|
02HK43Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1153
|
| 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
|
|
|
02HK4DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1154
|
| 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
|
|
|
02HK4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1156
|
| 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
|
|
|
02HK4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1157
|
| 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
|
|
|
02HK4MZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1158
|
| 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
|
|
|
02HK4YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1160
|
| 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
|
|
|
02HL00Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1161
|
| 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
|
|
|
02HL02Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1162
|
| 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
|
|
|
02HL03Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3175
|
| 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
|
|
|
02HL0DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3176
|
| 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
|
|
|
02HL0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1165
|
| 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
|
|
|
02HL0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1164
|
| 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
|
|
|
02HL0YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1167
|
| 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
|
|
|
02HL30Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1168
|
| 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
|
|
|
02HL32Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1169
|
| 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
|
|
|
02HL33Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3177
|
| 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
|
|
|
02HL3DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3178
|
| 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
|
|
|
02HL3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1171
|
| 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
|
|
|
02HL3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1172
|
| 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
|
|
|
02HL3YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1174
|
| 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
|
|
|
02HL40Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1175
|
| 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
|
|
|
02HL42Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1176
|
| 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
|
|
|
02HL43Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3179
|
| 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
|
|
|
02HL4DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3180
|
| 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
|
|
|
02HL4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1179
|
| 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
|
|
