|
02R50KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3276
|
| 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
|
|
|
02R547Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3277
|
| 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
|
|
|
02R548Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3278
|
| 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
|
|
|
02R54JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3279
|
| 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
|
|
|
02R54KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3280
|
| 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
|
|
|
02R607Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3281
|
| 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
|
|
|
02R608Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3282
|
| 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
|
|
|
02R60JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3283
|
| 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
|
|
|
02R60KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3284
|
| 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
|
|
|
02R647Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3285
|
| 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
|
|
|
02R648Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3286
|
| 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
|
|
|
02R64JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3287
|
| 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
|
|
|
02R64KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3288
|
| 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
|
|
|
02R707Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3289
|
| 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
|
|
|
02R708Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3290
|
| 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
|
|
|
02R70JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3291
|
| 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
|
|
|
02R70KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3292
|
| 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
|
|
|
02R747Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3293
|
| 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
|
|
|
02R748Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3294
|
| 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
|
|
|
02R74JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3295
|
| 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
|
|
|
02R74KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3296
|
| 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
|
|
|
02R907Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3297
|
| 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
|
|
|
02R908Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3298
|
| 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
|
|
|
02R90JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1294
|
| 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
|
|
|
02R90KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3299
|
| 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
|
|
