|
02RQ0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1332
|
| 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
|
|
|
02RR07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1333
|
| 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
|
|
|
02RR0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1334
|
| 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
|
|
|
02S00ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1335
|
| 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
|
|
|
02S10ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1336
|
| 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
|
|
|
02SP0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1337
|
| 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
|
|
|
02SW0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1338
|
| 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
|
|
|
02SX0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1339
|
| 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
|
|
|
02T50ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1340
|
| 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
|
|
|
02T53ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3368
|
| 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
|
|
|
02T54ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3369
|
| 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
|
|
|
02T80ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1341
|
| 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
|
|
|
02T90ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1342
|
| 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
|
|
|
02T93ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3370
|
| 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
|
|
|
02T94ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3371
|
| 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
|
|
|
02TD0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1343
|
| 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
|
|
|
02TD3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3372
|
| 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
|
|
|
02TD4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3373
|
| 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
|
|
|
02TH0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1344
|
| 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
|
|
|
02TH3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3374
|
| 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
|
|
|
02TH4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3375
|
| 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
|
|
|
02TM0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3376
|
| 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
|
|
|
02TM3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3377
|
| 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
|
|
|
02TM4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3378
|
| 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
|
|
|
02TN0ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1345
|
| 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
|
|
