|
02WG3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG3KZ
|
| Hospital Charge Code |
1531
|
| 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
|
|
|
02WG47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG47Z
|
| Hospital Charge Code |
3546
|
| 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
|
|
|
02WG47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG47Z
|
| Hospital Charge Code |
11516
|
| 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
|
|
|
02WG48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG48Z
|
| Hospital Charge Code |
3547
|
| 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
|
|
|
02WG48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG48Z
|
| Hospital Charge Code |
11517
|
| 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
|
|
|
02WG4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG4JZ
|
| Hospital Charge Code |
3548
|
| 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
|
|
|
02WG4JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG4JZ
|
| Hospital Charge Code |
11518
|
| 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
|
|
|
02WG4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG4KZ
|
| Hospital Charge Code |
3549
|
| 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
|
|
|
02WG4KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WG4KZ
|
| Hospital Charge Code |
11519
|
| 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
|
|
|
02WH07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH07Z
|
| Hospital Charge Code |
3550
|
| 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
|
|
|
02WH07Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH07Z
|
| Hospital Charge Code |
11520
|
| 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
|
|
|
02WH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH08Z
|
| Hospital Charge Code |
3551
|
| 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
|
|
|
02WH08Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH08Z
|
| Hospital Charge Code |
11521
|
| 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
|
|
|
02WH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH0JZ
|
| Hospital Charge Code |
11522
|
| 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
|
|
|
02WH0JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH0JZ
|
| Hospital Charge Code |
3552
|
| 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
|
|
|
02WH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH0KZ
|
| Hospital Charge Code |
3553
|
| 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
|
|
|
02WH0KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH0KZ
|
| Hospital Charge Code |
11523
|
| 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
|
|
|
02WH37Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH37Z
|
| Hospital Charge Code |
1532
|
| 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
|
|
|
02WH38Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH38Z
|
| Hospital Charge Code |
1533
|
| 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
|
|
|
02WH3JZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH3JZ
|
| Hospital Charge Code |
1534
|
| 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
|
|
|
02WH3KZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH3KZ
|
| Hospital Charge Code |
1535
|
| 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
|
|
|
02WH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH47Z
|
| Hospital Charge Code |
11524
|
| 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
|
|
|
02WH47Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH47Z
|
| Hospital Charge Code |
3554
|
| 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
|
|
|
02WH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH48Z
|
| Hospital Charge Code |
3555
|
| 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
|
|
|
02WH48Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02WH48Z
|
| Hospital Charge Code |
11525
|
| 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
|
|