|
02160ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
327
|
| 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
|
|
|
02163Z7
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
328
|
| 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
|
|
|
021648P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
329
|
| 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
|
|
|
021648Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
330
|
| 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
|
|
|
021648R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
331
|
| 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
|
|
|
021649P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
332
|
| 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
|
|
|
021649Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
333
|
| 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
|
|
|
021649R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
334
|
| 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
|
|
|
02164AP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
335
|
| 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
|
|
|
02164AQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
336
|
| 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
|
|
|
02164AR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
337
|
| 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
|
|
|
02164JP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
338
|
| 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
|
|
|
02164JQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
339
|
| 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
|
|
|
02164JR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
340
|
| 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
|
|
|
02164KP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
341
|
| 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
|
|
|
02164KQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
342
|
| 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
|
|
|
02164KR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
343
|
| 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
|
|
|
02164Z7
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
344
|
| 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
|
|
|
02164ZP
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
345
|
| 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
|
|
|
02164ZQ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
346
|
| 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
|
|
|
02164ZR
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
347
|
| 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
|
|
|
021708P
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
348
|
| 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
|
|
|
021708Q
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
349
|
| 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
|
|
|
021708R
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
350
|
| 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
|
|
|
021708S
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
351
|
| 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
|
|
