
02WG38Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WG38Z
|
| Hospital Charge Code |
1529
|
| 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
|
|
|
02WG3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WG3JZ
|
| Hospital Charge Code |
1530
|
| 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
|
|
|
02WG3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WG3KZ
|
| Hospital Charge Code |
1531
|
| 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
|
|
|
02WH37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WH37Z
|
| Hospital Charge Code |
1532
|
| 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
|
|
|
02WH38Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WH38Z
|
| Hospital Charge Code |
1533
|
| 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
|
|
|
02WH3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WH3JZ
|
| Hospital Charge Code |
1534
|
| 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
|
|
|
02WH3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WH3KZ
|
| Hospital Charge Code |
1535
|
| 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
|
|
|
02WJ37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WJ37Z
|
| Hospital Charge Code |
1536
|
| 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
|
|
|
02WJ38Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WJ38Z
|
| Hospital Charge Code |
1537
|
| 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
|
|
|
02WJ3JZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WJ3JZ
|
| Hospital Charge Code |
1538
|
| 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
|
|
|
02WJ3KZ
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02WJ3KZ
|
| Hospital Charge Code |
1539
|
| 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
|
|
|
02YA0Z0
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 02YA0Z0
|
| Hospital Charge Code |
1540
|
| 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
|
|
|
031309M
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 031309M
|
| Hospital Charge Code |
1541
|
| 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
|
|
|
031309M
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 031309M
|
| Hospital Charge Code |
11562
|
| 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
|
|
|
03130AM
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 03130AM
|
| Hospital Charge Code |
11564
|
| 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
|
|
|
03130AM
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 03130AM
|
| Hospital Charge Code |
1542
|
| 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
|
|