|
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
|
|
|
02UN4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN4JZ
|
| Hospital Charge Code |
11397
|
| 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
|
|
|
02UN4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN4JZ
|
| Hospital Charge Code |
3509
|
| 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
|
|
|
02UN4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN4KZ
|
| Hospital Charge Code |
11398
|
| 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
|
|
|
02UN4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UN4KZ
|
| Hospital Charge Code |
3510
|
| 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
|
|
|
02UW3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UW3JZ
|
| Hospital Charge Code |
11458
|
| 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
|
|
|
02UW3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UW3JZ
|
| Hospital Charge Code |
1467
|
| 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
|
|
|
02UW4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UW4JZ
|
| Hospital Charge Code |
1468
|
| 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
|
|
|
02UW4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UW4JZ
|
| Hospital Charge Code |
11462
|
| 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
|
|
|
02UX3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UX3JZ
|
| Hospital Charge Code |
1469
|
| 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
|
|
|
02UX4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02UX4JZ
|
| Hospital Charge Code |
1470
|
| 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
|
|
|
02VA0CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA0CZ
|
| Hospital Charge Code |
1471
|
| 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
|
|
|
02VA0CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA0CZ
|
| Hospital Charge Code |
11464
|
| 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
|
|
|
02VA0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA0ZZ
|
| Hospital Charge Code |
3511
|
| 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
|
|
|
02VA0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA0ZZ
|
| Hospital Charge Code |
11465
|
| 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
|
|
|
02VA3CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA3CZ
|
| Hospital Charge Code |
11466
|
| 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
|
|
|
02VA3CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA3CZ
|
| Hospital Charge Code |
3512
|
| 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
|
|
|
02VA3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA3ZZ
|
| Hospital Charge Code |
11467
|
| 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
|
|
|
02VA3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA3ZZ
|
| Hospital Charge Code |
3513
|
| 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
|
|
|
02VA4CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA4CZ
|
| Hospital Charge Code |
3514
|
| 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
|
|
|
02VA4CZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA4CZ
|
| Hospital Charge Code |
11468
|
| 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
|
|
|
02VA4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA4ZZ
|
| Hospital Charge Code |
11469
|
| 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
|
|
|
02VA4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VA4ZZ
|
| Hospital Charge Code |
3515
|
| 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
|
|
|
02VG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VG0ZZ
|
| Hospital Charge Code |
1472
|
| 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
|
|
|
02VG3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02VG3ZZ
|
| Hospital Charge Code |
1473
|
| 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
|
|