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Run Date and Time Stop Loss Initial Notice Report For MISSION
06/01/2011 15:53 Paid Date Range 05/01/11 thru 05/31/11 Paid Amt > 020000
Group Name Notice Type Initial Date Update Date 50% Date Contract Type Contract From Contract Thru Emp SSN Dep Dep DOB Dep Sex Dep Ben Date Dep Term Date EE Status Open Mail Unprocessed Claims Unprocessed Total Paid In Case Mgmt Trigger 1
MISSION Update 3/2/11 6/1/11 12/15 10/1/10 9/30/11 3746 e 8/1/77 m 10/1/09 Active 0.00 0.00 419.35 4463
MISSION 50 Pct 10/31/10 6/1/11 6/1/11 12/15 10/1/10 9/30/11 3994 e 8/12/49 m 10/1/09 Active 283.00 0.00 53,750.31
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 1342 e 8/18/51 m 10/1/09 Active 0.00 0.00 544.19 4019
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 9326 e 4/17/75 m 10/1/09 Active 0.00 440.00 152.56 78843
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 0715 e 5/9/71 m 10/1/09 Active 65.00 0.00 37.98 4019
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 2049 1 5/1/00 m 10/1/09 Active 0.00 0.00 483.33 4242
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 8300 e 11/3/56 m 10/1/09 Active 0.00 0.00 572.00 2724
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 2998 e 10/31/42 m 10/1/09 Active 0.00 0.00 745.06 2382
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 3415 e 10/25/58 f 10/1/09 Active 0.00 0.00 565.81 4019
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 4992 e 9/10/81 m 10/1/09 Active 0.00 0.00 58.21 490
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 9353 e 1/23/53 m 10/1/09 Active 90.00 0.00 0.00 78060
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 8777 e 5/2/67 m 10/1/09 Active 765.00 0.00 409.76 49310
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 1694 e 5/24/63 m 10/1/09 Active 40.00 0.00 337.03 8020
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 7615 e 9/23/57 m 10/1/09 Active 369.00 2,948.00 107.91 92411
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 6444 e 11/1/77 m 10/1/09 Active 0.00 0.00 406.99 8940
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8077 e 8/13/68 m 10/1/09 Active 100.00 0.00 498.81 4439
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 9109 2 12/14/99 f 10/1/09 Active 0.00 0.00 240.07 7862
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 9109 e 12/2/59 f 10/1/09 Active 0.00 0.00 728.39 78262
MISSION Update 3/2/11 6/1/11 12/15 10/1/10 9/30/11 9109 s 11/22/56 m 10/1/09 Active 0.00 1,481.00 53.79 4019
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 1329 e 5/1/87 m 10/1/09 Active 0.00 0.00 55.00 9233
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 1454 e 9/4/72 m 10/1/09 Active 720.00 0.00 0.00 92420
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 1671 e 2/18/63 m 10/1/09 Active 0.00 275.00 823.83 42760
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 1354 e 1/11/79 m 10/1/09 Active 0.00 0.00 769.51 7840
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 8564 e 6/13/56 m 10/1/09 Active 0.00 0.00 220.21 2449
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8564 s 4/30/53 f 10/1/09 Active 177.00 0.00 369.04 2720
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 0104 e 4/13/61 f 10/1/09 Active 0.00 0.00 957.87 7862
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 4856 e 7/30/71 m 10/1/09 Active 0.00 0.00 152.24 78906
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 8354 e 6/8/70 m 10/1/09 Active 150.00 0.00 70.33 2724
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 1256 e 9/12/63 m 10/1/09 Active 0.00 0.00 352.24 2720
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 6376 s 5/25/58 f 10/1/09 Active 0.00 98.00 513.48 78900
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 3630 e 7/15/65 m 10/1/09 Active 0.00 0.00 306.13 27651
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 2462 e 11/14/58 m 10/1/09 Active 0.00 0.00 181.33 2449
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 4048 1 11/4/98 f 10/1/09 Active 0.00 0.00 389.29 78060
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 2440 e 2/16/78 f 10/1/09 Active 0.00 0.00 2,858.39 65613
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 4826 e 6/19/68 m 10/1/09 Active 0.00 0.00 1,319.21 78060
MISSION Update 3/2/11 6/1/11 12/15 10/1/10 9/30/11 9310 1 2/20/94 m 10/1/09 Active 0.00 0.00 50.65 7821
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 4592 e 7/14/77 f 10/1/09 Active 440.00 370.00 1,671.12 7840
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 1134 e 10/30/74 m 10/1/09 Active 0.00 0.00 311.75 490
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 2976 1 4/29/04 m 10/1/09 Active 0.00 0.00 44.37 4660
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 5236 e 9/11/66 m 10/1/09 Active 0.00 0.00 453.95 4019
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 9988 e 11/7/55 f 10/1/09 Active 491.00 0.00 3,479.04 7833
MISSION Update 3/2/11 6/1/11 12/15 10/1/10 9/30/11 7572 e 6/27/63 m 10/1/09 Active 0.00 0.00 12,963.92 4019
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 8040 e 9/27/49 m 10/1/09 Active 3,401.00 596.00 5,164.52 2720
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 0059 e 10/27/58 m 10/1/09 Active 0.00 0.00 350.25 43885
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8820 e 1/5/58 f 10/1/09 Active 0.00 1,580.00 5,245.05 3574
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 5823 e 1/12/75 m 10/1/09 Active 0.00 0.00 1,801.55 78906
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 2166 s 12/20/77 f 10/1/09 Active 155.00 1,100.00 9,122.79 64891
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 1638 e 8/13/66 m 10/1/09 Active 0.00 0.00 6,770.23 4660
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 9265 e 10/19/60 m 10/1/09 Active 0.00 0.00 4,166.04 25000
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 9391 e 9/25/72 f 10/1/09 Active 450.00 0.00 0.00 9182
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 4306 1 3/30/10 f 3/30/10 Active 0.00 0.00 2,027.80 7862
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 2883 e 11/21/70 m 10/1/09 Active 0.00 0.00 235.80 78079
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 0968 1 12/30/98 f 10/1/09 Active 252.00 0.00 270.47 9597
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 4608 1 12/30/88 m 10/1/09 9/30/11 Active 0.00 0.00 241.53 78842
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 4608 e 6/1/64 f 10/1/09 Active 0.00 0.00 11,183.75 78903
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 8337 e 2/24/78 m 10/1/09 Active 0.00 0.00 4,113.40 20151
ecc8a107-8259-4cec-98f9-124d813f5f58.xlsx Page 1 of 4
Run Date and Time Stop Loss Initial Notice Report For MISSION
06/01/2011 15:53 Paid Date Range 05/01/11 thru 05/31/11 Paid Amt > 020000
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 2986 s 2/24/82 f 10/1/09 Active 1,100.00 82.00 21,944.21 42761
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 3955 s 9/20/63 f 10/1/09 Active 0.00 0.00 991.08 7804
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 2373 e 5/21/75 m 10/1/09 Active 0.00 0.00 205.00 27801
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 9774 e 7/2/56 f 10/1/09 Active 0.00 0.00 957.74 4019
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 5451 e 10/13/60 m 10/1/09 Active 0.00 0.00 1,382.87 4011
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 5451 s 8/7/60 f 10/1/09 Active 11,596.00 0.00 11,227.28 Y 7856
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 8935 e 8/5/79 m 10/1/09 Active 0.00 173.55 4,981.71 7820
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 9385 e 6/7/47 m 10/1/09 1/21/12 COC 0.00 0.00 239.32 V4581
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 2130 1 4/12/09 m 10/1/09 Active 0.00 0.00 792.30 49302
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 0757 e 6/9/70 m 10/1/09 Active 0.00 0.00 127.48 2724
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8954 e 6/21/58 m 10/1/09 Active 0.00 824.00 1,112.45 78650
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 1667 e 8/27/50 m 10/1/09 Active 0.00 0.00 106.71 25000
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 7782 2 9/2/91 f 10/1/09 9/30/11 Active 0.00 0.00 538.93 78321
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 7782 e 12/15/63 m 10/1/09 Active 0.00 2,136.00 500.11 71516
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 7782 s 4/8/69 f 10/1/09 Active 0.00 0.00 829.01 24290
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 4175 e 7/25/74 f 10/1/09 Active 701.06 0.00 1,341.78 7851
MISSION 50 Pct 12/2/10 6/1/11 6/1/11 12/15 10/1/10 9/30/11 9190 e 12/19/59 m 10/1/09 Active 1,590.00 16,956.75 111,596.64 Amt
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 9190 s 8/8/63 f 10/1/09 Active 0.00 0.00 5,482.23 78701
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 4313 s 4/4/63 f 10/1/09 Active 0.00 0.00 377.97 7851
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 0372 e 2/18/47 m 10/1/09 Active 0.00 1,000.00 59.36 7823
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8831 e 12/11/53 m 10/1/09 Active 0.00 0.00 57.14 41401
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 2275 2 9/15/99 m 10/1/09 Active 0.00 2,116.70 55.00 8500
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 3194 e 5/6/78 m 10/1/09 Active 0.00 0.00 477.62 27801
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 7460 e 7/25/58 f 10/1/09 Active 0.00 0.00 1,706.86 7948
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 9167 3 1/11/10 f 1/11/10 Active 0.00 0.00 7,959.51 5738
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 0666 e 4/24/72 m 10/1/09 Active 303.00 0.00 898.79 78064
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 1999 e 2/27/73 f 10/1/09 4/18/11 Inactive 0.00 0.00 207.20 63310
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 1413 s 6/13/55 f 10/1/09 Active 244.00 976.00 162.24 7866
MISSION Update 3/2/11 6/1/11 12/15 10/1/10 9/30/11 0311 e 5/26/55 f 10/1/09 Active 0.00 0.00 441.66 27400
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 4907 e 2/25/70 m 10/1/09 Active 1,940.00 15,099.79 5,519.09 2662
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 5195 e 10/26/70 m 10/1/09 Active 0.00 0.00 699.91 2768
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 0766 s 2/28/76 f 10/1/09 Active 433.00 0.00 9,197.37 7856
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 6825 e 8/9/70 m 10/1/09 Active 0.00 0.00 157.84 27651
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 8028 s 6/5/55 f 10/1/09 Active 339.02 0.00 6,873.85 25002
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 1633 3 2/17/00 m 10/1/09 Active 0.00 0.00 309.33 7830
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 1633 4 3/25/98 m 10/1/09 Active 0.00 0.00 160.31 7831
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 1633 e 4/13/82 f 10/1/09 Active 0.00 0.00 195.14 81602
MISSION 50 Pct 10/31/10 12/2/10 12/31/10 12/15 10/1/10 9/30/11 7746 e 10/7/75 m 10/1/09 12/31/10 Inactive 0.00 0.00 222,398.88
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 3519 e 6/3/74 m 10/1/09 Active 0.00 0.00 289.88 4011
MISSION Update 2/1/11 6/1/11 12/15 10/1/10 9/30/11 0540 2 11/20/99 m 10/1/09 Active 0.00 0.00 277.39 49392
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 4797 e 12/27/56 m 10/1/09 Active 0.00 0.00 241.79 7948
MISSION Update 4/1/11 6/1/11 12/15 10/1/10 9/30/11 2906 e 10/1/81 f 10/1/09 Active 865.16 2,400.80 0.00 E8150
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 7364 e 11/10/66 m 12/1/09 Active 0.00 0.00 391.54 2729
MISSION Update 12/2/10 6/1/11 12/15 10/1/10 9/30/11 2492 e 8/31/73 f 2/1/10 Active 0.00 0.00 569.10 79380
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 4761 e 9/1/70 m 10/1/09 Active 464.15 0.00 0.00 931
MISSION Update 10/31/10 6/1/11 12/15 10/1/10 9/30/11 1142 s 9/15/57 f 5/1/10 Active 935.00 0.00 3,287.87 2724
MISSION Update 4/30/11 6/1/11 12/15 10/1/10 9/30/11 6983 e 4/11/86 f 6/1/10 5/24/11 Inactive 4,325.61 18,300.71 3,889.72 30000
MISSION Update 12/31/10 6/1/11 12/15 10/1/10 9/30/11 9967 e 8/25/84 m 11/1/10 Active 0.00 1,591.40 132.42 E8120
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 3599 e 1/19/68 m 2/1/11 Active 0.00 0.00 50.65 78057
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 3599 s 5/18/69 f 2/1/11 Active 66.00 4,195.00 0.00 2720
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 2288 e 8/14/76 m 2/1/11 Active 0.00 0.00 177.76 7871
MISSION Initial 6/1/11 12/15 10/1/10 9/30/11 0013 e 7/11/75 m 4/1/11 Active 0.00 883.55 0.00 78079
ecc8a107-8259-4cec-98f9-124d813f5f58.xlsx Page 2 of 4
Run Date and Time Stop Loss Initial Notice Report For MISSION
06/01/2011 15:53 Paid Date Range 05/01/11 thru 05/31/11 Paid Amt > 020000
Trigger 1 Description Trigger 2 Trigger 2 Description Trigger 3 Trigger 3 Description Trigger 4 Trigger 4 Description Trigger 5 Trigger 5 Description
LETHAL MIDLINE GRANULOMA
HYPERTENSION NOS 591 HYDRONEPHROSIS 5921 URETERAL CALCULUS 78909 ABDOMINAL PAIN-SITE NEC
NOCTURIA 78841 URINARY FREQUENCY 78899 OTHER SYMPTOMS INVOLVING 2572 TESTICULAR HYPOFUNCT NEC 79093 ELEVATED PSA
HYPERTENSION NOS 5819 NEPHROTIC SYNDROME NOS
NONRHEUM TRICUSP DISORD 7852 CARDIAC MURMURS NEC
HYPERLIPIDEMIA NEC & NOS 4019 HYPERTENSION NOS 79029 ABNORMAL GLUCOSE NEC
SKIN UNC BEHAV NEOPL
HYPERTENSION NOS
BRONCHITIS NOS 78060 FEVER, UNSPECIFIED
FEVER, UNSPECIFIED
INTRINSIC ASTHMA NOS
CLOSED NASAL BONE FX
CONTUSION OF KNEE 2724 HYPERLIPIDEMIA NEC & NOS
OPEN WND LEG NEC
PERIPH VASCULAR DIS NOS 7823 EDEMA 2506 DIAB W NEUROLOGIC MANIF*
COUGH
FLUSHING 78650 CHEST PAIN NOS 30002 GENERAL ANXIETY DISORD
HYPERTENSION NOS
CONTUSION OF FINGER
CONTUSION OF FOOT
PREMATURE BEATS NOS
HEADACHE
HYPOTHYROIDISM NOS 2724 HYPERLIPIDEMIA NEC & NOS 79093 ELEVATED PSA
PURE HYPERCHOLESTEROLEM 4011 BENIGN HYPERTENSION 2449 HYPOTHYROIDISM NOS
COUGH
EPIGASTRIC ABD PAIN
HYPERLIPIDEMIA NEC & NOS
PURE HYPERCHOLESTEROLEM 5198 RESP SYSTEM DISEASE NEC
ABDOMINAL PAIN-SITE NOS
DEHYDRATION 5589 NONINF GASTROENT NEC&NOS
HYPOTHYROIDISM NOS 71500 GENERAL OA-SITE NOS
FEVER, UNSPECIFIED 81601 CL FX MID/PROX PHAL HAND
RH ISOIMMUNIZATION-AP
FEVER, UNSPECIFIED
NONSP SKIN ERUPTION NEC
HEADACHE
BRONCHITIS NOS
ACUTE BRONCHITIS
HYPERTENSION NOS
FEEDING PROBLEM
HYPERTENSION NOS 78079 MALAISE & FATIGUE NEC
PURE HYPERCHOLESTEROLEM 2724 HYPERLIPIDEMIA NEC & NOS 1960 2ND/NOS HEAD/NECK LN CA 2281 LYMPHANGIOMA ANY SITE 2440 POSTSURG HYPOTHYROIDISM
LATE EFFECT CVD-VERTIGO 2722 MIXED HYPERLIPIDEMIA
NEUROPATHY IN OTHER DIS
EPIGASTRIC ABD PAIN 7871 HEARTBURN
OTH CCE COMP PREG-DEL 66041 SHOULDER DYSTOCIA-DEL 66321 CORD COMPRESS NEC-DEL 66421 DEL W 3 DEGREE LAC-DEL 7852 CARDIAC MURMURS NEC
ACUTE BRONCHITIS 25002 DM2/NOS UNCOMP UNC 78449 VOICE DISTURBANCE NEC
DM2/NOS UNCOMP NSU 2724 HYPERLIPIDEMIA NEC & NOS
SUPERF INJ CONJUNCTIVA 9301 FB IN CONJUNCTIVAL SAC
COUGH
MALAISE & FATIGUE NEC
LOWER LEG INJURY NEC
POLYURIA
RLQ ABDOMINAL PAIN
NOD SCLEROSIS HEAD LN
ecc8a107-8259-4cec-98f9-124d813f5f58.xlsx Page 3 of 4
Run Date and Time Stop Loss Initial Notice Report For MISSION
06/01/2011 15:53 Paid Date Range 05/01/11 thru 05/31/11 Paid Amt > 020000
ATRIAL PREMATURE BEATS 42760 PREMATURE BEATS NOS
DIZZINESS & GIDDINESS
MORBID OBESITY 79029 ABNORMAL GLUCOSE NEC 78650 CHEST PAIN NOS 2722 MIXED HYPERLIPIDEMIA 4019 HYPERTENSION NOS
HYPERTENSION NOS 4011 BENIGN HYPERTENSION
BENIGN HYPERTENSION 51889 OTHER LUNG DISEASE NEC 78605 SHORTNESS OF BREATH
ENLARGEMENT LYMPH NODES
SKIN SENSATION DISTURB
AORTOCORONARY BYPASS V5873 SURG AFTERCARE-CIRC SYST
EXTR ASTHMA W EXACER
HYPERLIPIDEMIA NEC & NOS 2777 DYSMETABOLIC SYNDROME X 27800 OBESITY NOS
CHEST PAIN NOS 7220 CERV DISC DISPLACEMENT 7804 DIZZINESS & GIDDINESS
DM2/NOS UNCOMP NSU 27800 OBESITY NOS 41400 COR AS-GRAFT TYPE NOS
LOSS OF WEIGHT 30751 BULIMIA NERVOSA
LOC PRIMARY OA-LOWER LEG 7829 INTEGUMENT TISS SX NEC
THYROTOX NOS W/O CRISIS 27800 OBESITY NOS
PALPITATIONS 7820 SKIN SENSATION DISTURB 30000 ANXIETY STATE NOS 7804 DIZZINESS & GIDDINESS 2689 VITAMIN D DEFICIENCY NOS
78,605.47 30000 ANXIETY STATE NOS 7993 DEBILITY NOS
NAUSEA W VOMITING 78703 VOMITING ALONE
PALPITATIONS
EDEMA
COR AS-NATIVE VESSEL
CONCUSSION W/O LOC 85141 CEREBEL CONTUSION S LOC 95901 HEAD INJURY NOS
MORBID OBESITY
ABN LIVER FUNCTION STUDY
LIVER DISORDERS NEC 78900 ABDOMINAL PAIN-SITE NOS 78907 GENERALIZED ABD PAIN
CHILLS (WITHOUT FEVER)
TUBAL PREG W/O IU PREG
CHEST SWELLING/MASS/LUMP
GOUTY ANTHROPATHY, UNSPEC 7820 SKIN SENSATION DISTURB
B-COMPLEX DEF NEC 2724 HYPERLIPIDEMIA NEC & NOS 78659 CHEST PAIN NEC 41401 COR AS-NATIVE VESSEL 78900 ABDOMINAL PAIN-SITE NOS
HYPOPOTASSEMIA 5849 ACUTE RENAL FAILURE NOS 2551 HYPERALDOSTERONISM
ENLARGEMENT LYMPH NODES 78605 SHORTNESS OF BREATH 79431 NONSPECIFIC ABN EKG/ECG 7881 DYSURIA 78842 POLYURIA
DEHYDRATION
DM2/NOS UNCOMP UNC 7840 HEADACHE
ANOREXIA
ABNORMAL WEIGHT GAIN 9595 FINGER INJURY NEC & NOS
CL FX DIST PHALANX HAND
BENIGN HYPERTENSION 5831 MEMBRANOUS NEPHRITIS NOS
ASTHMA NOS W EXACER 78340 LACK NORMAL DEVEL NOS
ABN LIVER FUNCTION STUDY 78079 MALAISE & FATIGUE NEC 7804 DIZZINESS & GIDDINESS
HIGHWAY MV COLL-DRIVER
LIPOID METAB DISORD NOS 78079 MALAISE & FATIGUE NEC 78605 SHORTNESS OF BREATH
ABNORMAL MAMMOGRAM NOS
FB IN EAR
HYPERLIPIDEMIA NEC & NOS 78659 CHEST PAIN NEC 7804 DIZZINESS & GIDDINESS
ANXIETY STATE NOS
MV COLLISION NEC-DRIVER 920 CONTUSION HEAD X EYE
SLEEP APNEA NOS
PURE HYPERCHOLESTEROLEM 2724 HYPERLIPIDEMIA NEC & NOS 920 CONTUSION HEAD X EYE 95901 HEAD INJURY NOS 8505 CONCUSSION W COMA NOS
HEARTBURN 7862 COUGH
MALAISE & FATIGUE NEC 7840 HEADACHE
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