|
02UM48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM48Z
|
| Hospital Charge Code |
3499
|
| 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
|
|
|
02UM48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM48Z
|
| Hospital Charge Code |
11384
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM4JZ
|
| Hospital Charge Code |
1464
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM4JZ
|
| Hospital Charge Code |
11385
|
| 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
|
|
|
02UM4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM4KZ
|
| Hospital Charge Code |
11386
|
| 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
|
|
|
02UM4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UM4KZ
|
| Hospital Charge Code |
1465
|
| 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
|
|
|
02UN07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN07Z
|
| Hospital Charge Code |
3500
|
| 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
|
|
|
02UN07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN07Z
|
| Hospital Charge Code |
11387
|
| 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
|
|
|
02UN08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN08Z
|
| Hospital Charge Code |
3501
|
| 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
|
|
|
02UN08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN08Z
|
| Hospital Charge Code |
11388
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN0JZ
|
| Hospital Charge Code |
11389
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN0JZ
|
| Hospital Charge Code |
1466
|
| 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
|
|
|
02UN0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN0KZ
|
| Hospital Charge Code |
3502
|
| 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
|
|
|
02UN0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN0KZ
|
| Hospital Charge Code |
11390
|
| 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
|
|
|
02UN37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN37Z
|
| Hospital Charge Code |
11391
|
| 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
|
|
|
02UN37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN37Z
|
| Hospital Charge Code |
3503
|
| 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
|
|
|
02UN38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN38Z
|
| Hospital Charge Code |
3504
|
| 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
|
|
|
02UN38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN38Z
|
| Hospital Charge Code |
11392
|
| 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
|
|
|
02UN3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN3JZ
|
| Hospital Charge Code |
3505
|
| 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
|
|
|
02UN3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN3JZ
|
| Hospital Charge Code |
11393
|
| 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
|
|
|
02UN3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN3KZ
|
| Hospital Charge Code |
3506
|
| 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
|
|
|
02UN3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN3KZ
|
| Hospital Charge Code |
11394
|
| 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
|
|
|
02UN47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN47Z
|
| Hospital Charge Code |
3507
|
| 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
|
|
|
02UN47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN47Z
|
| Hospital Charge Code |
11395
|
| 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
|
|
|
02UN48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN48Z
|
| Hospital Charge Code |
3508
|
| 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
|
|