|
02160AQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160AQ
|
| Hospital Charge Code |
10271
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160AQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160AQ
|
| Hospital Charge Code |
316
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160AR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160AR
|
| Hospital Charge Code |
10272
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160AR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160AR
|
| Hospital Charge Code |
317
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JP
|
| Hospital Charge Code |
10273
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JP
|
| Hospital Charge Code |
318
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JQ
|
| Hospital Charge Code |
10274
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JQ
|
| Hospital Charge Code |
319
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JR
|
| Hospital Charge Code |
320
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160JR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160JR
|
| Hospital Charge Code |
10275
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KP
|
| Hospital Charge Code |
10276
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KP
|
| Hospital Charge Code |
321
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KQ
|
| Hospital Charge Code |
322
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KQ
|
| Hospital Charge Code |
10277
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KR
|
| Hospital Charge Code |
323
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160KR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160KR
|
| Hospital Charge Code |
10278
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160Z7
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160Z7
|
| Hospital Charge Code |
10279
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160Z7
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160Z7
|
| Hospital Charge Code |
324
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZP
|
| Hospital Charge Code |
10280
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZP
|
| Hospital Charge Code |
325
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZQ
|
| Hospital Charge Code |
326
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZQ
|
| Hospital Charge Code |
10281
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZR
|
| Hospital Charge Code |
10282
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02160ZR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02160ZR
|
| Hospital Charge Code |
327
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02163Z7
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02163Z7
|
| Hospital Charge Code |
328
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|