|
0CHY71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHY71Z
|
| Hospital Charge Code |
4897
|
| 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
|
|
|
0CHY81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0CHY81Z
|
| Hospital Charge Code |
4898
|
| 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
|
|
|
0D16079
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D16079
|
| Hospital Charge Code |
4899
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D1607A
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D1607A
|
| Hospital Charge Code |
4900
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160J9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160J9
|
| Hospital Charge Code |
4901
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160JA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160JA
|
| Hospital Charge Code |
4902
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160K9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160K9
|
| Hospital Charge Code |
4903
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160KA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160KA
|
| Hospital Charge Code |
4904
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160Z9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160Z9
|
| Hospital Charge Code |
4905
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D160ZA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D160ZA
|
| Hospital Charge Code |
4906
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D16479
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D16479
|
| Hospital Charge Code |
4907
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D16479
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D16479
|
| Hospital Charge Code |
14243
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D1647A
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D1647A
|
| Hospital Charge Code |
14244
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D1647A
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D1647A
|
| Hospital Charge Code |
4908
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164J9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164J9
|
| Hospital Charge Code |
14247
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164J9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164J9
|
| Hospital Charge Code |
4909
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164JA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164JA
|
| Hospital Charge Code |
14248
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164JA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164JA
|
| Hospital Charge Code |
4910
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164K9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164K9
|
| Hospital Charge Code |
4911
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164K9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164K9
|
| Hospital Charge Code |
14252
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164KA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164KA
|
| Hospital Charge Code |
4912
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164KA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164KA
|
| Hospital Charge Code |
14253
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164Z9
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164Z9
|
| Hospital Charge Code |
4913
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164ZA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164ZA
|
| Hospital Charge Code |
14255
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
|
0D164ZA
|
Facility
|
IP
|
$12,050.00
|
|
|
Service Code
|
ICD 0D164ZA
|
| Hospital Charge Code |
4914
|
| Min. Negotiated Rate |
$12,050.00 |
| Max. Negotiated Rate |
$12,050.00 |
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,050.00
|
|
