|
02N83ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N83ZZ
|
| Hospital Charge Code |
10915
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N84ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N84ZZ
|
| Hospital Charge Code |
10916
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N84ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N84ZZ
|
| Hospital Charge Code |
3191
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N90ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N90ZZ
|
| Hospital Charge Code |
10917
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N90ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N90ZZ
|
| Hospital Charge Code |
1237
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N93ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N93ZZ
|
| Hospital Charge Code |
3192
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N93ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N93ZZ
|
| Hospital Charge Code |
10918
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N94ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N94ZZ
|
| Hospital Charge Code |
3193
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02N94ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02N94ZZ
|
| Hospital Charge Code |
10919
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| Hospital Charge Code |
1238
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND0ZZ
|
| Hospital Charge Code |
10920
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND3ZZ
|
| Hospital Charge Code |
10921
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND3ZZ
|
| Hospital Charge Code |
3194
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND4ZZ
|
| Hospital Charge Code |
10922
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02ND4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02ND4ZZ
|
| Hospital Charge Code |
3195
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NF0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NF0ZZ
|
| Hospital Charge Code |
10923
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NF0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NF0ZZ
|
| Hospital Charge Code |
1239
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NG0ZZ
|
| Hospital Charge Code |
10924
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NG0ZZ
|
| Hospital Charge Code |
1240
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NH0ZZ
|
| Hospital Charge Code |
1241
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NH0ZZ
|
| Hospital Charge Code |
10925
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NJ0ZZ
|
| Hospital Charge Code |
10926
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NJ0ZZ
|
| Hospital Charge Code |
1242
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NK0ZZ
|
| Hospital Charge Code |
1243
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02NK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02NK0ZZ
|
| Hospital Charge Code |
10927
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|