|
0RG00J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG00J1
|
| Hospital Charge Code |
14445
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG00JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG00JJ
|
| Hospital Charge Code |
14446
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG00K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG00K0
|
| Hospital Charge Code |
14447
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG00K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG00K1
|
| Hospital Charge Code |
14448
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG00KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG00KJ
|
| Hospital Charge Code |
14449
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG0370
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG0370
|
| Hospital Charge Code |
14450
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG0371
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG0371
|
| Hospital Charge Code |
14451
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG037J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG037J
|
| Hospital Charge Code |
14452
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03A0
|
| Hospital Charge Code |
14453
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03AJ
|
| Hospital Charge Code |
14454
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03J0
|
| Hospital Charge Code |
14455
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03J1
|
| Hospital Charge Code |
14456
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03JJ
|
| Hospital Charge Code |
14457
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03K0
|
| Hospital Charge Code |
14458
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03K1
|
| Hospital Charge Code |
14459
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG03KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG03KJ
|
| Hospital Charge Code |
14460
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG0470
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG0470
|
| Hospital Charge Code |
14461
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG0471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG0471
|
| Hospital Charge Code |
14462
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG047J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG047J
|
| Hospital Charge Code |
14463
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04A0
|
| Hospital Charge Code |
14464
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04AJ
|
| Hospital Charge Code |
14465
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04J0
|
| Hospital Charge Code |
14466
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04J1
|
| Hospital Charge Code |
14467
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04JJ
|
| Hospital Charge Code |
14468
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|
|
0RG04K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG04K0
|
| Hospital Charge Code |
14469
|
| Min. Negotiated Rate |
$15,839.00 |
| Max. Negotiated Rate |
$15,839.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,839.00
|
|