|
02NK0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1243
|
| 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
|
|
|
02NK3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3196
|
| 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
|
|
|
02NK4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3197
|
| 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
|
|
|
02NL0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3198
|
| 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
|
|
|
02NL3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3199
|
| 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
|
|
|
02NL4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3200
|
| 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
|
|
|
02NM0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1244
|
| 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
|
|
|
02NM3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3201
|
| 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
|
|
|
02NM4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3202
|
| 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
|
|
|
02NN0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1245
|
| 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
|
|
|
02NN3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3203
|
| 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
|
|
|
02NN4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3204
|
| 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
|
|
|
02PA02Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1246
|
| 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
|
|
|
02PA03Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3205
|
| 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
|
|
|
02PA07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3206
|
| 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
|
|
|
02PA08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3207
|
| 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
|
|
|
02PA0CZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1247
|
| 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
|
|
|
02PA0DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3208
|
| 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
|
|
|
02PA0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3209
|
| 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
|
|
|
02PA0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3210
|
| 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
|
|
|
02PA0QZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1249
|
| 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
|
|
|
02PA0RS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1250
|
| 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
|
|
|
02PA0RZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1251
|
| 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
|
|
|
02PA0YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1252
|
| 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
|
|
|
02PA32Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1253
|
| 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
|
|
