|
02UA37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3415
|
| 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
|
|
|
02UA38Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3416
|
| 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
|
|
|
02UA3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1410
|
| 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
|
|
|
02UA3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1411
|
| 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
|
|
|
02UA47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3417
|
| 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
|
|
|
02UA48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3418
|
| 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
|
|
|
02UA4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1412
|
| 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
|
|
|
02UA4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1413
|
| 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
|
|
|
02UD07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3419
|
| 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
|
|
|
02UD08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3420
|
| 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
|
|
|
02UD0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1414
|
| 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
|
|
|
02UD0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3421
|
| 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
|
|
|
02UD37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3422
|
| 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
|
|
|
02UD38Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3423
|
| 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
|
|
|
02UD3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3424
|
| 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
|
|
|
02UD3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3425
|
| 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
|
|
|
02UD47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3426
|
| 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
|
|
|
02UD48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3427
|
| 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
|
|
|
02UD4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3428
|
| 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
|
|
|
02UD4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3429
|
| 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
|
|
|
02UF07J
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1415
|
| 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
|
|
|
02UF07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3430
|
| 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
|
|
|
02UF08J
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1416
|
| 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
|
|
|
02UF08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3431
|
| 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
|
|
|
02UF0JJ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1417
|
| 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
|
|
