|
0WHP71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHP71Z
|
| Hospital Charge Code |
5240
|
| 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
|
|
|
0WHP81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHP81Z
|
| Hospital Charge Code |
5241
|
| 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
|
|
|
0WHQ01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHQ01Z
|
| Hospital Charge Code |
5242
|
| 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
|
|
|
0WHQ31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHQ31Z
|
| Hospital Charge Code |
5243
|
| 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
|
|
|
0WHQ41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHQ41Z
|
| Hospital Charge Code |
5244
|
| 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
|
|
|
0WHQ71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHQ71Z
|
| Hospital Charge Code |
5245
|
| 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
|
|
|
0WHQ81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHQ81Z
|
| Hospital Charge Code |
5246
|
| 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
|
|
|
0WHR01Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHR01Z
|
| Hospital Charge Code |
5247
|
| 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
|
|
|
0WHR31Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHR31Z
|
| Hospital Charge Code |
5248
|
| 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
|
|
|
0WHR41Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHR41Z
|
| Hospital Charge Code |
5249
|
| 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
|
|
|
0WHR71Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHR71Z
|
| Hospital Charge Code |
5250
|
| 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
|
|
|
0WHR81Z
|
Facility
|
IP
|
$9,120.00
|
|
|
Service Code
|
ICD 0WHR81Z
|
| Hospital Charge Code |
5251
|
| 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
|
|
|
0WPD00Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD00Z
|
| Hospital Charge Code |
5252
|
| 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
|
|
|
0WPD00Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD00Z
|
| Hospital Charge Code |
13957
|
| 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
|
|
|
0WPD01Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD01Z
|
| Hospital Charge Code |
13958
|
| 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
|
|
|
0WPD01Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD01Z
|
| Hospital Charge Code |
5253
|
| 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
|
|
|
0WPD03Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD03Z
|
| Hospital Charge Code |
5254
|
| 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
|
|
|
0WPD03Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD03Z
|
| Hospital Charge Code |
13959
|
| 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
|
|
|
0WPD0YZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD0YZ
|
| Hospital Charge Code |
2716
|
| 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
|
|
|
0WPD0YZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD0YZ
|
| Hospital Charge Code |
13960
|
| 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
|
|
|
0WPD30Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD30Z
|
| Hospital Charge Code |
13961
|
| 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
|
|
|
0WPD30Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD30Z
|
| Hospital Charge Code |
5255
|
| 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
|
|
|
0WPD31Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD31Z
|
| Hospital Charge Code |
13962
|
| 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
|
|
|
0WPD31Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD31Z
|
| Hospital Charge Code |
5256
|
| 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
|
|
|
0WPD33Z
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 0WPD33Z
|
| Hospital Charge Code |
13963
|
| 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
|
|
