|
02U14KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1369
|
| 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
|
|
|
02U207Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1370
|
| 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
|
|
|
02U208Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1371
|
| 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
|
|
|
02U20JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1372
|
| 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
|
|
|
02U20KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1373
|
| 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
|
|
|
02U237Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1374
|
| 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
|
|
|
02U238Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1375
|
| 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
|
|
|
02U23JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1376
|
| 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
|
|
|
02U23KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1377
|
| 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
|
|
|
02U247Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1378
|
| 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
|
|
|
02U248Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1379
|
| 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
|
|
|
02U24JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1380
|
| 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
|
|
|
02U24KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1381
|
| 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
|
|
|
02U307Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1382
|
| 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
|
|
|
02U308Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1383
|
| 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
|
|
|
02U30JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1384
|
| 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
|
|
|
02U30KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1385
|
| 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
|
|
|
02U337Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1386
|
| 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
|
|
|
02U338Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1387
|
| 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
|
|
|
02U33JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1388
|
| 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
|
|
|
02U33KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1389
|
| 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
|
|
|
02U347Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1390
|
| 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
|
|
|
02U348Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1391
|
| 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
|
|
|
02U34JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1392
|
| 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
|
|
|
02U34KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1393
|
| 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
|
|
