|
02H44KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1074
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H44YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1076
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H600Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1077
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H602Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1078
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H603Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3165
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H60DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1079
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H60KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1081
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H60KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1082
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H60YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1084
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H630Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1085
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H632Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1086
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H63DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3166
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H63KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1089
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H63KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1088
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H63YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1091
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H640Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1092
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H642Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1093
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H643Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3167
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H64DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1094
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H64KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1097
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H64KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1096
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H64YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1099
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H700Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1100
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H702Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1101
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
|
02H703Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3168
|
| Min. Negotiated Rate |
$10,777.00 |
| Max. Negotiated Rate |
$10,777.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,777.00
|
|
