|
07HK31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HK31Z
|
| Hospital Charge Code |
4820
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HK41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HK41Z
|
| Hospital Charge Code |
4821
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HL01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HL01Z
|
| Hospital Charge Code |
4822
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HL31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HL31Z
|
| Hospital Charge Code |
4823
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HL41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HL41Z
|
| Hospital Charge Code |
4824
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HM01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HM01Z
|
| Hospital Charge Code |
4825
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HM31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HM31Z
|
| Hospital Charge Code |
4826
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HM41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HM41Z
|
| Hospital Charge Code |
4827
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HN01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HN01Z
|
| Hospital Charge Code |
4828
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HN31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HN31Z
|
| Hospital Charge Code |
4829
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HN41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HN41Z
|
| Hospital Charge Code |
4830
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HP01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HP01Z
|
| Hospital Charge Code |
4831
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HP31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HP31Z
|
| Hospital Charge Code |
4832
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HP41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HP41Z
|
| Hospital Charge Code |
4833
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HT01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HT01Z
|
| Hospital Charge Code |
4834
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HT31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HT31Z
|
| Hospital Charge Code |
4835
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
07HT41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 07HT41Z
|
| Hospital Charge Code |
4836
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
08H031Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 08H031Z
|
| Hospital Charge Code |
4837
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
08H0X1Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 08H0X1Z
|
| Hospital Charge Code |
4838
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
08H131Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 08H131Z
|
| Hospital Charge Code |
4839
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
08H1X1Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 08H1X1Z
|
| Hospital Charge Code |
4840
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
09HD01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 09HD01Z
|
| Hospital Charge Code |
4841
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
09HD05Z
|
Facility
|
IP
|
$31,070.00
|
|
|
Service Code
|
ICD 09HD05Z
|
| Hospital Charge Code |
2502
|
| Min. Negotiated Rate |
$31,070.00 |
| Max. Negotiated Rate |
$31,070.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,070.00
|
|
|
09HD06Z
|
Facility
|
IP
|
$31,070.00
|
|
|
Service Code
|
ICD 09HD06Z
|
| Hospital Charge Code |
2503
|
| Min. Negotiated Rate |
$31,070.00 |
| Max. Negotiated Rate |
$31,070.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,070.00
|
|
|
09HD0SZ
|
Facility
|
IP
|
$31,070.00
|
|
|
Service Code
|
ICD 09HD0SZ
|
| Hospital Charge Code |
2504
|
| Min. Negotiated Rate |
$31,070.00 |
| Max. Negotiated Rate |
$31,070.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,070.00
|
|
