|
0RG40JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG40JJ
|
| Hospital Charge Code |
14545
|
| 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
|
|
|
0RG40K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG40K0
|
| Hospital Charge Code |
14546
|
| 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
|
|
|
0RG40K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG40K1
|
| Hospital Charge Code |
14547
|
| 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
|
|
|
0RG40KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG40KJ
|
| Hospital Charge Code |
14548
|
| 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
|
|
|
0RG4370
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG4370
|
| Hospital Charge Code |
14549
|
| 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
|
|
|
0RG4371
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG4371
|
| Hospital Charge Code |
14550
|
| 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
|
|
|
0RG437J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG437J
|
| Hospital Charge Code |
14551
|
| 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
|
|
|
0RG43A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43A0
|
| Hospital Charge Code |
14552
|
| 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
|
|
|
0RG43AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43AJ
|
| Hospital Charge Code |
14553
|
| 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
|
|
|
0RG43J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43J0
|
| Hospital Charge Code |
14554
|
| 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
|
|
|
0RG43J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43J1
|
| Hospital Charge Code |
14555
|
| 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
|
|
|
0RG43JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43JJ
|
| Hospital Charge Code |
14556
|
| 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
|
|
|
0RG43K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43K0
|
| Hospital Charge Code |
14557
|
| 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
|
|
|
0RG43K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43K1
|
| Hospital Charge Code |
14558
|
| 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
|
|
|
0RG43KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG43KJ
|
| Hospital Charge Code |
14559
|
| 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
|
|
|
0RG4470
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG4470
|
| Hospital Charge Code |
14560
|
| 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
|
|
|
0RG4471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG4471
|
| Hospital Charge Code |
14561
|
| 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
|
|
|
0RG447J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG447J
|
| Hospital Charge Code |
14562
|
| 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
|
|
|
0RG44A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44A0
|
| Hospital Charge Code |
14563
|
| 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
|
|
|
0RG44AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44AJ
|
| Hospital Charge Code |
14564
|
| 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
|
|
|
0RG44J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44J0
|
| Hospital Charge Code |
14565
|
| 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
|
|
|
0RG44J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44J1
|
| Hospital Charge Code |
14566
|
| 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
|
|
|
0RG44JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44JJ
|
| Hospital Charge Code |
14567
|
| 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
|
|
|
0RG44K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44K0
|
| Hospital Charge Code |
14568
|
| 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
|
|
|
0RG44K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44K1
|
| Hospital Charge Code |
14569
|
| 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
|
|