|
02WF0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF0KZ
|
| Hospital Charge Code |
3537
|
| 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
|
|
|
02WF0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF0KZ
|
| Hospital Charge Code |
11507
|
| 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
|
|
|
02WF37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF37Z
|
| Hospital Charge Code |
1524
|
| 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
|
|
|
02WF38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF38Z
|
| Hospital Charge Code |
1525
|
| 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
|
|
|
02WF3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF3JZ
|
| Hospital Charge Code |
1526
|
| 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
|
|
|
02WF3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF3KZ
|
| Hospital Charge Code |
1527
|
| 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
|
|
|
02WF47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF47Z
|
| Hospital Charge Code |
3538
|
| 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
|
|
|
02WF47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF47Z
|
| Hospital Charge Code |
11508
|
| 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
|
|
|
02WF48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF48Z
|
| Hospital Charge Code |
11509
|
| 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
|
|
|
02WF48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF48Z
|
| Hospital Charge Code |
3539
|
| 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
|
|
|
02WF4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF4JZ
|
| Hospital Charge Code |
11510
|
| 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
|
|
|
02WF4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF4JZ
|
| Hospital Charge Code |
3540
|
| 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
|
|
|
02WF4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF4KZ
|
| Hospital Charge Code |
3541
|
| 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
|
|
|
02WF4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WF4KZ
|
| Hospital Charge Code |
11511
|
| 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
|
|
|
02WG07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG07Z
|
| Hospital Charge Code |
3542
|
| 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
|
|
|
02WG07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG07Z
|
| Hospital Charge Code |
11512
|
| 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
|
|
|
02WG08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG08Z
|
| Hospital Charge Code |
3543
|
| 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
|
|
|
02WG08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG08Z
|
| Hospital Charge Code |
11513
|
| 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
|
|
|
02WG0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG0JZ
|
| Hospital Charge Code |
11514
|
| 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
|
|
|
02WG0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG0JZ
|
| Hospital Charge Code |
3544
|
| 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
|
|
|
02WG0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG0KZ
|
| Hospital Charge Code |
11515
|
| 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
|
|
|
02WG0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG0KZ
|
| Hospital Charge Code |
3545
|
| 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
|
|
|
02WG37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG37Z
|
| Hospital Charge Code |
1528
|
| 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
|
|
|
02WG38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG38Z
|
| Hospital Charge Code |
1529
|
| 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
|
|
|
02WG3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG3JZ
|
| Hospital Charge Code |
1530
|
| 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
|
|