|
0RG44KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG44KJ
|
| Hospital Charge Code |
14570
|
| 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
|
|
|
0RG6070
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6070
|
| Hospital Charge Code |
14571
|
| 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
|
|
|
0RG6071
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6071
|
| Hospital Charge Code |
14572
|
| 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
|
|
|
0RG607J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG607J
|
| Hospital Charge Code |
14573
|
| 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
|
|
|
0RG60A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60A0
|
| Hospital Charge Code |
14574
|
| 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
|
|
|
0RG60AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60AJ
|
| Hospital Charge Code |
14575
|
| 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
|
|
|
0RG60J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60J0
|
| Hospital Charge Code |
14576
|
| 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
|
|
|
0RG60J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60J1
|
| Hospital Charge Code |
14577
|
| 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
|
|
|
0RG60JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60JJ
|
| Hospital Charge Code |
14578
|
| 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
|
|
|
0RG60K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60K0
|
| Hospital Charge Code |
14579
|
| 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
|
|
|
0RG60K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60K1
|
| Hospital Charge Code |
14580
|
| 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
|
|
|
0RG60KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG60KJ
|
| Hospital Charge Code |
14581
|
| 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
|
|
|
0RG6370
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6370
|
| Hospital Charge Code |
14582
|
| 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
|
|
|
0RG6371
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6371
|
| Hospital Charge Code |
14583
|
| 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
|
|
|
0RG637J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG637J
|
| Hospital Charge Code |
14584
|
| 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
|
|
|
0RG63A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63A0
|
| Hospital Charge Code |
14585
|
| 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
|
|
|
0RG63AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63AJ
|
| Hospital Charge Code |
14586
|
| 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
|
|
|
0RG63J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63J0
|
| Hospital Charge Code |
14587
|
| 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
|
|
|
0RG63J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63J1
|
| Hospital Charge Code |
14588
|
| 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
|
|
|
0RG63JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63JJ
|
| Hospital Charge Code |
14589
|
| 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
|
|
|
0RG63K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63K0
|
| Hospital Charge Code |
14590
|
| 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
|
|
|
0RG63K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63K1
|
| Hospital Charge Code |
14591
|
| 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
|
|
|
0RG63KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG63KJ
|
| Hospital Charge Code |
14592
|
| 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
|
|
|
0RG6470
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6470
|
| Hospital Charge Code |
14593
|
| 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
|
|
|
0RG6471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG6471
|
| Hospital Charge Code |
14594
|
| 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
|
|