|
0FHD71Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0FHD71Z
|
| Hospital Charge Code |
4969
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0FHD81Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0FHD81Z
|
| Hospital Charge Code |
4970
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0FHG01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0FHG01Z
|
| Hospital Charge Code |
4971
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0FHG31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0FHG31Z
|
| Hospital Charge Code |
4972
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0FHG41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0FHG41Z
|
| Hospital Charge Code |
4973
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0GHS01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0GHS01Z
|
| Hospital Charge Code |
4974
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0GHS31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0GHS31Z
|
| Hospital Charge Code |
4975
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0GHS41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0GHS41Z
|
| Hospital Charge Code |
4976
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHT01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHT01Z
|
| Hospital Charge Code |
4977
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHT31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHT31Z
|
| Hospital Charge Code |
4978
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHT71Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHT71Z
|
| Hospital Charge Code |
4979
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHTX1Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHTX1Z
|
| Hospital Charge Code |
4980
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHU01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHU01Z
|
| Hospital Charge Code |
4981
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHU31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHU31Z
|
| Hospital Charge Code |
4982
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHU71Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHU71Z
|
| Hospital Charge Code |
4983
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHUX1Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHUX1Z
|
| Hospital Charge Code |
4984
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHV01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHV01Z
|
| Hospital Charge Code |
4985
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHV31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHV31Z
|
| Hospital Charge Code |
4986
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHV71Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHV71Z
|
| Hospital Charge Code |
4987
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHVX1Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHVX1Z
|
| Hospital Charge Code |
4988
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHW01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHW01Z
|
| Hospital Charge Code |
4989
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHW31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHW31Z
|
| Hospital Charge Code |
4990
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHW71Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHW71Z
|
| Hospital Charge Code |
4991
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHWX1Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHWX1Z
|
| Hospital Charge Code |
4992
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
|
0HHX01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0HHX01Z
|
| Hospital Charge Code |
4993
|
| Min. Negotiated Rate |
$8,769.00 |
| Max. Negotiated Rate |
$8,769.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,769.00
|
|
