|
0WH001Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH001Z
|
| Hospital Charge Code |
5175
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH031Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH031Z
|
| Hospital Charge Code |
5176
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH041Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH041Z
|
| Hospital Charge Code |
5177
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH101Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH101Z
|
| Hospital Charge Code |
5178
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH131Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH131Z
|
| Hospital Charge Code |
5179
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH141Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH141Z
|
| Hospital Charge Code |
5180
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH201Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH201Z
|
| Hospital Charge Code |
5181
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH231Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH231Z
|
| Hospital Charge Code |
5182
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH241Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH241Z
|
| Hospital Charge Code |
5183
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH301Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH301Z
|
| Hospital Charge Code |
5184
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH331Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH331Z
|
| Hospital Charge Code |
5185
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH341Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH341Z
|
| Hospital Charge Code |
5186
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH401Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH401Z
|
| Hospital Charge Code |
5187
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH431Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH431Z
|
| Hospital Charge Code |
5188
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH441Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH441Z
|
| Hospital Charge Code |
5189
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH501Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH501Z
|
| Hospital Charge Code |
5190
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH531Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH531Z
|
| Hospital Charge Code |
5191
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH541Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH541Z
|
| Hospital Charge Code |
5192
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH601Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH601Z
|
| Hospital Charge Code |
5193
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH631Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH631Z
|
| Hospital Charge Code |
5194
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH641Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH641Z
|
| Hospital Charge Code |
5195
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH801Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH801Z
|
| Hospital Charge Code |
5196
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH831Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH831Z
|
| Hospital Charge Code |
5197
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH841Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH841Z
|
| Hospital Charge Code |
5198
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
|
0WH901Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WH901Z
|
| Hospital Charge Code |
5199
|
| Min. Negotiated Rate |
$9,120.00 |
| Max. Negotiated Rate |
$9,120.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,120.00
|
|
