|
02U507Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3381
|
| 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
|
|
|
02U508Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3382
|
| 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
|
|
|
02U50JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1394
|
| 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
|
|
|
02U50KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1395
|
| 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
|
|
|
02U537Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3383
|
| 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
|
|
|
02U538Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3384
|
| 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
|
|
|
02U53JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1396
|
| 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
|
|
|
02U53KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1397
|
| 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
|
|
|
02U547Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3385
|
| 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
|
|
|
02U548Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3386
|
| 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
|
|
|
02U54JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1398
|
| 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
|
|
|
02U54KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1399
|
| 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
|
|
|
02U607Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3387
|
| 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
|
|
|
02U608Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3388
|
| 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
|
|
|
02U60JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1400
|
| 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
|
|
|
02U60KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1401
|
| 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
|
|
|
02U637Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3389
|
| 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
|
|
|
02U638Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3390
|
| 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
|
|
|
02U63JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1402
|
| 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
|
|
|
02U63KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3391
|
| 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
|
|
|
02U647Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3392
|
| 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
|
|
|
02U648Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3393
|
| 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
|
|
|
02U64JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3394
|
| 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
|
|
|
02U64KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3395
|
| 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
|
|
|
02U707Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3396
|
| 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
|
|
