|
02R947Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R947Z
|
| Hospital Charge Code |
11078
|
| 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
|
|
|
02R947Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R947Z
|
| Hospital Charge Code |
3300
|
| 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
|
|
|
02R948Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R948Z
|
| Hospital Charge Code |
11079
|
| 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
|
|
|
02R948Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R948Z
|
| Hospital Charge Code |
3301
|
| 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
|
|
|
02R94JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R94JZ
|
| Hospital Charge Code |
11080
|
| 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
|
|
|
02R94JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R94JZ
|
| Hospital Charge Code |
3302
|
| 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
|
|
|
02R94KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R94KZ
|
| Hospital Charge Code |
3303
|
| 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
|
|
|
02R94KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02R94KZ
|
| Hospital Charge Code |
11081
|
| 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
|
|
|
02RD07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD07Z
|
| Hospital Charge Code |
3304
|
| 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
|
|
|
02RD07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD07Z
|
| Hospital Charge Code |
11082
|
| 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
|
|
|
02RD08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD08Z
|
| Hospital Charge Code |
3305
|
| 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
|
|
|
02RD08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD08Z
|
| Hospital Charge Code |
11083
|
| 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
|
|
|
02RD0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD0JZ
|
| Hospital Charge Code |
3306
|
| 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
|
|
|
02RD0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD0JZ
|
| Hospital Charge Code |
11084
|
| 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
|
|
|
02RD0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD0KZ
|
| Hospital Charge Code |
3307
|
| 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
|
|
|
02RD0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD0KZ
|
| Hospital Charge Code |
11085
|
| 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
|
|
|
02RD47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD47Z
|
| Hospital Charge Code |
11086
|
| 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
|
|
|
02RD47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD47Z
|
| Hospital Charge Code |
3308
|
| 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
|
|
|
02RD48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD48Z
|
| Hospital Charge Code |
11087
|
| 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
|
|
|
02RD48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD48Z
|
| Hospital Charge Code |
3309
|
| 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
|
|
|
02RD4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD4JZ
|
| Hospital Charge Code |
11088
|
| 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
|
|
|
02RD4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD4JZ
|
| Hospital Charge Code |
3310
|
| 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
|
|
|
02RD4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD4KZ
|
| Hospital Charge Code |
11089
|
| 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
|
|
|
02RD4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RD4KZ
|
| Hospital Charge Code |
3311
|
| 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
|
|
|
02RF07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RF07Z
|
| Hospital Charge Code |
11090
|
| 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
|
|