|
02PA33Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3211
|
| 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
|
|
|
02PA37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3212
|
| 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
|
|
|
02PA38Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3213
|
| 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
|
|
|
02PA3CZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3214
|
| 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
|
|
|
02PA3DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3215
|
| 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
|
|
|
02PA3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3216
|
| 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
|
|
|
02PA3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3217
|
| 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
|
|
|
02PA3QZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1255
|
| 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
|
|
|
02PA3RZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1256
|
| 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
|
|
|
02PA42Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1257
|
| 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
|
|
|
02PA43Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3218
|
| 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
|
|
|
02PA47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3219
|
| 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
|
|
|
02PA48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3220
|
| 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
|
|
|
02PA4CZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3221
|
| 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
|
|
|
02PA4DZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3222
|
| 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
|
|
|
02PA4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3223
|
| 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
|
|
|
02PA4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3224
|
| 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
|
|
|
02PA4QZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1259
|
| 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
|
|
|
02PA4RS
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1260
|
| 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
|
|
|
02PA4RZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1261
|
| 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
|
|
|
02PA4YZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1262
|
| 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
|
|
|
02Q00ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1264
|
| 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
|
|
|
02Q03ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3225
|
| 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
|
|
|
02Q04ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3226
|
| 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
|
|
|
02Q10ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3227
|
| 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
|
|
