|
037P07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P07Z
|
| Hospital Charge Code |
1810
|
| 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
|
|
|
037P34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P34Z
|
| Hospital Charge Code |
1811
|
| 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
|
|
|
037P35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P35Z
|
| Hospital Charge Code |
1812
|
| 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
|
|
|
037P36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P36Z
|
| Hospital Charge Code |
1813
|
| 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
|
|
|
037P37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P37Z
|
| Hospital Charge Code |
1814
|
| 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
|
|
|
037P44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P44Z
|
| Hospital Charge Code |
1815
|
| 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
|
|
|
037P45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P45Z
|
| Hospital Charge Code |
1816
|
| 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
|
|
|
037P46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P46Z
|
| Hospital Charge Code |
1817
|
| 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
|
|
|
037P47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037P47Z
|
| Hospital Charge Code |
1818
|
| 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
|
|
|
037Q04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q04Z
|
| Hospital Charge Code |
1819
|
| 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
|
|
|
037Q05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q05Z
|
| Hospital Charge Code |
1820
|
| 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
|
|
|
037Q06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q06Z
|
| Hospital Charge Code |
1821
|
| 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
|
|
|
037Q07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q07Z
|
| Hospital Charge Code |
1822
|
| 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
|
|
|
037Q34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q34Z
|
| Hospital Charge Code |
1823
|
| 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
|
|
|
037Q35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q35Z
|
| Hospital Charge Code |
1824
|
| 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
|
|
|
037Q36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q36Z
|
| Hospital Charge Code |
1825
|
| 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
|
|
|
037Q37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q37Z
|
| Hospital Charge Code |
1826
|
| 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
|
|
|
037Q44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q44Z
|
| Hospital Charge Code |
1827
|
| 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
|
|
|
037Q45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q45Z
|
| Hospital Charge Code |
1828
|
| 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
|
|
|
037Q46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q46Z
|
| Hospital Charge Code |
1829
|
| 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
|
|
|
037Q47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037Q47Z
|
| Hospital Charge Code |
1830
|
| 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
|
|
|
037R04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R04Z
|
| Hospital Charge Code |
1831
|
| 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
|
|
|
037R05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R05Z
|
| Hospital Charge Code |
1832
|
| 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
|
|
|
037R06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R06Z
|
| Hospital Charge Code |
1833
|
| 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
|
|
|
037R07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R07Z
|
| Hospital Charge Code |
1834
|
| 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
|
|