|
02UH07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH07Z
|
| Hospital Charge Code |
3454
|
| 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
|
|
|
02UH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH08Z
|
| Hospital Charge Code |
3455
|
| 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
|
|
|
02UH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH08Z
|
| Hospital Charge Code |
11328
|
| 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
|
|
|
02UH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH0JZ
|
| Hospital Charge Code |
11329
|
| 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
|
|
|
02UH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH0JZ
|
| Hospital Charge Code |
3456
|
| 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
|
|
|
02UH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH0KZ
|
| Hospital Charge Code |
3457
|
| 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
|
|
|
02UH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH0KZ
|
| Hospital Charge Code |
11330
|
| 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
|
|
|
02UH37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH37Z
|
| Hospital Charge Code |
11331
|
| 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
|
|
|
02UH37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH37Z
|
| Hospital Charge Code |
3458
|
| 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
|
|
|
02UH38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH38Z
|
| Hospital Charge Code |
3459
|
| 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
|
|
|
02UH38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH38Z
|
| Hospital Charge Code |
11332
|
| 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
|
|
|
02UH3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH3JZ
|
| Hospital Charge Code |
11333
|
| 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
|
|
|
02UH3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH3JZ
|
| Hospital Charge Code |
3460
|
| 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
|
|
|
02UH3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH3KZ
|
| Hospital Charge Code |
11334
|
| 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
|
|
|
02UH3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH3KZ
|
| Hospital Charge Code |
3461
|
| 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
|
|
|
02UH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH47Z
|
| Hospital Charge Code |
11335
|
| 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
|
|
|
02UH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH47Z
|
| Hospital Charge Code |
3462
|
| 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
|
|
|
02UH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH48Z
|
| Hospital Charge Code |
3463
|
| 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
|
|
|
02UH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH48Z
|
| Hospital Charge Code |
11336
|
| 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
|
|
|
02UH4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH4JZ
|
| Hospital Charge Code |
3464
|
| 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
|
|
|
02UH4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH4JZ
|
| Hospital Charge Code |
11337
|
| 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
|
|
|
02UH4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH4KZ
|
| Hospital Charge Code |
11338
|
| 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
|
|
|
02UH4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UH4KZ
|
| Hospital Charge Code |
3465
|
| 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
|
|
|
02UJ07G
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UJ07G
|
| Hospital Charge Code |
1440
|
| 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
|
|
|
02UJ07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UJ07Z
|
| Hospital Charge Code |
11339
|
| 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
|
|