|
047M45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047M45Z
|
| Hospital Charge Code |
2254
|
| 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
|
|
|
047M46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047M46Z
|
| Hospital Charge Code |
2255
|
| 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
|
|
|
047M47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047M47Z
|
| Hospital Charge Code |
2256
|
| 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
|
|
|
047N041
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N041
|
| Hospital Charge Code |
2257
|
| 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
|
|
|
047N04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N04Z
|
| Hospital Charge Code |
2258
|
| 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
|
|
|
047N05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N05Z
|
| Hospital Charge Code |
2259
|
| 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
|
|
|
047N06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N06Z
|
| Hospital Charge Code |
2260
|
| 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
|
|
|
047N07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N07Z
|
| Hospital Charge Code |
2261
|
| 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
|
|
|
047N341
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N341
|
| Hospital Charge Code |
2262
|
| 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
|
|
|
047N34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N34Z
|
| Hospital Charge Code |
2263
|
| 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
|
|
|
047N35Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N35Z
|
| Hospital Charge Code |
2264
|
| 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
|
|
|
047N36Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N36Z
|
| Hospital Charge Code |
2265
|
| 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
|
|
|
047N37Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N37Z
|
| Hospital Charge Code |
2266
|
| 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
|
|
|
047N441
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N441
|
| Hospital Charge Code |
2267
|
| 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
|
|
|
047N44Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N44Z
|
| Hospital Charge Code |
2268
|
| 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
|
|
|
047N45Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N45Z
|
| Hospital Charge Code |
2269
|
| 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
|
|
|
047N46Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N46Z
|
| Hospital Charge Code |
2270
|
| 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
|
|
|
047N47Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047N47Z
|
| Hospital Charge Code |
2271
|
| 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
|
|
|
047P041
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P041
|
| Hospital Charge Code |
2272
|
| 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
|
|
|
047P04Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P04Z
|
| Hospital Charge Code |
2273
|
| 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
|
|
|
047P05Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P05Z
|
| Hospital Charge Code |
2274
|
| 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
|
|
|
047P06Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P06Z
|
| Hospital Charge Code |
2275
|
| 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
|
|
|
047P07Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P07Z
|
| Hospital Charge Code |
2276
|
| 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
|
|
|
047P341
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P341
|
| Hospital Charge Code |
2277
|
| 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
|
|
|
047P34Z
|
Facility
|
IP
|
$12,567.00
|
|
|
Service Code
|
ICD 047P34Z
|
| Hospital Charge Code |
2278
|
| 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
|
|
