|
02QC0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC0ZZ
|
| Hospital Charge Code |
11020
|
| 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
|
|
|
02QC0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC0ZZ
|
| Hospital Charge Code |
1275
|
| 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
|
|
|
02QC3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC3ZZ
|
| Hospital Charge Code |
3253
|
| 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
|
|
|
02QC3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC3ZZ
|
| Hospital Charge Code |
11021
|
| 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
|
|
|
02QC4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC4ZZ
|
| Hospital Charge Code |
11022
|
| 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
|
|
|
02QC4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QC4ZZ
|
| Hospital Charge Code |
3254
|
| 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
|
|
|
02QD0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD0ZZ
|
| Hospital Charge Code |
1276
|
| 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
|
|
|
02QD0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD0ZZ
|
| Hospital Charge Code |
11023
|
| 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
|
|
|
02QD3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD3ZZ
|
| Hospital Charge Code |
3255
|
| 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
|
|
|
02QD3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD3ZZ
|
| Hospital Charge Code |
11024
|
| 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
|
|
|
02QD4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD4ZZ
|
| Hospital Charge Code |
3256
|
| 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
|
|
|
02QD4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QD4ZZ
|
| Hospital Charge Code |
11025
|
| 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
|
|
|
02QF0ZJ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF0ZJ
|
| Hospital Charge Code |
1277
|
| 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
|
|
|
02QF0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF0ZZ
|
| Hospital Charge Code |
1278
|
| 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
|
|
|
02QF0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF0ZZ
|
| Hospital Charge Code |
11026
|
| 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
|
|
|
02QF3ZJ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF3ZJ
|
| Hospital Charge Code |
1279
|
| 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
|
|
|
02QF3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF3ZZ
|
| Hospital Charge Code |
3257
|
| 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
|
|
|
02QF3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF3ZZ
|
| Hospital Charge Code |
11027
|
| 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
|
|
|
02QF4ZJ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF4ZJ
|
| Hospital Charge Code |
1280
|
| 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
|
|
|
02QF4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF4ZZ
|
| Hospital Charge Code |
3258
|
| 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
|
|
|
02QF4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QF4ZZ
|
| Hospital Charge Code |
11028
|
| 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
|
|
|
02QG0ZE
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG0ZE
|
| Hospital Charge Code |
1281
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG0ZZ
|
| Hospital Charge Code |
11029
|
| 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
|
|
|
02QG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG0ZZ
|
| Hospital Charge Code |
1282
|
| 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
|
|
|
02QG3ZE
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02QG3ZE
|
| Hospital Charge Code |
1283
|
| 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
|
|