|
02UL47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3492
|
| 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
|
|
|
02UL48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3493
|
| 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
|
|
|
02UL4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3494
|
| 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
|
|
|
02UL4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1458
|
| 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
|
|
|
02UM07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3495
|
| 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
|
|
|
02UM08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1459
|
| 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
|
|
|
02UM0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1460
|
| 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
|
|
|
02UM0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1461
|
| 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
|
|
|
02UM37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3496
|
| 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
|
|
|
02UM38Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3497
|
| 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
|
|
|
02UM3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1462
|
| 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
|
|
|
02UM3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1463
|
| 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
|
|
|
02UM47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3498
|
| 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
|
|
|
02UM48Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3499
|
| 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
|
|
|
02UM4JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1464
|
| 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
|
|
|
02UM4KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1465
|
| 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
|
|
|
02UN07Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3500
|
| 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
|
|
|
02UN08Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3501
|
| 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
|
|
|
02UN0JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
1466
|
| 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
|
|
|
02UN0KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3502
|
| 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
|
|
|
02UN37Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3503
|
| 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
|
|
|
02UN38Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3504
|
| 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
|
|
|
02UN3JZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3505
|
| 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
|
|
|
02UN3KZ
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3506
|
| 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
|
|
|
02UN47Z
|
Facility
|
IP
|
$10,777.00
|
|
| Hospital Charge Code |
3507
|
| 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
|
|
