|
02134KF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2896
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134KW
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2897
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134Z3
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
307
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134Z8
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
308
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134Z9
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2898
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134ZC
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2899
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02134ZF
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
2900
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021608P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
309
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021608Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
310
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021608R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
311
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021609P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
312
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021609Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
313
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
021609R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
314
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
315
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
316
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
317
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
318
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
319
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
320
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
321
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
322
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
323
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160Z7
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
324
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
325
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02160ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
326
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
