|
0RG80K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG80K0
|
| Hospital Charge Code |
14645
|
| 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
|
|
|
0RG80K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG80K1
|
| Hospital Charge Code |
14646
|
| 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
|
|
|
0RG80KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG80KJ
|
| Hospital Charge Code |
14647
|
| 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
|
|
|
0RG8370
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG8370
|
| Hospital Charge Code |
14648
|
| 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
|
|
|
0RG8371
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG8371
|
| Hospital Charge Code |
14649
|
| 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
|
|
|
0RG837J
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG837J
|
| Hospital Charge Code |
14650
|
| 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
|
|
|
0RG83A0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83A0
|
| Hospital Charge Code |
14651
|
| 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
|
|
|
0RG83AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83AJ
|
| Hospital Charge Code |
14652
|
| 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
|
|
|
0RG83J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83J0
|
| Hospital Charge Code |
14653
|
| 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
|
|
|
0RG83J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83J1
|
| Hospital Charge Code |
14654
|
| 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
|
|
|
0RG83JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83JJ
|
| Hospital Charge Code |
14655
|
| 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
|
|
|
0RG83K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83K0
|
| Hospital Charge Code |
14656
|
| 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
|
|
|
0RG83K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83K1
|
| Hospital Charge Code |
14657
|
| 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
|
|
|
0RG83KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG83KJ
|
| Hospital Charge Code |
14658
|
| 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
|
|
|
0RG8470
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG8470
|
| Hospital Charge Code |
14659
|
| 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
|
|
|
0RG8471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG8471
|
| Hospital Charge Code |
2621
|
| 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
|
|
|
0RG8471
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RG8471
|
| Hospital Charge Code |
14660
|
| 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
|
|
|
0RGA0AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0AJ
|
| Hospital Charge Code |
14674
|
| 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
|
|
|
0RGA0AJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0AJ
|
| Hospital Charge Code |
2622
|
| 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
|
|
|
0RGA0J0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0J0
|
| Hospital Charge Code |
14675
|
| 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
|
|
|
0RGA0J1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0J1
|
| Hospital Charge Code |
14676
|
| 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
|
|
|
0RGA0JJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0JJ
|
| Hospital Charge Code |
14677
|
| 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
|
|
|
0RGA0K0
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0K0
|
| Hospital Charge Code |
14678
|
| 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
|
|
|
0RGA0K1
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0K1
|
| Hospital Charge Code |
14679
|
| 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
|
|
|
0RGA0KJ
|
Facility
|
IP
|
$15,839.00
|
|
|
Service Code
|
ICD 0RGA0KJ
|
| Hospital Charge Code |
14680
|
| 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
|
|