|
02R947Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3300
|
| 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
|
|
|
02R948Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3301
|
| 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
|
|
|
02R94JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3302
|
| 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
|
|
|
02R94KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3303
|
| 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
|
|
|
02RD07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3304
|
| 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
|
|
|
02RD08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3305
|
| 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
|
|
|
02RD0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3306
|
| 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
|
|
|
02RD0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3307
|
| 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
|
|
|
02RD47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3308
|
| 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
|
|
|
02RD48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3309
|
| 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
|
|
|
02RD4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3310
|
| 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
|
|
|
02RD4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3311
|
| 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
|
|
|
02RF07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3312
|
| 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
|
|
|
02RF08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3313
|
| 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
|
|
|
02RF0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1295
|
| 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
|
|
|
02RF0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3314
|
| 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
|
|
|
02RF37H
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3315
|
| 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
|
|
|
02RF37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3316
|
| 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
|
|
|
02RF38H
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3317
|
| 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
|
|
|
02RF38Z
|
Facility
|
IP
|
$36,591.00
|
|
| Hospital Charge Code |
1296
|
| Min. Negotiated Rate |
$36,591.00 |
| Max. Negotiated Rate |
$36,591.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,591.00
|
|
|
02RF3JH
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1297
|
| 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
|
|
|
02RF3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3318
|
| 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
|
|
|
02RF3KH
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3319
|
| 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
|
|
|
02RF3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3320
|
| 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
|
|
|
02RF47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3321
|
| 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
|
|
