|
037B06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B06Z
|
| Hospital Charge Code |
1685
|
| 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
|
|
|
037B07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B07Z
|
| Hospital Charge Code |
1686
|
| 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
|
|
|
037B34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B34Z
|
| Hospital Charge Code |
1687
|
| 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
|
|
|
037B35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B35Z
|
| Hospital Charge Code |
1688
|
| 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
|
|
|
037B36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B36Z
|
| Hospital Charge Code |
1689
|
| 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
|
|
|
037B37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B37Z
|
| Hospital Charge Code |
1690
|
| 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
|
|
|
037B44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B44Z
|
| Hospital Charge Code |
1691
|
| 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
|
|
|
037B45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B45Z
|
| Hospital Charge Code |
1692
|
| 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
|
|
|
037B46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B46Z
|
| Hospital Charge Code |
1693
|
| 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
|
|
|
037B47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037B47Z
|
| Hospital Charge Code |
1694
|
| 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
|
|
|
037C04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C04Z
|
| Hospital Charge Code |
1695
|
| 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
|
|
|
037C05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C05Z
|
| Hospital Charge Code |
1696
|
| 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
|
|
|
037C06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C06Z
|
| Hospital Charge Code |
1697
|
| 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
|
|
|
037C07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C07Z
|
| Hospital Charge Code |
1698
|
| 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
|
|
|
037C34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C34Z
|
| Hospital Charge Code |
1699
|
| 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
|
|
|
037C35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C35Z
|
| Hospital Charge Code |
1700
|
| 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
|
|
|
037C36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C36Z
|
| Hospital Charge Code |
1701
|
| 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
|
|
|
037C37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C37Z
|
| Hospital Charge Code |
1702
|
| 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
|
|
|
037C44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C44Z
|
| Hospital Charge Code |
1703
|
| 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
|
|
|
037C45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C45Z
|
| Hospital Charge Code |
1704
|
| 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
|
|
|
037C46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C46Z
|
| Hospital Charge Code |
1705
|
| 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
|
|
|
037C47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037C47Z
|
| Hospital Charge Code |
1706
|
| 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
|
|
|
037D04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037D04Z
|
| Hospital Charge Code |
1707
|
| 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
|
|
|
037D05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037D05Z
|
| Hospital Charge Code |
1708
|
| 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
|
|
|
037D06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037D06Z
|
| Hospital Charge Code |
1709
|
| 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
|
|