|
037246Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037246Z
|
| Hospital Charge Code |
1585
|
| 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
|
|
|
037247Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037247Z
|
| Hospital Charge Code |
1586
|
| 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
|
|
|
037304Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037304Z
|
| Hospital Charge Code |
1587
|
| 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
|
|
|
037305Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037305Z
|
| Hospital Charge Code |
1588
|
| 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
|
|
|
037306Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037306Z
|
| Hospital Charge Code |
1589
|
| 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
|
|
|
037307Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037307Z
|
| Hospital Charge Code |
1590
|
| 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
|
|
|
037334Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037334Z
|
| Hospital Charge Code |
1591
|
| 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
|
|
|
037335Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037335Z
|
| Hospital Charge Code |
1592
|
| 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
|
|
|
037336Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037336Z
|
| Hospital Charge Code |
1593
|
| 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
|
|
|
037337Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037337Z
|
| Hospital Charge Code |
1594
|
| 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
|
|
|
037344Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037344Z
|
| Hospital Charge Code |
1595
|
| 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
|
|
|
037345Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037345Z
|
| Hospital Charge Code |
1596
|
| 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
|
|
|
037346Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037346Z
|
| Hospital Charge Code |
1597
|
| 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
|
|
|
037347Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037347Z
|
| Hospital Charge Code |
1598
|
| 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
|
|
|
037404Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037404Z
|
| Hospital Charge Code |
1599
|
| 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
|
|
|
037405Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037405Z
|
| Hospital Charge Code |
1600
|
| 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
|
|
|
037406Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037406Z
|
| Hospital Charge Code |
1601
|
| 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
|
|
|
037407Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037407Z
|
| Hospital Charge Code |
1602
|
| 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
|
|
|
037434Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037434Z
|
| Hospital Charge Code |
1603
|
| 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
|
|
|
037435Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037435Z
|
| Hospital Charge Code |
1604
|
| 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
|
|
|
037436Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037436Z
|
| Hospital Charge Code |
1605
|
| 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
|
|
|
037437Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037437Z
|
| Hospital Charge Code |
1606
|
| 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
|
|
|
037444Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037444Z
|
| Hospital Charge Code |
1607
|
| 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
|
|
|
037445Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037445Z
|
| Hospital Charge Code |
1608
|
| 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
|
|
|
037446Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037446Z
|
| Hospital Charge Code |
1609
|
| 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
|
|