|
021K0AQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0AQ
|
| Hospital Charge Code |
416
|
| 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
|
|
|
021K0AR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0AR
|
| Hospital Charge Code |
417
|
| 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
|
|
|
021K0AR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0AR
|
| Hospital Charge Code |
10334
|
| 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
|
|
|
021K0JP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JP
|
| Hospital Charge Code |
418
|
| 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
|
|
|
021K0JP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JP
|
| Hospital Charge Code |
10335
|
| 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
|
|
|
021K0JQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JQ
|
| Hospital Charge Code |
419
|
| 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
|
|
|
021K0JQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JQ
|
| Hospital Charge Code |
10336
|
| 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
|
|
|
021K0JR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JR
|
| Hospital Charge Code |
10337
|
| 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
|
|
|
021K0JR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0JR
|
| Hospital Charge Code |
420
|
| 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
|
|
|
021K0KP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KP
|
| Hospital Charge Code |
10338
|
| 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
|
|
|
021K0KP
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KP
|
| Hospital Charge Code |
421
|
| 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
|
|
|
021K0KQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KQ
|
| Hospital Charge Code |
10339
|
| 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
|
|
|
021K0KQ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KQ
|
| Hospital Charge Code |
422
|
| 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
|
|
|
021K0KR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KR
|
| Hospital Charge Code |
10340
|
| 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
|
|
|
021K0KR
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0KR
|
| Hospital Charge Code |
423
|
| 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
|
|
|
021K0Z5
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z5
|
| Hospital Charge Code |
424
|
| 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
|
|
|
021K0Z5
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z5
|
| Hospital Charge Code |
10341
|
| 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
|
|
|
021K0Z8
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z8
|
| Hospital Charge Code |
10342
|
| 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
|
|
|
021K0Z8
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z8
|
| Hospital Charge Code |
425
|
| 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
|
|
|
021K0Z9
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z9
|
| Hospital Charge Code |
2913
|
| 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
|
|
|
021K0Z9
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0Z9
|
| Hospital Charge Code |
10343
|
| 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
|
|
|
021K0ZC
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0ZC
|
| Hospital Charge Code |
426
|
| 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
|
|
|
021K0ZC
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0ZC
|
| Hospital Charge Code |
10344
|
| 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
|
|
|
021K0ZF
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0ZF
|
| Hospital Charge Code |
10345
|
| 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
|
|
|
021K0ZF
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 021K0ZF
|
| Hospital Charge Code |
2914
|
| 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
|
|