|
037K05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K05Z
|
| Hospital Charge Code |
1760
|
| 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
|
|
|
037K06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K06Z
|
| Hospital Charge Code |
1761
|
| 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
|
|
|
037K07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K07Z
|
| Hospital Charge Code |
1762
|
| 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
|
|
|
037K34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K34Z
|
| Hospital Charge Code |
1763
|
| 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
|
|
|
037K35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K35Z
|
| Hospital Charge Code |
1764
|
| 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
|
|
|
037K36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K36Z
|
| Hospital Charge Code |
1765
|
| 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
|
|
|
037K37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K37Z
|
| Hospital Charge Code |
1766
|
| 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
|
|
|
037K44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K44Z
|
| Hospital Charge Code |
1767
|
| 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
|
|
|
037K45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K45Z
|
| Hospital Charge Code |
1768
|
| 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
|
|
|
037K46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K46Z
|
| Hospital Charge Code |
1769
|
| 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
|
|
|
037K47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037K47Z
|
| Hospital Charge Code |
1770
|
| 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
|
|
|
037L04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L04Z
|
| Hospital Charge Code |
1771
|
| 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
|
|
|
037L05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L05Z
|
| Hospital Charge Code |
1772
|
| 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
|
|
|
037L06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L06Z
|
| Hospital Charge Code |
1773
|
| 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
|
|
|
037L07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L07Z
|
| Hospital Charge Code |
1774
|
| 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
|
|
|
037L34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L34Z
|
| Hospital Charge Code |
1775
|
| 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
|
|
|
037L35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L35Z
|
| Hospital Charge Code |
1776
|
| 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
|
|
|
037L36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L36Z
|
| Hospital Charge Code |
1777
|
| 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
|
|
|
037L37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L37Z
|
| Hospital Charge Code |
1778
|
| 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
|
|
|
037L44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L44Z
|
| Hospital Charge Code |
1779
|
| 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
|
|
|
037L45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L45Z
|
| Hospital Charge Code |
1780
|
| 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
|
|
|
037L46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L46Z
|
| Hospital Charge Code |
1781
|
| 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
|
|
|
037L47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037L47Z
|
| Hospital Charge Code |
1782
|
| 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
|
|
|
037M04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037M04Z
|
| Hospital Charge Code |
1783
|
| 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
|
|
|
037M05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037M05Z
|
| Hospital Charge Code |
1784
|
| 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
|
|