|
0WHD4YZ
|
Facility
|
IP
|
$10,777.00
|
|
|
Service Code
|
ICD 0WHD4YZ
|
| Hospital Charge Code |
5212
|
| 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
|
|
|
0WHF01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHF01Z
|
| Hospital Charge Code |
5213
|
| 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
|
|
|
0WHF31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHF31Z
|
| Hospital Charge Code |
5214
|
| 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
|
|
|
0WHF41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHF41Z
|
| Hospital Charge Code |
5215
|
| 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
|
|
|
0WHG01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHG01Z
|
| Hospital Charge Code |
5216
|
| 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
|
|
|
0WHG31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHG31Z
|
| Hospital Charge Code |
5217
|
| 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
|
|
|
0WHG41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHG41Z
|
| Hospital Charge Code |
5218
|
| 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
|
|
|
0WHH01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHH01Z
|
| Hospital Charge Code |
5219
|
| 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
|
|
|
0WHH31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHH31Z
|
| Hospital Charge Code |
5220
|
| 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
|
|
|
0WHH41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHH41Z
|
| Hospital Charge Code |
5221
|
| 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
|
|
|
0WHJ01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHJ01Z
|
| Hospital Charge Code |
5222
|
| 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
|
|
|
0WHJ31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHJ31Z
|
| Hospital Charge Code |
5223
|
| 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
|
|
|
0WHJ41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHJ41Z
|
| Hospital Charge Code |
5224
|
| 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
|
|
|
0WHK01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHK01Z
|
| Hospital Charge Code |
5225
|
| 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
|
|
|
0WHK31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHK31Z
|
| Hospital Charge Code |
5226
|
| 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
|
|
|
0WHK41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHK41Z
|
| Hospital Charge Code |
5227
|
| 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
|
|
|
0WHL01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHL01Z
|
| Hospital Charge Code |
5228
|
| 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
|
|
|
0WHL31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHL31Z
|
| Hospital Charge Code |
5229
|
| 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
|
|
|
0WHL41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHL41Z
|
| Hospital Charge Code |
5230
|
| 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
|
|
|
0WHM01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHM01Z
|
| Hospital Charge Code |
5231
|
| 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
|
|
|
0WHM31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHM31Z
|
| Hospital Charge Code |
5232
|
| 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
|
|
|
0WHM41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHM41Z
|
| Hospital Charge Code |
5233
|
| 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
|
|
|
0WHN01Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHN01Z
|
| Hospital Charge Code |
5234
|
| 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
|
|
|
0WHN31Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHN31Z
|
| Hospital Charge Code |
5235
|
| 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
|
|
|
0WHN41Z
|
Facility
|
IP
|
$8,769.00
|
|
|
Service Code
|
ICD 0WHN41Z
|
| Hospital Charge Code |
5236
|
| 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
|
|
