|
02RG4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RG4KZ
|
| Hospital Charge Code |
3334
|
| 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
|
|
|
02RH07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH07Z
|
| Hospital Charge Code |
11110
|
| 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
|
|
|
02RH07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH07Z
|
| Hospital Charge Code |
3335
|
| 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
|
|
|
02RH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH08Z
|
| Hospital Charge Code |
3336
|
| 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
|
|
|
02RH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH08Z
|
| Hospital Charge Code |
11111
|
| 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
|
|
|
02RH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH0JZ
|
| Hospital Charge Code |
11112
|
| 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
|
|
|
02RH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH0JZ
|
| Hospital Charge Code |
3337
|
| 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
|
|
|
02RH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH0KZ
|
| Hospital Charge Code |
3338
|
| 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
|
|
|
02RH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH0KZ
|
| Hospital Charge Code |
11113
|
| 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
|
|
|
02RH37H
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH37H
|
| Hospital Charge Code |
3339
|
| 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
|
|
|
02RH37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH37Z
|
| Hospital Charge Code |
3340
|
| 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
|
|
|
02RH38H
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH38H
|
| Hospital Charge Code |
3341
|
| 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
|
|
|
02RH38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH38Z
|
| Hospital Charge Code |
3342
|
| 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
|
|
|
02RH3JH
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH3JH
|
| Hospital Charge Code |
1304
|
| 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
|
|
|
02RH3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH3JZ
|
| Hospital Charge Code |
3343
|
| 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
|
|
|
02RH3KH
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH3KH
|
| Hospital Charge Code |
3344
|
| 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
|
|
|
02RH3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH3KZ
|
| Hospital Charge Code |
3345
|
| 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
|
|
|
02RH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH47Z
|
| Hospital Charge Code |
11114
|
| 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
|
|
|
02RH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH47Z
|
| Hospital Charge Code |
3346
|
| 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
|
|
|
02RH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH48Z
|
| Hospital Charge Code |
3347
|
| 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
|
|
|
02RH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH48Z
|
| Hospital Charge Code |
11115
|
| 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
|
|
|
02RH4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH4JZ
|
| Hospital Charge Code |
11116
|
| 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
|
|
|
02RH4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH4JZ
|
| Hospital Charge Code |
1305
|
| 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
|
|
|
02RH4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH4KZ
|
| Hospital Charge Code |
3348
|
| 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
|
|
|
02RH4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RH4KZ
|
| Hospital Charge Code |
11117
|
| 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
|
|