|
02RM4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RM4JZ
|
| Hospital Charge Code |
1328
|
| 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
|
|
|
02RN07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN07Z
|
| Hospital Charge Code |
11149
|
| 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
|
|
|
02RN07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN07Z
|
| Hospital Charge Code |
3360
|
| 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
|
|
|
02RN08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN08Z
|
| Hospital Charge Code |
11150
|
| 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
|
|
|
02RN08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN08Z
|
| Hospital Charge Code |
3361
|
| 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
|
|
|
02RN0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN0JZ
|
| Hospital Charge Code |
11151
|
| 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
|
|
|
02RN0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN0JZ
|
| Hospital Charge Code |
3362
|
| 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
|
|
|
02RN0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN0KZ
|
| Hospital Charge Code |
11152
|
| 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
|
|
|
02RN0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN0KZ
|
| Hospital Charge Code |
3363
|
| 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
|
|
|
02RN47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN47Z
|
| Hospital Charge Code |
11153
|
| 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
|
|
|
02RN47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN47Z
|
| Hospital Charge Code |
3364
|
| 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
|
|
|
02RN48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN48Z
|
| Hospital Charge Code |
11154
|
| 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
|
|
|
02RN48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN48Z
|
| Hospital Charge Code |
3365
|
| 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
|
|
|
02RN4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN4JZ
|
| Hospital Charge Code |
3366
|
| 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
|
|
|
02RN4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN4JZ
|
| Hospital Charge Code |
11155
|
| 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
|
|
|
02RN4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN4KZ
|
| Hospital Charge Code |
3367
|
| 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
|
|
|
02RN4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RN4KZ
|
| Hospital Charge Code |
11156
|
| 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
|
|
|
02RP0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RP0JZ
|
| Hospital Charge Code |
11159
|
| 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
|
|
|
02RP0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RP0JZ
|
| Hospital Charge Code |
1330
|
| 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
|
|
|
02RQ07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RQ07Z
|
| Hospital Charge Code |
1331
|
| 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
|
|
|
02RQ07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RQ07Z
|
| Hospital Charge Code |
11165
|
| 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
|
|
|
02RQ0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RQ0JZ
|
| Hospital Charge Code |
11167
|
| 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
|
|
|
02RQ0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RQ0JZ
|
| Hospital Charge Code |
1332
|
| 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
|
|
|
02RR07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RR07Z
|
| Hospital Charge Code |
11173
|
| 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
|
|
|
02RR07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02RR07Z
|
| Hospital Charge Code |
1333
|
| 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
|
|