|
037R34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R34Z
|
| Hospital Charge Code |
1835
|
| 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
|
|
|
037R35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R35Z
|
| Hospital Charge Code |
1836
|
| 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
|
|
|
037R36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R36Z
|
| Hospital Charge Code |
1837
|
| 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
|
|
|
037R37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R37Z
|
| Hospital Charge Code |
1838
|
| 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
|
|
|
037R44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R44Z
|
| Hospital Charge Code |
1839
|
| 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
|
|
|
037R45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R45Z
|
| Hospital Charge Code |
1840
|
| 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
|
|
|
037R46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R46Z
|
| Hospital Charge Code |
1841
|
| 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
|
|
|
037R47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037R47Z
|
| Hospital Charge Code |
1842
|
| 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
|
|
|
037S04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S04Z
|
| Hospital Charge Code |
1843
|
| 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
|
|
|
037S05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S05Z
|
| Hospital Charge Code |
1844
|
| 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
|
|
|
037S06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S06Z
|
| Hospital Charge Code |
1845
|
| 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
|
|
|
037S07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S07Z
|
| Hospital Charge Code |
1846
|
| 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
|
|
|
037S34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S34Z
|
| Hospital Charge Code |
1847
|
| 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
|
|
|
037S35Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S35Z
|
| Hospital Charge Code |
1848
|
| 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
|
|
|
037S36Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S36Z
|
| Hospital Charge Code |
1849
|
| 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
|
|
|
037S37Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S37Z
|
| Hospital Charge Code |
1850
|
| 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
|
|
|
037S44Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S44Z
|
| Hospital Charge Code |
1851
|
| 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
|
|
|
037S45Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S45Z
|
| Hospital Charge Code |
1852
|
| 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
|
|
|
037S46Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S46Z
|
| Hospital Charge Code |
1853
|
| 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
|
|
|
037S47Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037S47Z
|
| Hospital Charge Code |
1854
|
| 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
|
|
|
037T04Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037T04Z
|
| Hospital Charge Code |
1855
|
| 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
|
|
|
037T05Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037T05Z
|
| Hospital Charge Code |
1856
|
| 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
|
|
|
037T06Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037T06Z
|
| Hospital Charge Code |
1857
|
| 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
|
|
|
037T07Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037T07Z
|
| Hospital Charge Code |
1858
|
| 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
|
|
|
037T34Z
|
Facility
|
IP
|
$13,133.00
|
|
|
Service Code
|
ICD 037T34Z
|
| Hospital Charge Code |
1859
|
| 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
|
|
