|
02TN3ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3379
|
| 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
|
|
|
02TN4ZZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3380
|
| 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
|
|
|
02U007Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1346
|
| 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
|
|
|
02U008Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1347
|
| 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
|
|
|
02U00JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1348
|
| 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
|
|
|
02U00KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1349
|
| 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
|
|
|
02U037Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1350
|
| 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
|
|
|
02U038Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1351
|
| 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
|
|
|
02U03JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1352
|
| 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
|
|
|
02U03KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1353
|
| 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
|
|
|
02U047Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1354
|
| 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
|
|
|
02U048Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1355
|
| 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
|
|
|
02U04JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1356
|
| 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
|
|
|
02U04KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1357
|
| 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
|
|
|
02U107Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1358
|
| 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
|
|
|
02U108Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1359
|
| 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
|
|
|
02U10JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1360
|
| 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
|
|
|
02U10KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1361
|
| 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
|
|
|
02U137Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1362
|
| 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
|
|
|
02U138Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1363
|
| 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
|
|
|
02U13JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1364
|
| 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
|
|
|
02U13KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1365
|
| 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
|
|
|
02U147Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1366
|
| 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
|
|
|
02U148Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1367
|
| 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
|
|
|
02U14JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1368
|
| 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
|
|
