|
0RG1471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG1471
|
| Hospital Charge Code |
14495
|
| 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
|
|
|
0RG147J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG147J
|
| Hospital Charge Code |
14496
|
| 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
|
|
|
0RG14A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14A0
|
| Hospital Charge Code |
14497
|
| 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
|
|
|
0RG14AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14AJ
|
| Hospital Charge Code |
14498
|
| 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
|
|
|
0RG14J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14J0
|
| Hospital Charge Code |
14499
|
| 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
|
|
|
0RG14J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14J1
|
| Hospital Charge Code |
14500
|
| 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
|
|
|
0RG14JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14JJ
|
| Hospital Charge Code |
14501
|
| 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
|
|
|
0RG14K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14K0
|
| Hospital Charge Code |
14502
|
| 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
|
|
|
0RG14K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14K1
|
| Hospital Charge Code |
14503
|
| 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
|
|
|
0RG14KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG14KJ
|
| Hospital Charge Code |
14504
|
| 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
|
|
|
0RG2070
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG2070
|
| Hospital Charge Code |
14505
|
| 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
|
|
|
0RG2071
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG2071
|
| Hospital Charge Code |
14506
|
| 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
|
|
|
0RG207J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG207J
|
| Hospital Charge Code |
14507
|
| 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
|
|
|
0RG20A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20A0
|
| Hospital Charge Code |
14508
|
| 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
|
|
|
0RG20AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20AJ
|
| Hospital Charge Code |
14509
|
| 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
|
|
|
0RG20J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20J0
|
| Hospital Charge Code |
14510
|
| 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
|
|
|
0RG20J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20J1
|
| Hospital Charge Code |
14511
|
| 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
|
|
|
0RG20JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20JJ
|
| Hospital Charge Code |
14512
|
| 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
|
|
|
0RG20K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20K0
|
| Hospital Charge Code |
14513
|
| 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
|
|
|
0RG20K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20K1
|
| Hospital Charge Code |
14514
|
| 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
|
|
|
0RG20KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG20KJ
|
| Hospital Charge Code |
14515
|
| 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
|
|
|
0RG2370
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG2370
|
| Hospital Charge Code |
14516
|
| 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
|
|
|
0RG2371
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG2371
|
| Hospital Charge Code |
14517
|
| 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
|
|
|
0RG237J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG237J
|
| Hospital Charge Code |
14518
|
| 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
|
|
|
0RG23A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG23A0
|
| Hospital Charge Code |
14519
|
| 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
|
|