|
02UL47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL47Z
|
| Hospital Charge Code |
3492
|
| 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
|
|
|
02UL48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL48Z
|
| Hospital Charge Code |
3493
|
| 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
|
|
|
02UL48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL48Z
|
| Hospital Charge Code |
11372
|
| 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
|
|
|
02UL4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL4JZ
|
| Hospital Charge Code |
11373
|
| 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
|
|
|
02UL4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL4JZ
|
| Hospital Charge Code |
3494
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL4KZ
|
| Hospital Charge Code |
11374
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UL4KZ
|
| Hospital Charge Code |
1458
|
| 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
|
|
|
02UM07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM07Z
|
| Hospital Charge Code |
3495
|
| 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
|
|
|
02UM07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM07Z
|
| Hospital Charge Code |
11375
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| Hospital Charge Code |
1459
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM08Z
|
| Hospital Charge Code |
11376
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM0JZ
|
| Hospital Charge Code |
11377
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM0JZ
|
| Hospital Charge Code |
1460
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM0KZ
|
| Hospital Charge Code |
11378
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM0KZ
|
| Hospital Charge Code |
1461
|
| 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
|
|
|
02UM37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM37Z
|
| Hospital Charge Code |
11379
|
| 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
|
|
|
02UM37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM37Z
|
| Hospital Charge Code |
3496
|
| 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
|
|
|
02UM38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM38Z
|
| Hospital Charge Code |
11380
|
| 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
|
|
|
02UM38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM38Z
|
| Hospital Charge Code |
3497
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM3JZ
|
| Hospital Charge Code |
1462
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM3JZ
|
| Hospital Charge Code |
11381
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM3KZ
|
| Hospital Charge Code |
1463
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM3KZ
|
| Hospital Charge Code |
11382
|
| 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
|
|
|
02UM47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM47Z
|
| Hospital Charge Code |
3498
|
| 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
|
|
|
02UM47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM47Z
|
| Hospital Charge Code |
11383
|
| 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
|
|