|
02UA4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UA4KZ
|
| Hospital Charge Code |
1413
|
| 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
|
|
|
02UA4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UA4KZ
|
| Hospital Charge Code |
11290
|
| 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
|
|
|
02UD07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD07Z
|
| Hospital Charge Code |
3419
|
| 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
|
|
|
02UD07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD07Z
|
| Hospital Charge Code |
11291
|
| 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
|
|
|
02UD08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD08Z
|
| Hospital Charge Code |
3420
|
| 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
|
|
|
02UD08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD08Z
|
| Hospital Charge Code |
11292
|
| 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
|
|
|
02UD0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD0JZ
|
| Hospital Charge Code |
11293
|
| 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
|
|
|
02UD0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD0JZ
|
| Hospital Charge Code |
1414
|
| 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
|
|
|
02UD0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD0KZ
|
| Hospital Charge Code |
11294
|
| 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
|
|
|
02UD0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD0KZ
|
| Hospital Charge Code |
3421
|
| 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
|
|
|
02UD37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD37Z
|
| Hospital Charge Code |
3422
|
| 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
|
|
|
02UD37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD37Z
|
| Hospital Charge Code |
11295
|
| 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
|
|
|
02UD38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD38Z
|
| Hospital Charge Code |
11296
|
| 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
|
|
|
02UD38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD38Z
|
| Hospital Charge Code |
3423
|
| 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
|
|
|
02UD3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD3JZ
|
| Hospital Charge Code |
11297
|
| 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
|
|
|
02UD3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD3JZ
|
| Hospital Charge Code |
3424
|
| 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
|
|
|
02UD3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD3KZ
|
| Hospital Charge Code |
3425
|
| 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
|
|
|
02UD3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD3KZ
|
| Hospital Charge Code |
11298
|
| 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
|
|
|
02UD47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD47Z
|
| Hospital Charge Code |
11299
|
| 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
|
|
|
02UD47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD47Z
|
| Hospital Charge Code |
3426
|
| 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
|
|
|
02UD48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD48Z
|
| Hospital Charge Code |
11300
|
| 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
|
|
|
02UD48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD48Z
|
| Hospital Charge Code |
3427
|
| 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
|
|
|
02UD4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD4JZ
|
| Hospital Charge Code |
3428
|
| 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
|
|
|
02UD4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD4JZ
|
| Hospital Charge Code |
11301
|
| 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
|
|
|
02UD4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UD4KZ
|
| Hospital Charge Code |
3429
|
| 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
|
|