|
02Q94ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3250
|
| 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
|
|
|
02QA0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1268
|
| 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
|
|
|
02QA0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1269
|
| 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
|
|
|
02QA3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1272
|
| 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
|
|
|
02QA4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1273
|
| 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
|
|
|
02QB0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1274
|
| 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
|
|
|
02QB3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3251
|
| 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
|
|
|
02QB4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3252
|
| 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
|
|
|
02QC0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1275
|
| 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
|
|
|
02QC3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3253
|
| 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
|
|
|
02QC4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3254
|
| 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
|
|
|
02QD0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1276
|
| 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
|
|
|
02QD3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3255
|
| 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
|
|
|
02QD4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3256
|
| 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
|
|
|
02QF0ZJ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1277
|
| 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
|
|
|
02QF0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1278
|
| 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
|
|
|
02QF3ZJ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1279
|
| 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
|
|
|
02QF3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3257
|
| 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
|
|
|
02QF4ZJ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1280
|
| 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
|
|
|
02QF4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3258
|
| 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
|
|
|
02QG0ZE
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1281
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1282
|
| 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
|
|
|
02QG3ZE
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1283
|
| 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
|
|
|
02QG3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3259
|
| 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
|
|
|
02QG4ZE
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1284
|
| 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
|
|
