|
02QG3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG3ZZ
|
| Hospital Charge Code |
3259
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QG3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG3ZZ
|
| Hospital Charge Code |
11030
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QG4ZE
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG4ZE
|
| Hospital Charge Code |
1284
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QG4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG4ZZ
|
| Hospital Charge Code |
11031
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QG4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG4ZZ
|
| Hospital Charge Code |
3260
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH0ZZ
|
| Hospital Charge Code |
1285
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH0ZZ
|
| Hospital Charge Code |
11032
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH3ZZ
|
| Hospital Charge Code |
11033
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH3ZZ
|
| Hospital Charge Code |
3261
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH4ZZ
|
| Hospital Charge Code |
3262
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QH4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QH4ZZ
|
| Hospital Charge Code |
11034
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ0ZG
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ0ZG
|
| Hospital Charge Code |
1286
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ0ZZ
|
| Hospital Charge Code |
11035
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ0ZZ
|
| Hospital Charge Code |
1287
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ3ZG
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ3ZG
|
| Hospital Charge Code |
1288
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ3ZZ
|
| Hospital Charge Code |
3263
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ3ZZ
|
| Hospital Charge Code |
11036
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ4ZG
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ4ZG
|
| Hospital Charge Code |
1289
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ4ZZ
|
| Hospital Charge Code |
11037
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QJ4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QJ4ZZ
|
| Hospital Charge Code |
3264
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QK0ZZ
|
| Hospital Charge Code |
11038
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QK0ZZ
|
| Hospital Charge Code |
1290
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QK3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QK3ZZ
|
| Hospital Charge Code |
11039
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QK3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QK3ZZ
|
| Hospital Charge Code |
3265
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02QK4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QK4ZZ
|
| Hospital Charge Code |
11040
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|