|
047F46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047F46Z
|
| Hospital Charge Code |
2179
|
| 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
|
|
|
047F47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047F47Z
|
| Hospital Charge Code |
2180
|
| 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
|
|
|
047H041
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H041
|
| Hospital Charge Code |
2181
|
| 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
|
|
|
047H04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H04Z
|
| Hospital Charge Code |
2182
|
| 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
|
|
|
047H05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H05Z
|
| Hospital Charge Code |
2183
|
| 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
|
|
|
047H06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H06Z
|
| Hospital Charge Code |
2184
|
| 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
|
|
|
047H07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H07Z
|
| Hospital Charge Code |
2185
|
| 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
|
|
|
047H341
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H341
|
| Hospital Charge Code |
2186
|
| 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
|
|
|
047H34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H34Z
|
| Hospital Charge Code |
2187
|
| 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
|
|
|
047H35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H35Z
|
| Hospital Charge Code |
2188
|
| 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
|
|
|
047H36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H36Z
|
| Hospital Charge Code |
2189
|
| 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
|
|
|
047H37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H37Z
|
| Hospital Charge Code |
2190
|
| 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
|
|
|
047H441
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H441
|
| Hospital Charge Code |
2191
|
| 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
|
|
|
047H44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H44Z
|
| Hospital Charge Code |
2192
|
| 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
|
|
|
047H45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H45Z
|
| Hospital Charge Code |
2193
|
| 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
|
|
|
047H46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H46Z
|
| Hospital Charge Code |
2194
|
| 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
|
|
|
047H47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047H47Z
|
| Hospital Charge Code |
2195
|
| 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
|
|
|
047J041
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J041
|
| Hospital Charge Code |
2196
|
| 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
|
|
|
047J04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J04Z
|
| Hospital Charge Code |
2197
|
| 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
|
|
|
047J05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J05Z
|
| Hospital Charge Code |
2198
|
| 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
|
|
|
047J06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J06Z
|
| Hospital Charge Code |
2199
|
| 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
|
|
|
047J07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J07Z
|
| Hospital Charge Code |
2200
|
| 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
|
|
|
047J341
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J341
|
| Hospital Charge Code |
2201
|
| 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
|
|
|
047J34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J34Z
|
| Hospital Charge Code |
2202
|
| 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
|
|
|
047J35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047J35Z
|
| Hospital Charge Code |
2203
|
| 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
|
|
