|
02Q13ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3228
|
| 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
|
|
|
02Q14ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3229
|
| 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
|
|
|
02Q20ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3230
|
| 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
|
|
|
02Q23ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3231
|
| 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
|
|
|
02Q24ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3232
|
| 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
|
|
|
02Q30ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3233
|
| 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
|
|
|
02Q33ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3234
|
| 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
|
|
|
02Q34ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3235
|
| 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
|
|
|
02Q40ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3236
|
| 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
|
|
|
02Q43ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3237
|
| 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
|
|
|
02Q44ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3238
|
| 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
|
|
|
02Q50ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1265
|
| 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
|
|
|
02Q53ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3239
|
| 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
|
|
|
02Q54ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3240
|
| 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
|
|
|
02Q60ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1266
|
| 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
|
|
|
02Q63ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3241
|
| 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
|
|
|
02Q64ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3242
|
| 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
|
|
|
02Q70ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3243
|
| 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
|
|
|
02Q73ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3244
|
| 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
|
|
|
02Q74ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3245
|
| 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
|
|
|
02Q80ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3246
|
| 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
|
|
|
02Q83ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3247
|
| 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
|
|
|
02Q84ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3248
|
| 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
|
|
|
02Q90ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1267
|
| 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
|
|
|
02Q93ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3249
|
| 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
|
|
