|
02H70DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3169
|
| 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
|
|
|
02H70KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1103
|
| 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
|
|
|
02H70KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1102
|
| 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
|
|
|
02H70YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1105
|
| 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
|
|
|
02H730Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1106
|
| 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
|
|
|
02H732Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1107
|
| 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
|
|
|
02H733Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3170
|
| 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
|
|
|
02H73DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3171
|
| 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
|
|
|
02H73KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1109
|
| 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
|
|
|
02H73KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1108
|
| 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
|
|
|
02H73YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1111
|
| 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
|
|
|
02H740Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1112
|
| 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
|
|
|
02H742Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1113
|
| 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
|
|
|
02H743Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3172
|
| 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
|
|
|
02H74DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3173
|
| 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
|
|
|
02H74KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1115
|
| 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
|
|
|
02H74KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1114
|
| 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
|
|
|
02H74YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1117
|
| 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
|
|
|
02HA0QZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1119
|
| 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
|
|
|
02HA0QZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1118
|
| 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
|
|
|
02HA0RJ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1120
|
| 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
|
|
|
02HA0RS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1121
|
| 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
|
|
|
02HA0RZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1122
|
| 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
|
|
|
02HA0RZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1123
|
| 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
|
|
|
02HA0YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1124
|
| 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
|
|
