|
0BH071Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BH071Z
|
| Hospital Charge Code |
4872
|
| 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
|
|
|
0BH081Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BH081Z
|
| Hospital Charge Code |
4873
|
| 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
|
|
|
0BHK01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHK01Z
|
| Hospital Charge Code |
4874
|
| 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
|
|
|
0BHK31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHK31Z
|
| Hospital Charge Code |
4875
|
| 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
|
|
|
0BHK41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHK41Z
|
| Hospital Charge Code |
4876
|
| 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
|
|
|
0BHK71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHK71Z
|
| Hospital Charge Code |
4877
|
| 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
|
|
|
0BHK81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHK81Z
|
| Hospital Charge Code |
4878
|
| 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
|
|
|
0BHL01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHL01Z
|
| Hospital Charge Code |
4879
|
| 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
|
|
|
0BHL31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHL31Z
|
| Hospital Charge Code |
4880
|
| 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
|
|
|
0BHL41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHL41Z
|
| Hospital Charge Code |
4881
|
| 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
|
|
|
0BHL71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHL71Z
|
| Hospital Charge Code |
4882
|
| 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
|
|
|
0BHL81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0BHL81Z
|
| Hospital Charge Code |
4883
|
| 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
|
|
|
0CH701Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CH701Z
|
| Hospital Charge Code |
4884
|
| 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
|
|
|
0CH731Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CH731Z
|
| Hospital Charge Code |
4885
|
| 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
|
|
|
0CH7X1Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CH7X1Z
|
| Hospital Charge Code |
4886
|
| 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
|
|
|
0CHA01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHA01Z
|
| Hospital Charge Code |
4887
|
| 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
|
|
|
0CHA31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHA31Z
|
| Hospital Charge Code |
4888
|
| 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
|
|
|
0CHA71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHA71Z
|
| Hospital Charge Code |
4889
|
| 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
|
|
|
0CHA81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHA81Z
|
| Hospital Charge Code |
4890
|
| 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
|
|
|
0CHS01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHS01Z
|
| Hospital Charge Code |
4891
|
| 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
|
|
|
0CHS31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHS31Z
|
| Hospital Charge Code |
4892
|
| 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
|
|
|
0CHS71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHS71Z
|
| Hospital Charge Code |
4893
|
| 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
|
|
|
0CHS81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHS81Z
|
| Hospital Charge Code |
4894
|
| 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
|
|
|
0CHY01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHY01Z
|
| Hospital Charge Code |
4895
|
| 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
|
|
|
0CHY31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHY31Z
|
| Hospital Charge Code |
4896
|
| 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
|
|
